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Tuberculosis:an experience from Mycobacterium smears and culture analysis
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作者 Zeehaida M Siti Asma H +2 位作者 Siti Hawa H Zaidah AR Norbanee TH 《Asian Pacific Journal of Tropical Medicine》 SCIE CAS 2009年第2期47-53,共7页
Objective:Simple tests like direct smear of the acid fast bacilli(AFB) and Mycobacterium culture could assist the diagnosis of tuberculosis.This study is aimed at reviewing the outcome of smears,culture results and co... Objective:Simple tests like direct smear of the acid fast bacilli(AFB) and Mycobacterium culture could assist the diagnosis of tuberculosis.This study is aimed at reviewing the outcome of smears,culture results and contamination rate among specimens requested for AFB smear and Mycobacterium culture.Methods:Retrospective laboratory data analysis requesting for Mycobacterium culture from January 2005 till December 2006 was done in a tertiary teaching hospital of Universiti Sains Malaysia,Kubang Kerian,Kelantan,Malaysia.Results: Four hundred and sixty seven(36.6%) isolates grew from 1 277 specimens.Of these isolates,314 (67.2%) grew Mycobacterium tuberculosis,23(4.9%) grew Mycobacterium other than tuberculosis and 38 (8.1%) grew contaminants.Among the M.tuberculosis cultures,165(52.5%) had growth of more than 100 confluent colonies,whereas 39 cultures(12.4%) had growth of less than 19 colonies.Direct smear for AFB among smear positive cases showed presence of more than 50 bacilli/line in 231(49.5%) cases and smear negative cases accounted for 63(13.5%).Among smear positive cases,291(94.5%) cultures grew Mycobacterium species and another 17(5.5%) cultures grew contaminants.In smear negative cases,32(62.7%) cultures grew Mycobacterium species and 19(37.3%) cultures grew contaminants.Conclusion:The results from data analysis of the Mycobacterium cultures should be critically utilized in order to review the laboratory performance and to improve its services in the future.Some of the data is also useful to the administrators of the hospital in terms of estimating the risk of occupational hazard faced by the health care workers. 展开更多
关键词 tuberculosis MYCOBACTERIUM tuberculosis culture Acid fast BACILLI SMEAR CONTAMINATION
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Evaluation of Lo"wenstein-Jensen Medium Culture,MGIT 960 Culture and Different Specimen Types inDiagnosis of Bone and Joint Tuberculosis
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作者 Guirong Wang Weijie Dong +5 位作者 Liping Zhao Xia Yu Suting Chen Yuhong Fu Shibing Qin Hairong Huang 《Journal of Pharmacy and Pharmacology》 2015年第3期128-132,共5页
Objective: The aim of this study was to evaluate L-J (Lo"wenstein-Jensen) medium culture, MGIT 960 culture anddifferent specimen types in diagnosis of BJTB (bone and joint tuberculosis). Methods:: Specimens of... Objective: The aim of this study was to evaluate L-J (Lo"wenstein-Jensen) medium culture, MGIT 960 culture anddifferent specimen types in diagnosis of BJTB (bone and joint tuberculosis). Methods:: Specimens of pus, caseous necrosis,tuberculous granuloma and sequestrum were collected from 52 BJTB patients. All specimens were cultured using both MGIT 960system and L-J medium; and all pus were amplified using real-time PCR to detect the presence of M. tuberculosis DNA. KeyFindings: A total of 191 specimens were collected. Granuloma had better chance to produce positive outcomes by L-J mediumculture, while for sequestrum MGIT 960 culture had higher yield, but there was no significant difference in the recovery rates amongdifferent types of specimen either by L-J culture (Z2 = 0.638, P = 0.888) or by MGIT960 culture (Z2 = 1.399, P = 0.706). MGIT960culture had significantly higher recovery rate than L-J culture, With a combined culture and PCR-based test, the recovery rate of pusspecimen was significantly higher than that of either method alone (P 〈 0.05). Conclusion: MGIT 960 culture is superior to L-Jculture in BJTB diagnosis; pus, sequestrum, granuloma and caseous necrosis are usable specimen for mycobacterial culture;combination of culture and molecular techniques can provide a better diagnostic significance. 展开更多
关键词 Bone and joint tuberculosis mycobacteria SPECIMEN type culture.
