基因芯片法菌种鉴定技术在非结核诊断中的应用

Application of microarray technology in the diagnosis of non-tuberculosis

目的应用基因芯片法菌种鉴定技术研究丽水地区非结核分枝杆菌分布情况,探讨其在临床非结核诊断中的应用价值。方法应用基因芯片法菌种鉴定技术检测84例改良罗氏法阳性的分枝杆菌,比较2种方法菌种鉴定的一致率,并记录具体菌型。结果 84株PNB阳性菌株菌种鉴定后获得7株结核复合群和77株非结核分枝杆菌,种群分布达8种,最常见的是胞内分枝杆菌,占71.4%。传统罗氏培养方法和基因芯片法菌种鉴定共有77例检测结果一致,一致率为91.7%。鸟分枝杆菌、龟-脓肿分枝杆菌、堪萨斯分枝杆菌、戈登分枝杆菌、马赛分枝杆菌对异烟肼、利福平、链霉素、乙胺丁醇全部耐药,胞内分枝杆菌对异烟肼、利福平、链霉素全部耐药,对乙胺丁醇耐药率为91.7%。结论丽水地区分枝杆菌中以胞内分枝杆菌、龟-脓肿分枝杆菌、鸟分枝杆菌为主。开展NTM菌种鉴定对鉴别诊断和有效治疗有重要意义。

Objective Microarray technique was applied to study the distribution of nontuberculosis Mycobacteria in Lishui,so as to explore its clinical value in the diagnosis of non-tuberculosis. Methods 84 cases of Lowenstein-Jensen positive mycobacterial strains were detected by microarray to compare the consistency rate of two results and record the specific bacteria type.Results 84 cases of PNB positive mycobacterial strains were detected by microarray,7 strains were identified as mycobacterium tuberculosis complex,77 strains were identified as nontuberculous mycobacteria; there were 8 mycobacterial species,M. intracellular was the most common found in total 84 strains,accounting for 71. 4%. The consistent rate of microarray to Lowenstein-Jensen was 91. 7% on 77 cases. M. avium,M. chelonae,M. kansasii,M. gordonae and M. massiliense were all resistant to INH,REP,SM and EMB; and M. intracellular were all resistant to INH,REP,SM and EMB,and its resistance rate to ethambutol was 91. 7%. Conclusion M. intracellular,M. chelonae and M. avium were the main mycobacteria in Lishui. The identification of NTM is important to diagnosis and effective treatment.