非结核分枝杆菌快速药敏试验研究

Rapid drug susceptibility experimental research on nontuberculosis mycobacteria

目的研究结核分枝杆菌BACTEC MGIT 960系统液体培养法和美国临床实验室标准化协会(Clinical and Laboratory Standards Institute,CLSIM)24-A微量肉汤稀释法的快速药敏试验与对非结核分枝杆菌的意义。方法分别采用BACTEC MGIT 960液体培养法联合微量肉汤稀释法的快速药敏试验与L-J固体培养法和绝对浓度药敏法分别对48份非结核分支杆菌(nontubeerculous mycobacteria,NTM)培养时间和药敏报告时间进行比较研究。结果 48份NTM在BACTEC MGIT 960培养仪的平均阳性报告时间(7.0±1.1)d,L-J培养基平均阳性报告时间(17.6±3.9)d,两者比较差异有统计学意义(t=-18,P<0.01);微量肉汤稀释法结果报告时间为(7.2±1.2)d,L-J固体药敏试验报告时间为(27.3±2.4)d,两者比较差异有统计学意义(t=-52.2,P<0.01),两种药敏试验方法对相同种类药物的耐药率均为90%以上,微量肉汤稀释法比L-J法可以检测的药物种类更多。结论 BACTEC MGIT 960液体培养法联合微量肉汤稀释法的快速药敏试验比L-J固体培养法和绝对浓度药敏法在培养时间和药敏结果种类及报告时间上有着明显优势。

Objective To study the significance of BACTEC MGIT 960 liquid culture method and the CLSIM （Clinical and Laboratory Standards Institute） 24 -A micro broth dilution method on rapid susceptibility testing and the nontuberculosis mycobacteria. Methods By using the BACTEC MGIT 960 liquid culture combined with micro broth dilution methodg rapid susceptibility testing, L -J solid culture method and the absolute con- centration susceptibility method respectively to compare and research 48 patients＂ NTM culture time and sensi- tivity reporting period. Results 48 cases of NTM culture in BACTEC MGIT 960 instrument average positive report time is （7.0 ± 1.1 ） d, L -J media reported positive average time is （ 17.6 ±3.9） d, there were significant difference of the two （t = - 18, P 〈0. 01 ）, micro broth dilution results reported time is （7.2± 1.2） d, L - J solid susceptibility test report time is （27.3± 2.4） d, there were significant difference of the two （t = -52. 2, P 〈0. 01 ）, two kinds of drug sensitive test method of resistance to the same kinds of drugs were both more than 90%, micro broth dilution method can detect more types of drugs than the L - J method. Conclusions BACTEC MGIT 960 liquid culture combined the micro broth dilution method rapid susceptibility testing has obvious advantages on the incubation time, drug susceptibility results and reporting time than L -J solid culture method and the absolute concentration susceptibility method.