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Diagnostic performance and problem analysis of commercial tuberculosis antibody detection kits in China 被引量:10
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作者 Xue-Juan Bai You-Rong Yang +5 位作者 Jian-Qin Liang Hui-Ru An Jie Wang Yan-Bo Ling Zhong-Yuan Wang Xue-Qiong Wu 《Military Medical Research》 SCIE CAS 2018年第3期242-250,共9页
Background: The diagnosis of bacterium-negative pulmonary tuberculosis(TB) and extra-pulmonary TB is challenging clinically. The detection of the anti-TB antibody has an important, auxiliary, clinical diagnostic value... Background: The diagnosis of bacterium-negative pulmonary tuberculosis(TB) and extra-pulmonary TB is challenging clinically. The detection of the anti-TB antibody has an important, auxiliary, clinical diagnostic value. Therefore, TB antibody detection kits should be screened and evaluated, and the reagents with the highest sensitivity and specificity should be chosen and used clinically.Methods: The diagnostic performance of 7 commercially available TB antibody detection kits(kits A, B, C, D, E, F and G) based on the gold immunoassay detection of immunoglobulin(Ig) G or IgM antibodies were simultaneously evaluated and compared in 62 TB cases and 56 non-TB cases in a laboratory. A retrospective analysis including 2549 cases was carried out to assess the clinical diagnosis values of bacteriological examinations and TB antibody tests(kits B and H used in the clinic).Results: The sensitivities of TB antibody kits A, B, C, D, E, F and G in the sera from 62 TB patients were 50.0%, 83.9%, 38.7%, 9.7%, 48.4%, 69.4% and 79.0%, respectively; the sensitivities in the sera from 24 smear-negative TB patients were 29.2%, 79.2%, 29.2%, 12.5%, 29.2%, 54.2% and 79.2%, respectively; the specificities in the sera from 56 nonTB patients were 73.2%, 25.0%, 85.7%, 96.4%, 78.6%, 78.6% and 50.0%, respectively. Of the 2549 clinically diagnosed cases, there were 1752 pulmonary TB cases, 505 extra-pulmonary TB cases, 87 old pulmonary TB cases and 205 non-TB cases. The positive results for smear, culture, TB antibody kit B and kit H in pulmonary TB cases were 39.8%(543/1365), 48.6%(372/765), 45.8%(802/1752) and 25.2%(442/1752), respectively; the results in extra-pulmonary TB cases were 3.4%(6/178), 5.8%(4/69), 35.4%(179/505), and 11.3%(57/505), respectively; the results in old pulmonary TB cases were 0%(0/64), 0%(0/30), 32.2%(28/87), and 9.2%(8/87), respectively; and the results in non-TB cases were 0%(0/121), 0%(0/56), 21.5%(44/205), and 2.4%(5/205), respectively. Of 624 smear-positive and/or culture-positive pulmonary TB cases, the sensitivities of antibody test kits B and H were 53.0% and 36.4%, respectively. Of 901 smear-negative and/or culture-negative pulmonary TB cases, the sensitivities of antibody test kits B and H were 42.5% and 19.0%, respectively. The positive rate of antibody detection in the bacterium-positive pulmonary TB cases was significantly higher than that in the bacterium-negative pulmonary TB cases(P<0.05).Conclusion: The colloidal gold-labeled TB antibody IgG detection assay is a simple, rapid and economical method that provides a better clinical auxiliary diagnosis value on TB, especially in smear-negative pulmonary TB and extrapulmonary TB. The production, quality control, screening and evaluation of antibody detection kits are very important for its clinical application. 展开更多
关键词 tuberculosis tuberculosis ANTIBODY TEST SMEAR culture
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Misdiagnosis of tuberculosis and the clinical relevance of nontuberculous mycobacteria in Zambia 被引量:2
