胶体金法结合涂片形态学特征快速鉴别结核分枝杆菌复合群的应用评价

Identification of Mycobacterium tuberculosis complex using the morphological characteristic with colloidal gold method

目的探讨结核分枝杆菌抗原胶体金法结合涂片形态学特征鉴别结核分枝杆菌复合群的应用价值。方法采用涂片形态学特征和结核分枝杆菌抗原胶体金法对853株分枝杆菌临床分离株进行鉴别并与传统菌种鉴定结果进行比较。结果涂片法鉴别结核分枝杆菌的敏感度为98.4%(750/762),特异度为96.7%(88/91);胶体金试验鉴别结核分枝杆菌的敏感度为99.0%(754/762),特异度为98.9%(90/91);两种方法均为阳性,可报告菌株中含有结核分枝杆菌复合群(MTC),其阳性预测值为100.0%(741/741);两种方法均为阴性,可报告非结核分枝杆菌(NTM),其阴性预测值为100.0%(87/87)。结论结合涂片形态和结核分枝杆菌抗原胶体金两种方法鉴别结核分枝杆菌可以提高检测的准确性,是一种快速、简便,适于各级实验室使用的方法。

Objective To study the value of the morphological characteristic with colloidal gold method in rapid identification of mycobacterial species.Methods A total of 853 clinical isolates of Mycobacteria were identified using morphological characteristic and colloidal gold method,and the results were compared with traditional experimental methods.Results The sensitivity and specificity of mycobacterial species identification by morphological characteristic were respectively 98.4%（750/762） and 96.7%（88/91）.The sensitivity and specificity of identification by colloidal gold method were respectively 99.0%（754/762） and 98.9%（90/91）.When the smears of culture-positive samples showed serpentine cord morphology and the colliodal gold test was positive,the culture would be reported to contain Mycobacterium tuberculosis complex,and it＇s PPV was 100.0%（741/741）.When the cord morphology and the colloidal gold method test were all negative,the culture would be reported to contain non-tuberculous mycobacteria,and it＇s NPV is 100.0%（87/87）.Conclusion The morphological characteristic with colloidal gold method for the dentification of Mycobacterium tuberculosis complex could improve detection accuracy,was a fast,easy method and suitable for all levels of laboratory.