耐利福平作为筛选宁波地区耐多药结核病指标的评估研究

Evaluation of rifampicin resistance as the screening indicator for multi-drug resistant tuberculosis

目的探讨耐利福平作为宁波地区耐多药结核病筛选指标的可行性。方法对结核分枝杆菌临床分离株采用美国BD公司BACTEC MGIT 960全自动快速分枝杆菌培养鉴定药敏实验,并对数据进行分析。应用诊断性试验评价指标评价耐利福平作为耐多药结核病筛选指标的科学性。结果在2603株结核分枝杆菌临床分离株中,312株对利福平耐药,其中267株至少同时对异烟肼耐药,结核分枝杆菌的耐多药率为10.3%。若以至少同时耐异烟肼和利福平作为诊断耐多药结核病的参考标准,以耐利福平作为耐多药结核病筛选指标的敏感性为100%、特异性为98.1%、准确度为98.3%、阳性预测值为85.6%、阴性预测值为100%、阳性似然比为5.9、阴性似然比为0。结论耐利福平可以作为宁波地区耐多药结核病的初步筛选指标。

Objective To study the feasibility of using rifampicin resistance （ Rif - resistance） as the screening indicators of multi - drug resistance tuberculosis （ MDR - TB）. Methods The drug sensitivity of clinical mycobacterium tuberculosis strains were tested by BACTEC MGIT 960 system. The results were analyzed by statistics. The evaluation indicators of diagnostic test were used to assess the scientificity of rifampicin as screening indicator of multi - drug resistant tuberculosis. Results There were 312 rifampicin - resistant strains in 2603 strains of mycobacterium tuberculosis isolates, 267 of which were isoniazid - re- sistant at least at the same time. The muhi - drug resistance rate of these strains was 10.3%. If taking resistance to both INH and RFP as the standard of MDR - TB diagnosis, the accuracy, sensitivity, specificity, positive predictive value, negative pre- dictive value, positive likelihood ratio and negative likelihood ratio of Rif - resistance as multi - drug resistance tuberculosis di- agnosis were 98.3%, 100%, 98.1%, 85.6%, 100%, 5.9 and 0 respectively. Conclusion Rif - resistance can be used as preliminary screening indicator for multi - drug resistant tuberculosis.