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作者 Patricia CAM Buijtels Michael D Iseman +4 位作者 Shelagh Parkinson Cas S de Graaff Henri A Verbrugh Pieter LC Petit Dick van Soolingen 《Asian Pacific Journal of Tropical Medicine》 SCIE CAS 2010年第5期386-391,共6页
Objective:To determine the accuracy of TB diagnosis of TB in Zambia in the era of increasing HIV prevalence.Methods:Sputum of the clinically diagnosed TB cases was additionally subjected to liquid culture and molecula... Objective:To determine the accuracy of TB diagnosis of TB in Zambia in the era of increasing HIV prevalence.Methods:Sputum of the clinically diagnosed TB cases was additionally subjected to liquid culture and molecular identification.This study distinguished between TB cases confirmed by positive Mycobacterium tuberculosis(M.tuberculosis) cultures and mycobacterial disease caused by non-tuberculous mycobacteria(NTM).Results:Only 49% of the 173 presumptively diagnosed TB cases was M.tuberculosis cultured,while in 13% (22) cases,a combination of M.tuberculosis and NTM was found.In 18% of the patients only NTM were cultured.In 28% ,no mycobacteria was cultivable.HIV positive status was correlated with the isolation of NTM(P【0.05).Conclusions:The diagnosis of tuberculosis based on symptoms, sputum smear and/or chest X-ray leads to significant numbers of false-positive TB cases in Zambia,most likely due to the increased prevalence of HIV.The role of NTM in tuberculosislike disease also seems relevant to the false diagnosis of TB in Zambia. 展开更多
关键词 tuberculosis Diagnosis LIQUID culture Non-tuberculous MYCOBACTERIA Zambia
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Diagnosis of Mycobacterium tuberculosis using molecular biology technology 被引量:1
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作者 Juan Garberi Jorge Labrador +5 位作者 Federico Garberi Juan Ezequiel Garberi Julian Peneipil Miguel Garberi Luis Scigliano Alcides Troncoso 《Asian Pacific Journal of Tropical Biomedicine》 SCIE CAS 2011年第2期89-93,共5页
Objective:To present an integrated molecular biology dedicated system for tuberculosis diagnosis.Methods:One hundred and five sputum specimens from patients strongly suspected by clinical parameters of tuberculosis we... Objective:To present an integrated molecular biology dedicated system for tuberculosis diagnosis.Methods:One hundred and five sputum specimens from patients strongly suspected by clinical parameters of tuberculosis were studied by Ziehl-Neelsen staining,by cultivation on solid medium and by a balanced hemincsted fluorometric PCR system(Orange C3TB) that could preserve worker safety and produce a rather pure material free of potential inhibitors. DNA amplification was performed in a low cost tuberculosis termocycler-fluorotneter.Produced double stranded DNA was flurometrically detected.The whole reaction was conducted in one single tube which would not be opened after adding the processed sample in order to minimize the risk of cross contamination with amplicons.Results:The assay was able to delect 30 bacillus per sample mL with 99.8%interassay variation coefficient.PCR was positive in 23(21.9%) tested samples(21 of them were smear negative).In our study it showed a preliminary sensitivity of 94.5%for sputum and an overall specificity of 98.7%.Conclusions:Total run time of the test is 4 h with 2.5 real working time.All PCR positive samples are also positive by microbiological culture and clinical criteria.Results show that it could be a very useful tool to increase detection efficiency of tuberculosis disease in low bacilus load samples.Furthermore,its low cost and friendly using make it feasible to run in poor regions. 展开更多
关键词 tuberculosis SPUTUM MOLECULAR DIAGNOSIS Low cost Real-time PCR MYCOBACTERIUM tuberculosis MOLECULAR biology TECHNOLOGY SPUTUM sample Microbiological culture
