DNA-微阵列芯片检测技术与Gene-Xpert MTB/RIF技术在新疆维吾尔自治区结核分枝杆菌耐药性诊断中的应用

Application of DNA-microarray chips and Gene-Xpert MTB/RIF in the diagnosis of drug resistance of Mycobacterium tuberculosis in Xinjiang Uygur Autonomous Region

目的探索DNA-微阵列芯片检测技术(以下简称基因芯片技术)和利福平耐药实时荧光定量核酸扩增检测技术(Gene-Xpert MTB/RIF技术)检测新疆维吾尔自治区结核分枝杆菌中利福平和异烟肼耐药性的应用价值。方法收集2015年新疆维吾尔自治区结核病耐药监测菌株115株,对所有的菌株进行比例法药敏试验、基因芯片技术、Gene-Xpert MTB/RIF技术检测。以比例法药敏试验为“金标准”,分别计算基因芯片技术与Gene-Xpert MTB/RIF技术对结核分枝杆菌耐药性诊断的效能并进行评价。结果比例法药敏试验结果显示,利福平耐药患者40例(34.78%),异烟肼耐药患者48例(41.74%)。以比例法药敏试验结果为“金标准”,基因芯片技术检测结核分枝杆菌对利福平和异烟肼耐药耐药性诊断的灵敏度、特异度分别为80.00%、89.33%和77.08%、97.01%,Gene-Xpert MTB/RIF技术检测结核分枝杆菌对利福平耐药性诊断的灵敏度、特异度分别为92.50%、94.67%。基因芯片技术和Gene-Xpert MTB/RIF技术对利福平耐药患者的诊断效能差异无统计学意义(P>0.05)。结论对于新疆维吾尔自治区结核病耐药监测菌株,基因芯片技术和Gene-Xpert MTB/RIF技术对耐药结核病的诊断均具有较高的灵敏度和特异度。Gene-Xpert MTB/RIF技术操作方法简单,检测时间短;基因芯片技术耐药检测范围广,耗时少,为新疆维吾尔自治区广泛开展耐药结核病快速检测提供了有力的技术支持。

Objective To explore DNA-microarray chip detection technology(gene chip technology)and rifampicin resistance real-time fluorescent quantitative nucleic acid amplification detection technology(Gene-Xpert MTB/RIF technology)in the detection of the resistance of Mycobacterium tuberculosis to rifampicin and isoniazid in Xinjiang Uygur Autonomous Region.Methods The 115 tuberculosis-resistance strains were collected from Xinjiang Uygur Autonomous Region in 2015.All strains were tested for proportional drug sensitivity test,gene chip technology,Gene-Xpert MTB/RIF technology.Taking the proportional drug sensitivity test as the"gold standard",the efficacy of gene chip technology and Gene-Xpert MTB/RIF technology in the diagnosis of drug resistance of Mycobacterium tuberculosis was calculated and evaluated.Results The results of the proportional drug susceptibility test showed that there were 40 rifampicin-resistant patients(34.78%),48 isoniazid-resistant patients(41.74%).Taking the results of the proportional drug sensitivity test as the"gold standard",the sensitivity,specificity of the gene chip technology for the diagnosis of rifampicin and isoniazid-resistant tuberculosis were 80.00%,89.33%and 77.08%,97.01%,respectively.The sensitivity and specificity of Gene-Xpert MTB/RIF technology for the diagnosis of rifampicin-resistant tuberculosis were 92.50%and 94.67%,respectively.The diagnostic efficiency of gene chip technology and Gene-Xpert MTB/RIF technology on rifampicin-resistant tuberculosis was not statistically different(P>0.05).Conclusion For the tuberculosis-resistance strains of Xinjiang Uygur Autonomous Region,gene chip technology and Gene-Xpert MTB/RIF technology have high sensitivity and specificity for the diagnosis of drug-resistant tuberculosis.Gene-Xpert MTB/RIF technology has simple operation methods and short detection time;gene chip technology has a wide range of drug resistance detection and is less time-consuming,providing strong technical support for the extensive rapid detection of drug-resistant tuberculosis in the Xinjiang Uygur Autonomous Region.