DNA微阵列芯片法检测耐药结核分枝杆菌的价值探讨

To explore the value of detecting the drug-resistant Mycobacterium tuberculosis by the DNA microarray chip

目的评价DNA微阵列芯片法快速检测耐药结核分枝杆菌的效果。方法对125份结核分枝杆菌痰涂片阳性标本和40份结核分枝杆菌传统培养阳性菌株样本,采用DNA微阵列芯片法进行异烟肼(isoniazid,INH)、利福平(rifampin,RFP)耐药性快速检测。同时以传统结核杆菌药物敏感试验方法作为金标准,对DNA微阵列芯片法检测结核分枝杆菌耐药性的一致率进行评价分析。结果 DNA微阵列芯片法检测结核分枝杆菌对INH耐药的敏感度为87.5%,特异度为100%,与传统药物敏感法的一致率为98.8%。DNA微阵列芯片法检测结核分枝杆菌对RFP耐药的敏感度为83.3%,特异度为100%,与传统药物敏感法的一致率为99.4%。DNA微阵列芯片法检测结核分枝杆菌耐多药的敏感度为100%,特异度为100%,与传统药物敏感法的一致率为100%。结论 DNA微阵列芯片法检测结核分枝杆菌的耐药性与传统药物敏感法有较高的一致率,较为可靠,且检测所需时间短,可以作为临床肺结核耐药性的快速筛查方法。

Objective To evaluate the effect of rapid test of drug-resistant Mycobacterium tuberculosis by the method of DNA microarray chip. Methods Isoniazid（INH） and rifampin（RFP） resistance were rapidly detected using DNA microarray chip method for 125 samples positive for Mycobacterium tuberculosis sputum smear and 40 samples positive for Mycobacterium tuberculosis traditional culture. At the same time, taking the traditional Mycobacterium tuberculosis drug sensitivity test as the gold standard, the consistency of drug resistance of Mycobacterium tuberculosis detected by the DNA microarray chip method was analyzed. Results The sensitivity of diagnosis of INH resistance by the DNA microarray chip method was 87.5%, and the specificity was 100%. The concordance rate with traditional drug sensitivity method was 98.8%. The sensitivity of diagnosis of RFP resistance by the DNA microarray chip method was 83.3%, and the specificity was 100%. The concordance rate with traditional drug sensitivity method was 99.4%. The sensitivity of diagnosis of multi drug resistance by the DNA microarray chip method was 100%, and the specificity was 100%. The concordance rate with traditional drug sensitivity method was 100%. Conclusions Compared with the traditional drug sensitivity method, the DNA microarray chip method has a high coincidence rate when used to detect drug resistance of Mycobacterium tuberculosis, so it has good reliability, and the detection process takes a short time. This method can be a rapid screen method on the diagnosis of tuberculosis drug resistance.