MGIT960联合快速药敏在结核分枝杆菌药物敏感性检测中的应用

Application of MGIT 960 combined with rapid drug susceptibility in detection of drug susceptibility of Mycobacterium tuberculosis

目的评价结核分枝杆菌快速培养及快速药物敏感试验在结核病诊治中的指导意义。方法应用MGIT 960液体快速培养方法及美国临床和实验室标准协会(clinical and laboratory standards institute,CLSI)推荐的M24-A(CLSI M24-A)微量肉汤稀释法对结核分枝杆菌临床分离菌株进行快速培养及快速药物敏感试验。结果对540株结核分枝杆菌临床分离菌株进行快速培养及快速药物敏感试验,耐药结果检出的平均时间为40.4天,<40天获得药物敏感试验结果的比例达50.37%。快速药敏组平均报告天数比常规罗氏药敏试验平均报告天数缩短近18天,差异有统计学意义(t=9.137,P<0.05)。对异烟肼、利福平、乙胺丁醇、左氧氟沙星、莫西沙星、环丙沙星、克拉霉素、利福布丁和利奈唑胺等药物低浓度耐药和高浓度耐药比例差异均有统计学意义(P<0.05)。结论河北地区结核耐药形势依旧严峻,通过缩短结核分枝杆菌培养及药物敏感性试验的时间,使得药物敏感试验结果更加快速、准确,使得病人得到更加快速准确的治疗方案,及时地服务于临床。

Objective To evaluate the guiding significance of the applications of rapid culture and rapid drug susceptibility test of Mycobacterium tuberculosis(MTB)in TB diagnosis.Methods MGIT 960 rapid liquid culture method and M24-A micro broth dilution method recommended by the clinical and laboratory standards institute(CLSI M24-A)were used to rapidly culture the clinical isolates of MTB and carry out drug susceptibility test on them.Results Totally 540 clinical isolates of MTB were cultured rapidly and underwent drug susceptibility test.The average detection time of drug resistance was 40.4 days,and 50.37%of the isolates had a detection time less than 40 days.The average reporting days in the rapid drug susceptibility group were nearly 18 days shorter than those in the routine Roche drug susceptibility test,and the difference was statistically significant(t=9.137,P<0.05).There were statistically significant differences in the proportion of low concentration drug resistance and high concentration drug resistance to isoniazid,rifampicin,ethambutol,levofloxacin,mosfloxacin,ciprofloxacin,clarithromycin,rifambutin and linetazolamide(P<0.05).Conclusion The situation of TB drug resistance in Hebei is still grim.By shortening the time of MTB culture and drug sensitivity test,the results of drug sensitivity test are more rapid and accurate.Therefore,patients can get more rapid and accurate treatment plan,which can serve for clinical treatment in time.