噬菌体生物扩增法快速检测脊柱结核脓液中结核分枝杆菌

Experimental Study of Rapid Detection of Mycobacterium Tuberculosis in Pott's Disease by Phage Amplified Biologically Assay

【目的】探讨噬菌体生物扩增(PhaB)法快速检测脊柱结核脓液中结核分枝杆菌的临床应用价值。【方法】应用直接涂片法,BACTECMGIT-960法及PhaB法分别检测56例脊柱结核患者的56份脓液标本以及10株结核分枝杆菌标准株,15株非结核分枝杆菌及5株非分枝杆菌。【结果】PhaB法检测10株结核分支杆菌标准株均为阳性,15株非结核分支杆菌和5株非分支杆菌均为阴性。46份BACTECMGIT-960培养阳性和10份BACTECMGIT-960培养阴性的标本中,PhaB法分别有42份(91.3%)、3份(30.0%)阳性,检出率分别为82.1%和80.4%(P>0.05)。涂片检查阳性仅13份(23.2%),阴性43份(76.8%),而应用PhaB法可以检测出45份(80.4%)阳性,其中有33份为涂片阴性的标本(P<0.05)。用PhaB法能在18～24h内得出结果,较BACTECMGIT-960法提前5～17d。【结论】PhaB法与直接涂片法、BACTECMGIT-960法相比,可以简便、快速地检测结核分支杆菌,全程只需1d,并且具有较高的敏感性和特异性。

To study the clinical value of the phage amplified biologically assay（PhaB） on rapid detection of mycobacterium tuberculosis in pus of Pott＇s disease. [Methods] All the specimens were collected during the operation on the principal of asepsis. 10 clinical isolates of Mycobacterium tuberculosis, 15 strains of non-mycobacterium tuberculosis, 5 strains of non-mycobacterium and 56 pus specimens of pott＇s disease patients were detected with AFB test, rapid culture with BACTEC MGIT-960 system or PhaB respectively. [Results] All the strains of mycobacterium tuberculosis clinical isolates detected with PhaB were positive, while all of the non-mycobacterium tuberculosis and non-mycobacterium strains were negative. 46 pus speci- mens with BACTEC MGIT-960 culture positive and 10 pus specimens with BACTEC MGIT-960 negative were detected with PhaB, the number of positive specimens were 42 （91.3%）and 3 （30. 0%） respectively （ P 〈0. 05）. The positive rate were 82. 1% and 80.4% respectively. The positive of smear was only 13 cases （23. 2%）, negative was 43（76.8）. However, the number of positive specimens detected by PhaB was 45（80.4%）, 30 of them were negative detected by pus smear（ P d〈0.05）. The result of PhaB could be reported in 18～24 hours, and 5～17 days were advanced compared with BACTEC MGIT-960. [Conclusion] The PhaB can detect the mycobacterium tuberculosis more easily and quickly with high sensitivity and specificity compared with direct smear and BACTEC MGIT-960. The whole process just need one day.