摘要
目的评价目前两种商用试剂盒对分枝杆菌菌种鉴定的诊断价值，并对结核及非结核分枝杆菌感染的临床特点进行回顾性分析。方法对临床样本中培养出的51株分枝杆菌分别用免疫胶体金法（结核分枝杆菌抗原检测试剂盒）和多重聚合酶链反应（Multiplex PCR）方法（Seeplex MTB NTM ACE Detection试剂盒）进行菌株鉴定，并用16SrDNA测序的方法评价此两种快速检测技术的诊断价值；在菌种鉴定的基础上分析结核与非结核分枝杆菌临床特点的异同。结果以16SrRNA测序结果为金标准，胶体金法敏感性为56．3％（9／16），特异性为97．1％（34／35）；多重PCR法敏感性为81．3％（13／16），特异性为100％（35／35）。51株罗氏培养分枝杆菌阳性菌株中，经明确鉴定为非结核分枝杆菌的共16株，主要来自创面、皮肤组织及痰、渗出液等分泌物取材培养，且以龟／脓肿分枝杆菌（50．O％，8／16）、海分枝杆菌（25．0％，4／16）感染占多数。结论两种结核分枝杆菌菌株快速鉴定试剂均具有较好的特异性，多重PCR法在敏感性上显著优于胶体金法，更适合用于临床对结核分枝杆菌及非结核分枝杆菌的鉴别。16SrDNA直接测序能更好的鉴定分枝杆菌至种水平，有效鉴别各种非结核分枝杆菌，有助于临床诊断。
Objective To evaluate the diagnostic value of two commercial kits in identifying Mycobacterium tuberculosis （MTB） and Nontuberculous mycobacterium （NTM） infection, and to compare the clinical characteristics of the two types of infections. Methods The MTB isolates from 51 clinical samples were identified by Diagnostic Kit for MTB （Colloidal Gold） and Seeplex MTB NTM ACE Detection Kit （ Multiplex PCR）. 16S rDNA PCR assay was applied to compare the diagnostic value of the two methods. The similarity and differences of the clinical characteristics of the two types of infections were compared, retrospectively. Results The sensitivities of Colloidal Gold method and Seeplex Multiplex PCR method were 56.3% （9/16） and 81.3% （13/16） , respectively, while the specificities were 97.1% （34/35） and 100% （35/35） , respectively. Among the 51 isolates, 16S rDNA direct sequencing demonstrated that 16 of them were NTM, most of which were from cuhures of skin samples and sputum, with the majority of M. chelonei/M, abscessus and M. marinum were 50. 0% （8/16） and 25. 0% （4/16）, respectively. Conclusions The specificities of the two kits are both high, while the sensitivity of Multiplex PCR method is significantly higher, which is more suitable for clinical practice to distinguish MTB and NTM infection. Furthermore, 16S rDNA direct sequencing could effectively identify Mycobacteria to species level, which could be helpful for the clinical diagnosis on distinguishing MTB infection.
出处
《中华实验和临床感染病杂志（电子版）》
CAS
2013年第1期35-38,共4页
Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)
基金
上海市卫生局课题(No.2010088)
上海市科委重点项目(No.10411955000)
关键词
分枝杆菌
非结核分枝杆菌
菌种鉴定
Mycobacterium
Nontuberculous mycobacterium
Bacterium species identification
