摘要
目的分析和评价3种结核杆菌（MTB）药物敏感性测定方法,建立适合临床应用和疾病控制的快速、简便、低成本的MTB耐药性检测方法。方法应用绝对浓度法、噬菌体生物扩增法（PhaB）和BacT-ALERT快速培养系统检测183株MTB临床分离株对异烟肼（INH）、链霉素（SM）、乙氨丁醇（EMB）和利福平（RFP）的耐药性,比较检测结果的符合率、敏感性、特异性和准确性。结果以国内公认的绝对浓度法检测结果为判断标准,PhaB法检测对4种药物耐药性结果的敏感性、特异性和准确性分别为INH：94.1%、88.6%和89.1%,SM：97.3%、97.3%和96.2%,EMB：100.0%、94.4%和96.6%,RFP：97.6%、97.9%和97.8%;BacT-ALERT快速培养系统检测4种药物耐药性结果的敏感性、特异性和准确性分别为INH：100.0%、97.0%和97.8%,SM：91.9%、94.5%和94.0%,EMB：100.0%、99.4%和99.5%,RFP：88.1%、93.6%和92.3%。结论PhaB法和BacT-ALERT快速培养系统检测MTB耐药性具有较高的敏感性、特异性和准确性,与我国常用的耐药性检测方法相比具有很高的符合率。尤其是PhaB法试验周期短、低成本、无需特殊仪器设备,可作为基层单位MTB耐药性快速测定的筛选方法。BacT-ALERT法准确、快速、操作简便,适合于专科医院批量MTB耐药性快速检测。
Objective To analyze three detection methods of drug-resistant tuberculosis and establish a detection method,which is rapid,simple,low cost,and suitable for clinical practice and disease control.Methods The susceptibility was tested for isonicotinoylhydrazine（INH）,ethambutol（EMB）,streptomycin（SM） and rimfapicin（RFP） to treat 183 Mycobacterium tuberculosis clinical isolates by absolute concentration method,PhaB and BacT-ALERT rapid culture system,also their coincidence rates,sensibility,specificity and accuracy were compared.Results If absolute concentration method was taken as the standard,the sensibility,specificity and accuracy by PhaB was 94.1%,88.6% and 89.1%,SM 97.3%,97.3% and 96.2%,EMB 100.0%,94.4% and 96.6%,RFP 97.6%,97.9% and 97.8% respectively.The sensibility,specificity and accuracy EMB by BacT-ALERT was 100%,97.0% and 97.8%,SM 91.9%,94.5% and 94.0%,EMB 100.0%,99.4% and 99.5%,RFP 88.1%,93.6% and 92.3% respectively.Conclusions More susceptive,specific,accurate drug-resistance tuberculosis detection may be obtained by PhaB and BacT-ALERT methods,which are also coincided with conventional methods used in China.The former,as a cost effective and easy to implement,short-term culture,offers potential for basic hospital to screen drug-resistanct tuberculosis rapidly.While the later,with rapid,accurate,simple features to perform,offers potential for tuberculosis hospital to detect drug-resistant tuberculosis in batches.
出处
《国际呼吸杂志》
2007年第23期1767-1769,共3页
International Journal of Respiration
基金
安徽省“十五”科技攻关传染病综合防治研究项目（编号：040130327）
关键词
结核杆菌
结核
噬菌体
耐药性
Mycobacterium tuberculosis
Tuberculosis
Mycobacteriophage
Drug resistance