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Diagnostic Evaluation of GeneXpert MTB/RIF Assay for the Detection of Rifampicin Resistant Mycobacterium tuberculosis among Pulmonary Tuberculosis Patients in Bangladesh 被引量:1
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作者 Hosne Jahan Sanya Tahmina Jhora +4 位作者 Zakir H. Habib Md. Abdullah Yusuf Imtiaz Ahmed Aleya Farzana Rafia Parveen 《Journal of Tuberculosis Research》 2016年第1期55-60,共6页
Background: The emergence of multidrug resistant tuberculosis (MDR-TB) and extensively drug- resistant tuberculosis (XDR-TB) has highlighted the need for early accurate detection and drug susceptibility. Objective: Th... Background: The emergence of multidrug resistant tuberculosis (MDR-TB) and extensively drug- resistant tuberculosis (XDR-TB) has highlighted the need for early accurate detection and drug susceptibility. Objective: The purpose of the present study was to evaluate the accuracy of GeneX-pert MTB/RIF assay for the detection of Mycobacterium tuberculosis and rifampicin resistance. Methodology: This cross sectional study was done in the Department of Microbiology at Sir Salimullah Medical College, Dhaka and National Institute of Chest Disease & Hospital (NIDCH), Dhaka during the period of January 2014 to December 2014 for a period of 1 (one) year. Sputum samples from suspected MDR-TB patients were collected by purposive sampling technique from OPD of Sir Salimullah Medical College (SSMC) and NIDCH. Microscopy, liquid culture in liquid MGIT 960 media and GeneXpert MTB/RIF were done for MTB diagnosis and detection of rifampicin resistance. MGIT 960 media were also used for determination of drug resistance. Result: Liquid culture yielded higher growth (68%) from 100 samples while GeneXpert MTB assay showed similar result (67% positive and 33% negative). Drug susceptibility test in MGIT 960 media showed that out of 68 positive cases Rifampicin resistant cases were 15 (22.05%) whereas GeneXpert MTB assay detected 14 (20.89%) were Rifampicin resistant out of 67 MTB positive samples. When compared to liquid culture the calculated sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and accuracy of GeneXpert MTB were 98.52%, 100%, 96.96%, 100% and 99%. Conclusion: GeneXpert MTB/RIF assay is high detection rate of pulmonary tuberculosis and multidrug resistant tuberculosis. 展开更多
关键词 MDR-TB GeneXpert MTB/RIF Liquid culture Pulmonary tuberculosis
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Pulmonary Tuberculosis in HIV-infected Patients Presenting with Normal Chest Radiograph and Negative Sputum Smear
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作者 Mounika Arrabelli Raghuram Reddy Adidala +3 位作者 Chakrapani Chatla Sireesha Tanniru Suryaprakash Chakramahanty Malathi Jojula 《Journal of Health Science》 2016年第3期125-130,共6页
Deaths due to Tuberculosis (TB) are high among the TB-HIV co-infected patients. Among PLHIV most of the instances the sputum smear is found to be negative for MTb. Chest X-rays also don't yield much diagnostic valu... Deaths due to Tuberculosis (TB) are high among the TB-HIV co-infected patients. Among PLHIV most of the instances the sputum smear is found to be negative for MTb. Chest X-rays also don't yield much diagnostic value mainly due to the advanced immune suppressed condition. This study makes an attempt to find out the utility of alternate staining methods such as Light Emitting Diode (LED), Fluorescent Microscopy (FM) and solid culture in resource limited settings for effective diagnosis of TB among PLHIV. 