线性探针技术在丽水地区结核菌耐药检验中的应用

Application of HAIN technology in TB drug resistance testing in Lishui

目的应用线性探针(HAIN)技术研究丽水地区结核菌耐药情况,从而提高丽水地区结核病的防控能力。方法收集2014年8月-2015年8月丽水地区219例初治涂阳患者,33例复治涂阳患者的痰标本进行HAIN技术检测,同时以比例法固体药敏试验作为对照标准。结果将227例具有完整耐药结果的患者纳入分析,线性探针试验和比例法药敏试验异烟肼耐药率分别为8.3%和10.1%,利福平耐药率分别为5.3%和6.2%,2种方法耐药率差异均无统计学意义(P>0.05)。与比例法固体药敏对照,HAIN技术检测异烟肼、利福平耐药的一致率分别为98.2%、99.1%;检测异烟肼耐药的敏感度为82.6%,特异度为100.0%;利福平耐药的敏感度为85.7%,特异度为100.0%。结论丽水地区结核菌对异烟肼、利福平总的耐药率低于全国平均水平;HAIN技术检测异烟肼、利福平耐药有较高的敏感度,对耐多药结核病的早期快速诊断有较好的应用前景。

Objective Application of the linear probe（ HAIN） was adopted to anayze the resistance of TB in Lishui,so as to enhance the ability of tuberculosis prevention and control in Lishui. Methods Sputum samples were collected from 219 patients with smear- positive and 33 retreatment patients in Lishui during August 2014- August 2015 for the detection with HAIN,and meanwhile,solid susceptibility testing proportion method was selected as the control standard. Results The 227 cases of drug-resistant patients with complete results were collected in the analysis. The resistant rates of isoniazid with linear probe test and the proportion drug sensitivity test were 8. 3% and 10. 1%,and the resistance rates of rifampicin were 5. 3% and 6. 2%,so the difference of resistance rate with the 2 kinds of methods had no statistical significance（ P 〈0. 05）. Compared with the proportion solid drug sensitive detection,the consistent rates of isoniazid,rifampin with HAIN were 98. 2%,99. 1%; the sensitivity of isoniazid resistance was 82. 6%,specificity was 100. 0%; sensitivity and specificity of rifampin were 85. 7% and 100. 0%. Conclusion The overall resistance rate of TB to isoniazid,rifampicin in Lishui is below the national average; HAIN detection has a higher sensitivity in the resistance detection of isoniazid,rifampicin,and have better prospects to the early rapid MDR- TB diagnosis.