液体MGIT培养法在结核分枝杆菌检测中的应用评估

Application evaluation of liquid MGIT culture method in detection of Mycobacterium tuberculosis

目的分别用液体分枝杆菌培养管(MGIT)培养法与固体罗氏(L-J)培养法及痰直接涂片抗酸染色检测结核分枝杆菌,评估液体MGIT培养法在结核病诊断中的应用。方法收集上海市松江区中心医院2010年11月至2011年8月肺结核门诊及住院的疑似和确诊后治疗复诊的患者痰标本共1 598例,其中828例为疑似新发患者、770例为已确诊治疗后复诊患者痰标本,所有标本均分别用液体MGIT培养法、固体L-J培养法及痰涂片抗酸染色进行检测。结果疑似新发患者痰液体MGIT培养法报阳时间[(13.63±7.14)d]与固体L-J培养法报阳时间[(28.67±10.04)d]间,复诊患者痰液体MGIT培养法报阳时间[(22.94±9.55)d]与固体L-J培养法报阳时间[(28.53±10.40)d]间差异有统计学意义(P<0.05);疑似新发患者痰液体MGIT培养法培养阳性率[32.00%(265/828)]比痰涂片抗酸染色法[14.80%(123/828)]和固体L-J培养法[17.90%(148/828)]高(P<0.05),复诊患者痰液体MGIT培养法培养阳性率为9.30%(72/770),痰涂片抗酸染色法为6.10%(47/770),二者差异无统计学意义(P>0.05),但比固体L-J培养法[2.60%(20/770)]高(P<0.05);液体MGIT培养法污染率为[6.57%(105/1 598)],比固体L-J培养法[4.00%(64/1 598)]高(P<0.05)。结论液体MGIT培养法在提高阳性率、缩短报阳时间上均优于传统的检测方法,而且操作简便,不需要昂贵设备,在基层医院易于操作和推广。

Objective To use liquid Mycobacterium growth indicator tube （MGIT） culture method, solid Roche （L-J） culture method and sputum direct smear acid-fast staining test for the detection of Mycobacterium tuberculosis, and to evaluate the application of liquid MGIT culture method in the diagnosis of tuberculosis. Methods Froin November 2010 to August 2011 in Shanghai Songjiang District Central Hospital, 1 598 sputum samples were collected from the suspected and confirmed tuberculosis inpatients and outpatients, who were diagnosed again after treatment （828 suspected newly cases and 770 cases from the follow-up patients being diagnosed again）, and all cases were detected by liquid MGIT culture method, solid L-J culture method and sputum direct smear acid-fast staining test. Results By liquid MGIT culture method, the reporting positive time of suspected newly cases was （13.63 ± 7. 14） d, and the reporting positive time by solid L-J culture method was （28.67 ±10.04） d, with statistical significance （P 〈0.05） . The reporting positive time of the being diagnosed again cases by liquid MGIT culture method was （ 22.94 ± 9.55 ） d, and was （28.53 ± 10.40） d by solid L-J culture method with statistical significance （P 〈0.05 ）. The positive rate of suspected newly patients by liquid MGIT culture method was 32.00% （265/828）, which was higher than those by sputum direct smear acid-fast staining test [ 14.80% （123/828） ] and solid L-J culture method [ 17.90% （148/828） ] with statistical significance （P 〈 0.05 ）. The positive rate of being diagnosed again cases by liquid MGIT culture method was 9.30% （72/770） , and was 6.10% （47/770） by sputum direct smear acid-fast staining test without statistical significance （P 〉 0.05 ）, but that by liquid MGIT culture method was higher than that by solid L-J culture method [ 2.60% （20/770） ] （P 〈 0.05）. The contamination rate of liquid MGIT culture method [ 6.57% （ 105/1 598） ] was higher than that by solid L-J method [ 4.00% （64/1 598） ] （P 〈 0.05 ）. Conclusions The liquid MGIT culture method in terms of increasing the positive rate and shortening the reporting positive time is better than traditional detection methods, and it is easy to operate without using expensive equipment and suitable to use in the primary hospital.