2 sputum samples were collected from 102 successive presumptive TB cases, whose smear microscopy and X-Ray were negative for MTb among PLHIVs visiting ICTC at MGM hospital, Warangal, Telangana State, India. All the 102 samples were repeated with ZN microscopy and X-ray. Additionally LED and FM microscopy procedures were conducted with the NALC-NAOH concentration method. All the samples were inoculated on LJ medium for solid culture and all the positive cultures were subjected for biochemical test to identify phenotypic appearance, nitrate reduction, niacin and PNB susceptibility test for all the first line anti TB drugs as per standard guidelines. Samples found positive on microscopy were cross checked with Line probe assay (LPA). All the 102 samples collected showed negative for MTb on ZN technique and negative for pulmonary TB on chest X-rays. 15 samples were positive for MTb both on LED and FM. LPA reconfirmed the MTb in all the 15 samples tested with 11 sensitive for both INH and Rifampicin, 3 INH mono resistant and I Rifmono resistance patterns. Of the 102 inoculations in LJ medium, 25 culture inoculations were positive for MTb growth and also were confirmed as MTb strains based on morphological, biochemical test and growth was seen after 4th week of inoculation. Of the 25 culture positives 20 were sensitive for INH and Rif, 4 INH mono resistant and 1 resistant to all first line anti TB drugs. In smear negative and chest X-ray negative presumptive TB cases, especially in immune compromised groups such as PLHIV, it is found to be useful to subject the sputum samples to LED and FM methods and at least solid culture wherever available. These methods clearly demonstrated additional yield over conventional ZN staining which can be recommended especially in the settings where high throughput equipment such as Xpert MTB/RIFor liquid culture is not available. These proactive measures can help in early diagnosis of TB which in turn can reduce mortality due to TB among PLHIV and break the chain of transmission of TB. Recommendations: Technology such as LED or FM microscopy can be advised for effective diagnosis of TB among Presumptive TB cases in PLHIV in settings where Xpert MTB/RIF is not available. 展开更多
关键词 tuberculosis drug sensitivity direct AFB vs concentrated smear microscopy LED microscopy and FM Line Probe Assay culture DST.
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痰涂片、固体培养法、GeneXpert MTB/RIF单独及联合检测结核分枝杆菌能力的比较
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作者 黄新蕾 陈建保 《临床肺科杂志》 2025年第1期88-91,125,共5页
目的 评估痰涂片、固体培养法、 Gene Xpert MTB/RIF单独及联合检测对结核分枝杆菌的检出能力。方法 选取2019年1月-2024年3月在天津市蓟州区人民医院结核门诊就诊的疑似肺结核的患者568例,满足同时送检痰涂片、固体培养法、GeneXpert M... 目的 评估痰涂片、固体培养法、 Gene Xpert MTB/RIF单独及联合检测对结核分枝杆菌的检出能力。方法 选取2019年1月-2024年3月在天津市蓟州区人民医院结核门诊就诊的疑似肺结核的患者568例,满足同时送检痰涂片、固体培养法、GeneXpert MTB/RIF三种检测方法,以临床最终诊断结果为金标准,评价上述三种方法检出结核分枝杆菌的能力。结果 在568例疑似肺结核患者中,临床最终诊断依据《肺结核诊断》(WS 288—2017)[1]标准进行,肺结核患者280例,非结核患者288例。痰涂片、固体培养法、GeneXpert MTB/RIF检测结核分枝杆菌的灵敏度分别为60.4%、84.3%、95.0%,差异具有统计学意义(χ^(2)=109.616,P<0.001),其中GeneXpert MTB/RIF灵敏度最高;三种检测方法特异度比较结果显示,差异无统计学意义(χ^(2)=1.002,P=0.606)。三种方法两两组合检测分析结果显示,痰涂片+固体培养法、痰涂片+GeneXpert MTB/RIF、固体培养法+GeneXpert MTB/RIF灵敏度分别为92.9%、98.2%、99.6%,差异具有统计学意义(χ^(2)=23.893,P<0.001),其中固体培养法+Gene Xpert MTB/RIF组合的灵敏度最高。两种方法联合检测特异度比较结果显示,差异无统计学意义(χ^(2)=0.502,P=0.778)。三种方法联合检测的灵敏度为100%,与金标准相一致;特异度比较结果显示,差异无统计学意义(χ^(2)=2.007,P=0.157)。结论 三种方法联合检测结核分枝杆菌优于单独检测及任意两种方法联合检测,所以建议三种方法同时检测有助于提高结核分枝杆菌的检出率,避免漏诊。 展开更多
关键词 结核分枝杆菌 痰涂片 固体培养法 GeneXpert MTB/RIF
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线性探针杂交技术在结核病诊断及耐药检测中的应用价值分析
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作者 李箫 潘洪秋 +1 位作者 王捷婷 朱东来 《中国社区医师》 2024年第36期89-91,共3页
