신속면역크로마토그래픽법을 이용한 결핵균 검사결과 위음성을 보인 Mycobacterium tuberculosis 에서 관찰된 mpt64 유전자의 63 bp 결손 1예
A Case of a 63-bp Deletion in the mpt64 Gene of Mycobacterium tuberculosis Strains Which Showed False Negativity in the Immunochromatographic Assay
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초록
면역크로마토그래픽법(immunochromatographic assay, ICA)을 사용하여 Mycobacterium tuberculosis complex (MTBC)를 non-tuberculous mycobacteria (NTM)와 감별한다. 이 방법은 MTBC에서 분비되는 주요한 단백질인 MPT64에 대한 monoclonal antibody의 반응에 기초를 두고 있다. 최근 원자력병원에서 SD TB-negative Mycobacterium tuberculosis strains를 발견하였고 mpt64 유전자의 sequence analysis를 시행한 결과 뉴클레오티드 196에서 258까지의 63 bp 결손을 발견하였다. MPT64 음성인 mycobacterium이 발견된 경우에는 정확한 진단을 위해서 TB PCR을 시행할 필요가 있다.
Abstract
Mycobacterium tuberculosis complex (MTBC) is discriminated from non-tuberculous mycobacteria (NTM) via an immunochromatographic assay (ICA) which is based on the reactions of monoclonal antibodies against MPT64, one of the predominant proteins excreted by MTBC. Recently, the authors of the present study discovered SD TB-negative Mycobacterium tuberculosis strains. In addition, sequence analysis of the mpt64 genes in these strains was performed and showed a deletion of 63 bp from nucleotides 196 to 258. In cases of MPT64-negative mycobacterium, the authors recommend performing TB PCR for correct diagnosis.
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