两种方法对结核杆菌耐多药性检测结果的比较

Comparison on two methods to evaluate the resistance of Mycobacterium tuberculosis

目的对照比例法,探讨线性探针技术(Genotype MTBDRplus)对耐多药结核分枝杆菌进行快速诊断的应用价值。方法收集宝鸡市2014年部分县区疾控分离培养结核杆菌阳性菌株,以传统药敏技术(比例法)作为对照参比,评价MTBDRplus法对阳性菌株的耐多药性检测以及对异烟肼和利福平耐药性检测的灵敏度、特异性。结果 MTBDRplus法和比例法对耐多药的检出率为均为46.7%,二者的耐多药检出率一致。对照比例法,线性探针技术检测出MDR-TB的敏感性和特异性分别为92.9%和93.8%,检测出异烟肼的敏感性和特异性分别为100.0%和90.9%,检测出利福平的敏感性和特异性分别为94.7%和100.0%,差异均无统计学意义(χ2=0.00,P>0.05)。结论 MTBDRplus法操作简单快捷,结果准确,为耐多药性结核病的快速诊断提供有利依据。因此,该项技术可结合传统药敏在临床上推广应用。

Objective To investigate Genotype MTBDRplus line probe assay for rapid diagnosis of multidrug-resistant tuberculosis compared with conventional drug susceptibility. Methods Compared with conventional drug susceptibility,collecting Mycobacterium tuberculosis clinical isolates in some countries CDC of Baoji city in 2014 for detection by MTBDRplus method to get the sensitivity and the specificity of rifampicin and isoniazid- resistance. Results MTBDR plus assay and conventional drug susceptibility testing for the detection of MDR same rate were 46. 7%. compared to the results of conventional rug susceptibility testing,the sensitivity and specificity of MTBDRplus assay for MDR- TB detection were 92. 9% and 93. 8%. The detection of isoniazid were 100% and 90. 9%,the detection of rifampic were 94. 7% and 100%. There was no significant difference between the 2 methods（ χ2= 0. 00,P 〉0. 05）. Conclusions MTBD Rplus assay can be used for rapid detection of MDR- TB because of its fast and accurate analysis. So,it should be combined with the conventional drug susceptibility testing to be promoted in clinical practice.