目的:探讨线性探针杂交(HAIN)技术在结核病诊断及耐药检测中的应用价值。方法:选取2015年1月—2021年12月于江苏大学附属镇江三院就诊的疑似结核病患者345例进行研究,收集患者痰标本进行HAIN检测和罗氏固体培养,并对罗氏固体培养为阳性... 目的:探讨线性探针杂交(HAIN)技术在结核病诊断及耐药检测中的应用价值。方法:选取2015年1月—2021年12月于江苏大学附属镇江三院就诊的疑似结核病患者345例进行研究,收集患者痰标本进行HAIN检测和罗氏固体培养,并对罗氏固体培养为阳性的标本进行传统药敏试验和HAIN耐药检测。分析HAIN技术诊断结核病、耐药性的效能及对耐异烟肼(INH)和耐利福平(RFP)、多重耐药性(MDR)的检出率。结果:345例疑似结核病患者中,罗氏固体培养检测诊断阳性181例,HAIN技术检测诊断阳性180例。HAIN检测与罗氏固体培养检测结果的一致性较高(Kappa=0.861,P<0.001)。传统药敏试验检出耐药92例,HAIN检测检出耐药91例。HAIN技术与传统药敏试验结果的一致性较高(Kappa=0.884,P<0.001)。HAIN检测耐INH、耐RFP、MDR的检出率与传统药敏试验对比,差异无统计学意义(P>0.05)。结论:HAIN技术在结核病诊断及耐药检测中的应用价值较高,可用于结核病早期筛查和诊断。 展开更多
关键词 线性探针杂交技术 结核病 耐药检测 罗氏固体培养 传统药敏试验
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电子支气管镜及刷检对支气管结核诊断价值
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作者 阿力木·吾斯曼 发如克·帕尔哈提 杨俊勇 《新疆医学》 2024年第3期310-313,319,共5页
目的探讨电子支气管镜及刷对支气管结核诊断价值。方法分析48例支气管结核患者检查前痰结核杆菌涂片结果与电子支气管镜检查及刷检的结核分枝杆菌均快速培养及结核均培养的阳性率。结果镜下炎性浸润型28例占58.33%、溃疡坏死型4例占8.33... 目的探讨电子支气管镜及刷对支气管结核诊断价值。方法分析48例支气管结核患者检查前痰结核杆菌涂片结果与电子支气管镜检查及刷检的结核分枝杆菌均快速培养及结核均培养的阳性率。结果镜下炎性浸润型28例占58.33%、溃疡坏死型4例占8.33%、瘢痕狭窄型9例占18.75%、肉芽增生型3例占6.25%、淋巴瘘型3例占6.25%、管壁软化型1例占2.08%,痰结核杆菌涂片阳性率35.4%,刷检的结核分枝杆菌快速培养阳性率50%,刷检的结核菌培养的阳性率60.4%。结论电子支气管镜及刷检的结核分枝杆菌快培养及结核菌培养对支气管结核有重要的诊断价值,刷检的结核菌培养明显优于痰结核杆菌涂片阳性率,支气管结核以炎性浸润性为主。 展开更多
关键词 电子支气管镜 支气管结核 结核分枝杆菌均快速培养 结核菌培养 诊断价值
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三种肺结核实验室检测的方法学评价和临床应用价值 被引量:1
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作者 张晓坤 李勰璘 李筱慧 《广东医学》 CAS 2024年第3期382-385,共4页
目的探讨Xpert(MTB/RIF)法、培养法和涂片法3种方法在结核分枝杆菌及利福平耐药性检测中的临床应用价值。方法收集广州市荔湾中心医院2021年10月至2022年9月结核门诊及住院共529例肺结核患者痰液标本,采用Xpert法、培养法和涂片法3种方... 目的探讨Xpert(MTB/RIF)法、培养法和涂片法3种方法在结核分枝杆菌及利福平耐药性检测中的临床应用价值。方法收集广州市荔湾中心医院2021年10月至2022年9月结核门诊及住院共529例肺结核患者痰液标本,采用Xpert法、培养法和涂片法3种方法进行结核分枝杆菌及利福平耐药性检测,并对检测结果进行统计分析。结果Xpert法、培养法和涂片法3种检测方法的敏感度分别为40.64%(215/529)、35.35%(187/529)和15.31%(81/529),Xpert法检测的敏感度与培养法差异无统计学意义(χ^(2)=1.23,P>0.05),与涂片法差异有统计学意义(χ^(2)=67.21,P<0.05)。在利福平耐药性检测中,Xpert法检出结核分枝杆菌菌株对利福平的耐药率为22.46%(42/187),Xpert法的敏感度和特异度分别为95.12%(39/41)和97.95%(143/146),与培养法比较差异无统计学意义(χ^(2)=0.167,P>0.05)。结论3种检测方法中Xpert MTB/RIF系统检测结核杆菌及利福平耐药性敏感度及特异度最高,并且可以快速检测,临床应用价值最高,值得推广使用。 展开更多
关键词 肺结核 方法学 Xpert(MTB/RIF)法 培养法 涂片法 临床应用
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Socio-cultural features and help-seeking preferences for leprosy and tuberculosis: a cultural epidemiological study in a tribal district of Maharashtra, India 被引量:1
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作者 Amar Prakash Maske Pravin Arun Sawant +2 位作者 Saju Joseph Uma Satish Mahajan Abhay Machindra Kudale 《Infectious Diseases of Poverty》 SCIE 2015年第1期257-270,共14页
Background:India is a major contributor to the global burden of leprosy and tuberculosis(TB),which adversely affects the poorest tribal communities.Despite prioritisation by disease control programmes,programme perfor... Background:India is a major contributor to the global burden of leprosy and tuberculosis(TB),which adversely affects the poorest tribal communities.Despite prioritisation by disease control programmes,programme performance for leprosy and TB in tribal communities continues to be a challenge.In addition to access to services and infrastructural limitations,socio-cultural concepts of illness causation and related help seeking(HS)rooted in distinct features of tribal culture need to be addressed to improve programme outcomes.Methods:A cultural epidemiological survey of leprosy and TB patients was carried out using a locally adapted,semi-structured explanatory model interviews.A total of 100 leprosy and 50 TB patients registered for treatment at government health facilities were selected randomly from tribal dominant blocks of the Thane district,Maharashtra state.The perceived causes(PCs)of leprosy and TB in patients were compared based on prominence categories.The relationship between PCs as