结核菌罗氏培养基药敏试验结果判读时间分析

Time analysis of drug sensitivity test results of TB Roche culture medium

目的分析结核菌罗氏培养基药敏试验结果的合理判读时间,从而使药敏实验的准确性得到提高。方法选择2013年4月—2016年12月期间淮安市疾病预防控制中心收治的2 371例肺结核患者作为研究对象,其中新涂阳初治患者2 136例,复治涂阳患者235例。患者痰标本均在实验室质控下完成检测,作为标准结果,同时在本院进行罗氏培养基药敏试验,分别培养4周和6周后,将检测结果与标准结果进行对比分析,分别统计比对培养4周和6周的结果准确率。结果初治患者培养4周药敏试验结果准确率异烟肼(98.60%)、链霉素(95.22%)、利副平(96.54%)、乙胺丁醇(95.88%)与培养6周准确率(94.48%、96.54%、97.94%、97.24%)比较,差异均有统计学意义(P<0.05)。复治患者培养4周异烟肼药敏试验准确率(98.30%)与培养6周准确率(93.62%)比较差异具有统计学意义(P<0.05);培养4周链霉素(94.89%)、利副平(96.60%)、乙胺丁醇(96.32%)药敏试验准确率与培养6周准确率(95.74%、97.87%、97.02%)比较,差异均无统计学意义(P>0.05)。初治和复治患者:4周和6周的准确率比较差异无统计学意义。结论结核菌罗氏培养基药敏试验结果准确性与判读时间存在一定联系,应根据具体药物选择具体时间。

Objective To analyze the reasonable time of drug sensitivity test of TB Roche culture medium,to improve theaccuracy of drug susceptibility test.Methods Totally 2 371 cases of pulmonary tuberculosis patients in Huaian MunicipalCenter for Disease Control and Prevention during the period of April 2013 to December 2016 as the research object, amongthem, 2 136 patients were treated with the initial treatment, and 235 cases were retreated, sputum specimens of patientsunderwent complete testing in the laboratory, as a result of standards, at the same time, the Roche medium of drug sensitivitytest in our hospital, were cultured for 4 weeks and 6 weeks, the detection results and the statistical alignment accuracy ofresults were compared with standard results, respectively.Results With 4 weeks of incubation, the sensitivity test accuracyrate of initial treatment patients of isoniazid（98.60%） and streptomycin（95.22%）, rifampicin（96.54%）, ethambutol（95.88%）were compared with 6 weeks of incubation（94.48%, 96.54%, 97.94%, 97.24%）, the difference were statistically significant（P〈0.05）. The isoniazid accuracy rate（98.30%） of re-treated cases compared with the 6-week accuracy（93.62%）, and thedifference was statistically significant（P〈0.05）. Cultivation 4 weeks of drug sensitive test accuracy of streptomycin（94.89%）,rifampicin（96.60%）, ethambutol（96.32%）, compared with accuracy of six weeks（95.74%, 97.87%, 97.02%）, there were nostatistically significant difference（P 〉0.05）. Initial and re-treated patients： drug sensitive test accuracy of 4 and 6 weeks, therewas no statistically significant difference. Conclusion There is a certain relationship between the accuracy of TBsusceptibility test and the time of interpretation, and the specific time should be chosen according to the specific drug.