摘要
目的比较噬菌体生物扩增法(PhaB)及分枝杆菌快速侦测系统(BacT—ALERT)测定结核杆菌(MTB)药物敏感度结果,研究其临床应用价值。方法应用PhaB、BacT-AIERT检测200株MTB对异烟肼(INH)、链霉素(SM)、乙胺丁醇(EMB)和利福平(RFP)的耐药性,并以传统的耐药性测定方法作为金标准,评价其敏感度、特异度和准确度。结果以绝对浓度法结果为判断标准:PhaB检测INH的敏感度、特异度和准确度分别为95.2%、88.3%和89.0%,检测SM的敏感度、特异度和准确度分别为95.1%、97.5%和98.0%.检测EMB的敏感度、特异度和准确度分别为100.0%、94.4%和94.5%,检测RFP的敏感度、特异度和准确度分别为95.7%、97.4%和97.0%;BacT- ALERT检测INH的敏感度、特异度和准确度分别为100.0%、97.2%和97.5%,检测SM的敏感度、特异度和准确度分别为92.7%、94.3%和94.0%,检测EMB的敏感度、特异度和准确度分别为100.0%、99.4%和99.5%。检测RFP敏感度、特异度和准确度分别为87.0%、93.5%和92.5%。以比例法结果为判断标准:PhaB检测INH的敏感度、特异度和准确度分别为58.3%、99.4%和94.5%,检测SM的敏感度、特异度和准确度分别为88.1%、96.8%和95.0%,检测EMB的敏感度、特异度和准确度分别为100.0%、94.4%和94.5%,检测RFP敏感度、特异度和准确度分别为88.0%、96.7%和94.5%。BacT—ALERT检测INH的敏感度、特异度和准确度分别为83.3%、97.7%和95.5%,检测SM的敏感度、特异度和准确度分别为88.1%、94.9%和93.5%,检测EMB的敏感度、特异度和准确度分别为100.0%、98.8%和99.0%,检测RFP敏感度、特异度和准确度分别为78.0%、96.0%和91.5%。结论PhaB法和BacT—ALERT法俭测MTB耐药性均具有较高的敏感度、特异度和准确度,可作为MTB耐药性的快速检测方法。
Objective To compare the drug resistance results in multi-drug resistant Mycobacterium tuberculosis （MTB） obtained by phage amplified biologically assay（PhaB） and BacT-ALERT method and to evaluate their performance in clinical isolates. Methods The susceptibilities to isoniazid （ INH ）, ethambutol （ EMB）, streptomycin （ SM ） and rimfapicin （RFP） in 200 MTB clinical isolates were detected by PhaB and BacT-ALERT methods. Thereafter, the sensitivity, specificity and accuracy of there two methods were compared with two conventional methods, i.e. absolute concentration method and proportion method. Results If absolute concentration method was used as the standard, the sensitivity, specificity and accuracy of PhaB for IN H resistance was 95.2 %, 88.3 % and 89.0%, 95.1%, 97. 5% and 98. 0% for SM resistance, 100. 0%, 94. 4% and 94. 5% for EMB resistance, 95.7%, 97.4% and 97.0% for RFP resistance, respectively. The sensitivity, specificity and accuracy of BacT-ALERT was 100.0%, 97. 2% and 97. 5% for INH resistance, 92.7%, 94. 3% and 94.0% for SM resistance, 100.0%, 99.4% and 99.5% for EMB resistance, 87.0%, 93.5% and 92.5% respectively for RFP resistance. If proportion method was taken as the standard, the sensitivity, specificity and accuracy of PhaB for detecting INH resistance was 58.3%, 99.4% and 94.5% respectively, 88. 1%, 96.8% and 95.0% for SM resistance, 100.0%, 94.4% and 94.5% for EMB resistance, 88.0%, 96.7% and 94.5% for RFP resistance. The corresponding values of BacT-ALERT for detecting INH resistance was 83.3%, 97.7% and 95.5% respectively, 88.1%, 94.9% and 93.5% for SM resistance, 100.0%, 98.8% and 99.0% for EMB resistance, 78.0%, 96.0% and 91. 5% respectively for RFP resistance. Conelusions PhaB and BacT-ALERT methods are highly sensitive, specific and accurate when used for drug-resistance detection in MTB, which can be utilized for rapid detection of MTB drug-resistance.
出处
《中华传染病杂志》
CAS
CSCD
北大核心
2007年第11期690-694,共5页
Chinese Journal of Infectious Diseases
基金
安徽省"十五"科技攻关传染病综合防治研究项目(040130327)
关键词
分枝杆菌
结核
分枝杆菌噬菌体
抗药性
细菌
微生物敏感性试验
Mycobacterium tuberculosis
Mycobacteriophages
Drug resistance, bacterial Microbial sensitivity test