predictors,and disease conditions and HS preferences as outcome variables were assessed using multivariate logistic regression.Results:In the multivariate logistic regression model with disease conditions as outcome variables,TB patients were significantly more likely to report PCs in the categories of ingestion;health,illness and injury;and traditional,cultural and supernatural.Tuberculosis patients more frequently first sought help from private facilities as compared to leprosy patients who preferred government health facilities.In a combined analysis of leprosy and TB patients employing multivariate logistic regression,it was found that patients who reported PCs in the environmental and contact-related categories were more likely to visit traditional rather than non-traditional practitioners.In another multivariate combined model,it was found that patients who reported PCs in the traditional,cultural and supernatural category were significantly more likely to visit private rather than public health facilities.Conclusion:Cultural concepts about illness causation and associated HS behaviours should be considered as priorities for action,which in turn would provide the necessary impetus to ensure that tribal patients seek help in a timely and appropriate manner,and could facilitate improvement in programme performance in general. 展开更多
关键词 Socio-cultural features Help seeking LEPROSY tuberculosis TRIBAL cultural epidemiology ACSM IEC INDIA
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基于BACTEC MGIT 960培养的结核分枝杆菌与非结核分枝杆菌混合感染检测方法的研究
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作者 陈振华 郭婧玮 +4 位作者 王珏 胡培磊 易松林 刘怡 谭云洪 《中国防痨杂志》 CAS CSCD 北大核心 2024年第10期1243-1249,共7页
目的:探讨结核分枝杆菌复合群(Mycobacterium tuberculosis complex,MTBC)和非结核分枝杆菌(nontuberculous mycobacteria,NTM)混合感染的检测方法,为临床诊治混合感染提供参考依据。方法:使用脓肿分枝杆菌、鸟分枝杆菌、胞内分枝杆菌3... 目的:探讨结核分枝杆菌复合群(Mycobacterium tuberculosis complex,MTBC)和非结核分枝杆菌(nontuberculous mycobacteria,NTM)混合感染的检测方法,为临床诊治混合感染提供参考依据。方法:使用脓肿分枝杆菌、鸟分枝杆菌、胞内分枝杆菌3种NTM和MTBC标准菌株(H37Rv)各制备3种不同初始浓度(10^(-2)mg/ml、10^(-4)mg/ml和10^(-6)mg/ml)的菌液,将每个浓度的NTM与MTBC采用9种不同比例(NTM标准菌株与H37Rv按照1∶99、5∶95、10∶90、20∶80、50∶50、80∶20、90∶10、95∶5和99∶1)混合制成81种混合感染标本。3种感染模型分别为脓肿分枝杆菌和H37Rv、鸟分枝杆菌和H37Rv、胞内分枝杆菌和H37Rv。经BACTEC MGIT 960培养,采用MPB64抗原检测、对硝基苯甲酸(PNB)生长试验、荧光PCR熔解曲线法和恒温扩增实时荧光法4种方法对培养液进行检测。结果:3种混合感染模型的81份标本均在34 d内报告阳性。其中,MPB64抗原检测阳性3份(3.7%,3/81);PNB生长试验阳性78份(96.3%,78/81);荧光PCR熔解曲线法仅检出相应的NTM 64份(79.0%,64/81),仅检出MTBC 3份(3.7%,3/81),同时检出相应的NTM和MTBC 14份(17.3%,14/81);恒温扩增实时荧光法检出MTBC 67份(82.7%,67/81)。结论:临床标本经BACTEC MGIT 960培养,仪器报告阳性后,用MPB64抗原检测和PNB生长试验初判,若有NTM生长,建议采用分子生物学方法鉴定NTM,同时用单一检测MTBC核酸的方法对培养液进行检测,以免MTBC漏检。 展开更多
关键词 分枝杆菌 结核 非典型性细菌 重叠感染 培养技术 研究技术
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肺结核新型诊断技术研究与评价
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作者 彭磊 周敏 +2 位作者 张翠 刘丹 尹琼 《国外医药(抗生素分册)》 CAS 2024年第5期342-346,共5页
目的探讨实时荧光定量核酸扩增检测(Xpert)和结核分枝杆菌(MTB)/利福平(RIF)检测诊断肺结核的价值。方法选择2021年1月—2023年7月新余市人民医院接诊的疑似肺结核患者164例,均接受痰涂片镜检、Xpert&MTB/RIF检测,以结核分枝杆菌培... 目的探讨实时荧光定量核酸扩增检测(Xpert)和结核分枝杆菌(MTB)/利福平(RIF)检测诊断肺结核的价值。方法选择2021年1月—2023年7月新余市人民医院接诊的疑似肺结核患者164例,均接受痰涂片镜检、Xpert&MTB/RIF检测,以结核分枝杆菌培养作为金标准,对比两种检测方式诊断肺结核的价值及与临床诊断的一致性,并对比两种检测方式的检查所需时间。结果164例疑似肺结核患者,经临床确诊为肺结核84例(51.22%),非肺结核80例(48.78%)。Xpert&MTB/RIF对肺结核诊断的阴性预测值为72.73%、特异度为100.00%(80/80)、灵敏度为64.29%(54/84)、准确度为81.71%(134/164)、阳性预测值为100.00%(54/54),均高于痰涂片镜检,有统计学差异(P<0.05);Xpert&MTB/RIF诊断结果与临床诊断结果一致性尚可(kappa=0.637,P<0.05);痰涂片镜检诊断结果与临床诊断结果一致性不佳(kappa=0.278,P<0.05);Xpert&MTB/RIF检查所需时间短于痰涂片镜检,有统计学差异(P<0.05)。结论Xpert&MTB/RIF诊断效能优于痰涂片镜检,且检查所需时间较短,利于临床早期制定治疗方案。 展开更多
关键词 肺结核 痰涂片镜检 结核分枝杆菌培养 Xpert&MTB/RIF 一致性
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结核抗体、结核感染T细胞斑点试验(T-SPOT.TB)及痰涂片、痰培养联合诊断活动性肺结核的实践价值
