Hain和Xpert MTB/RIF技术对结核分枝杆菌药物敏感性的检测

Detection of drug susceptibility to Mycobacterium tuberculosis by Hain and Xpert MTB/RIF technology

目的应用线性探针耐多药检测技术(Hain)和利福平耐药实时荧光定量核酸扩增检测技术(Xpert MTB/RIF)分析辽宁地区耐多药结核分枝杆菌(multiple-drug resistant Mycobacterium tuberculosis,MDR-TB)的检出情况,为本地区结核病的控制及临床诊断治疗提供科学依据。方法收集193株结核分枝杆菌菌株应用Hain、Xpert MTB/RIF和比例法鉴定利福平(rifampin,RFP)和异烟肼(isoniazid,INH)的耐药性;以比例法为金标准,分析另外两种方法检测耐药结核分枝杆菌的敏感性和特异性。结果 Hain检测利福平耐药的灵敏度为81.8%(72/88),特异度为87.6%(92/105);Hain检测异烟肼耐药的灵敏度为81.2%(82/101),特异度为70.7%(65/92);Hain检测MDR-TB的灵敏度为76.7%(46/60),特异度为81.2%(108/133);Xpert MTB/RIF检测利福平耐药的灵敏度为90.9%(80/88),特异度为81.9%(86/105)。Hain、Xpert MTB/RIF两种检测方法与比例法相比差异均无统计学意义(P>0.05)。结论 Hain和Xpert MTB/RIF是快速有效地检测结核分枝杆菌耐药的方法,适用于辽宁地区结核病患者耐药性检测。

Objective To detect the multidrug-resistant of Mycobacterium tuberculosis by Hain and Xpert MTB/RIFtechnology in Liaoning Province,and we provide for the control of tuberculosis（TB） in this region and scientific evidence forclinical diagnosis and treatment. Methods Hain,Xpert MTB/RIF and ratio method were simultaneously used to detectrifampin（RFP） and isoniazid（INH） resistance of the 193 stains. By the ratio method as the gold standard,the two methods wasalso employed to analyse the sensitivity and specificity of detection MDR-TB. Results By Hain,the sensitivity andspecificity of detection RFP resistance was 81.8%（72/88）,87.6%（92/105）; By Hain,the sensitivity and specificity of detectionINH resistance was 81.2%（82/101）,70.7%（65/92）; By Hain,the sensitivity and specificity of detection MDR-TB was 76.7%（46/60）,81.2%（108/133）; By Xpert MTB/RIF,the sensitivity and specificity of detection RFP resistance was 90.9%（80/88）,81.9%（86/105）.The two methods with no statistical difference with ratio method（P〉0.05）. Conclusion Hain and Xpert MTB/RIF are rapid and effective methods for detection of drug resistant tuberculosis,and they are applicable to Liaoning Province.