结核分支杆菌药物敏感性不同检测方法结果的比较

Comparison of susceptibility testing results of M. tuberculosis by different methods

目的 比较不同标准和方法检测结核分支杆菌耐药性的结果。方法 对 15 8株临床分离的结核分支杆菌同时采用我国现行标准绝对浓度法、WHO/IUATLD推荐标准 1%比例法和绝对浓度法检测药物敏感性。结果 WHO/IUATLD规定的耐药性标准检测的耐药率为 5 3 8% (85 / 15 8) ,我国现行标准检测结果为 5 0 0 % (79/ 15 8) (P >0 0 5 ,差异无显著性 )。WHO/IUATLD耐药性检测标准检测出耐INH、SM、EMB、RFP率分别为 41 8% (6 6 / 15 8)、34 2 % (5 4/ 15 8)、2 2 1% (35 / 15 8)、2 7 8% (44 /15 8) ,我国现行标准检测的结果分别为 34 2 % (5 4/ 15 8)、30 4% (48/ 15 8)、18 4% (2 9/ 15 8)、2 7 2 % (43/15 8) ;经统计学处理 ,两标准在检测耐药性时 ,除INH差异有显著性 (χ2 =18 4,P <0 0 1)外 ,其余三种药物的检测结果差异无显著性。WHO/IUATLD耐药性检测标准应用 1%比例法和绝对浓度法检测的结果一致。结论 耐药性检测标准对药物敏感性检测结果有较大影响 ,但相应标准下采用不同的检测方法并不影响药物敏感性结果。

Objective To compare the susceptibility testing results of M. tuberculosis detected with different standards and methods. Method 158 strains of M. tuberculosis isolated from clinical patients were detected for the drug sensitivity by Chinese standard and method ( absolute concentration method),1% resistance ratio and absolute concentration method of WHO/IUATLD standard. Results The drug resistant rate detected by the standard of WHO/IUATLD was 53.8%(85/158),while by the Chinese standard 50.0%(79/158). The drug resistant rates to INH,SM,EMB and RFP by WHO/IUATLD standard were 41.8%(66/158), 34.2%(54/158), 22.1%(35/158) and 27.8%(44/158) respectively,whereas by the Chinese standard 34.2%(54/158), 30.4%(48/158 ),18.4%(29/158)and 27.2%(43/158 ) respectively. There was no significant difference between the results detected with WHO/IUATLD and Chinese standard, except for the results of INH. There was no significant difference between the results detected with WHO/IUATLD standard by 1% resistant ratio and absolute concentration methods. Conclusion The results of drug sensitivity were interfered by the detected standards but not by the tested methods.