MGIT960分枝杆菌液体快速培养前处理方式的临床评价

Clinical evaluation of the pretreatment method for rapid culture of Mycobacterium tuberculosis MGIT960 system

目的探讨原装进口配套试剂、传统常用的4%氢氧化钠前处理液与手工配制的NaOH-NALC前处理液对分枝杆菌液体快速培养指标的影响,建立一种适合国内现状的分枝杆菌液体快速培养前处理方法。方法通过原装进口样本前处理液、4%氢氧化钠样本前处理液、手工配制的NAOH-NALC对五类抗酸染色级别不同的痰标本进行培养前平行处理,观察不同前处理方法分枝杆菌培养阳性率、平均报阳天数及污染率并进行试剂成本核算。结果三种前处理方法阳性率一致。原装进口试剂组和NAOH-NALC手工配制组平均报阳时间为8天,两组没有明显区别,而4%氢氧化钠样本处理组较另两组平均报阳天数要长,统计学差异显著(P<0.01)。三种处理方式的污染率差别不具有统计学意义。平均每例耗材花费情况原装进口试剂组86.00元、4%氢氧化钠样本处理组73.50元、NAOH-NALC手工配制组77.30元。结论 NAOH-NALC手工配制组相较4%氢氧化钠组明显缩短了分枝杆菌快速培养的报阳天数,污染率无差别,而相比原装进口试剂组耗材花费经济便宜。因此NAOH-NALC手工配制前处理方式适合成为MGIT960分枝杆菌液体快速培养前处理首选方式。

Objective To establish a pretreatment method for mycobacterium tuberculosis rapid culture in the domestic situation and to discuss the effect on indicators of the rapid culture for mycobacterium tuberculosis com- paring the pretreatment methods which include original imported kit, traditional 4% sodium hydroxide pretrcatment solution and handcrafted NaOH-NALC pretreatment liquid. Methods Parallel pretreatment culture of the five level of acid fast staining sputum were through original imported kit, traditional 4% sodium hydroxide pretreatment solution and handcrafted NaOH-NALC pretreatment liquid. The positive reporting days, positive rate, contamination rate and reagent cost were analyzed. Results The positive rate of the three methods were consistent. There was no significant difference between the original import reagent group and the NAOH-NALC preparation group. The average positive re- port time was 8 days. The average positive report days of the 4% sodium hydroxide group was longer, which was sta- tistically significant difference with the other two groups （ P 〈 0. 01 ）. The pollution rate of the three treatments was not statistically significant. The average cost of each case was 86.00 Yuan in the original import reagent group, 73.50 Yuan in the 4% sodium hydroxide group, and 77. 30 Yuan in the handcrafted NaOH-NALC group. Conclu- sion Compared with the 4% sodium hydroxide group, the positive report days of rapid culture of mycobacterium in the handcrafted NaOH-NALC group is significantly reduced and the pollution rate has no difference, but the average cost in the handcrafted NaOH-NALC group is cheaper than the original import reagents group. Therefore, the hand- crafted NaOH-NALC pretreatment method is suitable to become the preferred pretreatment method of MGIT960 Myco- bacterium liquid rapid culture.