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作者 张伟 《工业微生物》 CAS 2024年第4期144-146,共3页
文章探讨了结核抗体、结核感染T细胞斑点试验(T-SPOT.TB)及痰涂片、痰培养联合应用在活动性肺结核诊断中的临床实践价值。以2023年1月—12月期间甘肃医学院附属医院检验室接收的120例疑似肺结核患者样本为研究对象,对其血液和痰液样本... 文章探讨了结核抗体、结核感染T细胞斑点试验(T-SPOT.TB)及痰涂片、痰培养联合应用在活动性肺结核诊断中的临床实践价值。以2023年1月—12月期间甘肃医学院附属医院检验室接收的120例疑似肺结核患者样本为研究对象,对其血液和痰液样本进行检测,并评估单一检测结果与联合检测结果的诊断效能。研究结果显示,结核抗体、T-SPOT.TB、四种方法联合检测与临床检出结果无显著差异(P>0.05),痰涂片、痰培养检出阳性率显著低于临床检查结果(P<0.05)。四种方法联合检测的灵敏度和特异度分别为97.96%和95.45%,显著高于单一方法(P<0.05)。结核抗体、T-SPOT.TB及痰涂片、痰培养联合应用有助于提高活动性肺结核的诊断灵敏度,值得进一步推广应用。 展开更多
关键词 结核抗体 结核感染T细胞斑点试验 痰涂片 痰培养 活动性肺结核
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四种不同的检测技术对活动性肺结核诊断的效果评估
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作者 曹烜标 王燕茹 +1 位作者 洪丽娟 黄莉苹 《检验医学与临床》 CAS 2024年第S02期61-65,共5页
目的研究BD960结核液体培养法、实时荧光定量PCR法(溶解曲线法)、抗酸染色、结核感染T细胞检测(T-SPOT.TB)对活动性肺结核患者诊断的效果评价。方法分析该院2021年4月-2022年4月住院及门诊104例肺结核患者以及50例随机对照,按照痰涂片... 目的研究BD960结核液体培养法、实时荧光定量PCR法(溶解曲线法)、抗酸染色、结核感染T细胞检测(T-SPOT.TB)对活动性肺结核患者诊断的效果评价。方法分析该院2021年4月-2022年4月住院及门诊104例肺结核患者以及50例随机对照,按照痰涂片找抗酸菌的结果将研究对象分为痰阳组和痰阴组,以临床最终诊断为标准,分析其MGIT960结核液体培养系统、实时荧光PCR(溶解曲线法)、抗酸染色、结核感染T细胞检测(T-SPOT.TB)对活动性肺结核诊断的效果评估。结果结核液体培养法对活动性结核的诊断效果最好,其灵敏度、特异度、准确度分别99.04%,100%,99.35%。痰涂片阳性组中,结核液体培养对活动性结核的诊断效果最好,其灵敏度、特异度均为100%。痰涂片阴性组中结核液体培养对活动性结核的诊断效果最好,其灵敏度、特异度分别为98.04%、100%。在活动性肺结核中预测抗酸染色阳性结果的ESAT6抗原、CFP10抗原最佳阈值为28.5、36.5,其灵敏度为79.6%、70.4%,特异度为80%、90%。结论MGIT960结核液体培养法对活动性肺结核的辅助诊断效果最好,在活动性肺结核患者中T-SPOT.TB结果对初筛抗酸染色阳性结果具有一定的预测价值。 展开更多
关键词 活动性肺结核 MGIT960结核液体培养 外周血结核感染T细胞检测 实时荧光PCR溶解曲线法
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基于利福平耐药结核分枝杆菌半巢式实时荧光定量PCR技术检测胃液结核分枝杆菌在儿童肺结核中的诊断价值
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作者 阮树松 欧维正 祁仁杰 《当代医学》 2024年第14期134-138,共5页
目的分析基于利福平耐药结核分枝杆菌半巢式实时荧光定量PCR技术(Xpert-MTB/RIF)检测胃液结核分枝杆菌在儿童肺结核中的诊断价值。方法选取2020年1月到2021年12月贵阳市公共卫生救治中心儿童结核科收治50例疑似肺结核患儿作为研究对象,... 目的分析基于利福平耐药结核分枝杆菌半巢式实时荧光定量PCR技术(Xpert-MTB/RIF)检测胃液结核分枝杆菌在儿童肺结核中的诊断价值。方法选取2020年1月到2021年12月贵阳市公共卫生救治中心儿童结核科收治50例疑似肺结核患儿作为研究对象,取所有患儿晨起空腹胃液,分别行抗酸染色涂片、Xpert-MTB/RIF及罗氏(L-J)培养检测。以MTB培养作为金标准,分析不同检测方法结果,比较不同检测方法对儿童肺结核的诊断效能,分析Xpert-MTB/RIF及L-J培养阳性患儿MTB利福平耐药性情况及Xpert-MTB/RIF检测法与L-J培养法的药敏试验一致性。结果50例疑似肺结核患儿中,MTB培养结果检出36例肺结核,肺炎14例。抗酸染色涂片法检出阳性1例,阴性49例;L-J培养法检出阳性11例,阴性39例;Xpert MTB/RIF检测法检出阳性18例,阴性32例。Xpert MTB/RIF检测法、L-J培养法对儿童肺结核的诊断灵敏度高于抗酸染色涂片检测法,差异有统计学意义(P<0.05),Xpert MTB/RIF检测与L-J培养法诊断灵敏度比较差异无统计学意义。不同检测方法对儿童肺结核的诊断特异度、阳性预测值、阴性预测值比较差异均无统计学意义。Xpert MTB/RIF检测MTB对利福平的耐药敏感结果与L-J培养法的一致性Kappa值为0.891,具有较高的一致性。结论Xpert MTB/RIF检测较方便与快捷,具有较高的诊断效能,其检测MTB对利福平的药敏试验结果与L-J培养法一致性较高,有利于临床及早诊断儿童肺结核疾病并进行干预指导。 展开更多
关键词 肺结核 胃液 利福平 结核分枝杆菌 抗酸染色涂片 罗氏培养
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荧光定量PCR在肺结核诊断的优势对比研究
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作者 李芙琼 冯承启 +1 位作者 韦琴 杨通森 《中外医学研究》 2024年第30期61-64,共4页
目的:分析在肺结核临床诊断中对肺泡灌洗液进行荧光定量聚合酶链式反应(polymerase chain reaction,PCR)、纤支镜灌洗液结核分枝杆菌培养及灌洗液刷片抗酸(刷片法)检测的诊断价值。方法:选取2022年1月—2023年12月清镇市中医医院收治的... 目的:分析在肺结核临床诊断中对肺泡灌洗液进行荧光定量聚合酶链式反应(polymerase chain reaction,PCR)、纤支镜灌洗液结核分枝杆菌培养及灌洗液刷片抗酸(刷片法)检测的诊断价值。方法:选取2022年1月—2023年12月清镇市中医医院收治的160例患者作为研究对象,根据是否患有肺结核分为肺结核组和非肺结核组,每组各80例,共送检160份肺泡灌洗液标本。分别采PCR、培养法及刷片法对肺泡灌洗液标准进行诊断分析,对比3类检测方式下的诊断效能。以纤支镜肺泡灌洗液结核分枝杆菌培养检测结果为金标准,分析计算PCR及刷片法检测诊断的Kappa值,同时对比3种检测方式下的阳性预测值(PPV)和阴性预测值(NPV)。结果:肺结核组的PCR诊断阳性率高于培养法,差异无统计学意义(χ^(2)=10.03,P>0.05);PCR诊断阳性率高于刷片法,差异有统计学意义(χ^(2)=16.667,P<0.05);培养法诊断阳性率高于刷片法,差异有统计学意义(χ^(2)=10.03,P<0.05)。3种检测方法中PCR检测灵敏度、特异性最高,培养法次之,刷片法最低。PCR检测一致性较好(Kappa=0.82),刷片法检测结果一致性一般(Kappa=0.63)。3种诊断方式阳性预测值比较,差异无统计学意义(P>0.05);PCR阴性预测值高于刷片法,差异有统计学意义(P<0.05)。结论:荧光定量PCR在诊断肺结核方面具有较高的诊断效能,诊断优势明显,可作为一种有价值的工具用于肺结核的诊断。 展开更多
关键词 肺泡灌洗液 肺结核 诊断 培养法 聚合酶链式反应 刷片法
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4种检测方法对骨结核的诊断价值比较
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作者 李晓琴 马志强 +3 位作者 田楠 陈薇 李才信 周敏 《昆明医科大学学报》 CAS 2024年第2期131-135,共5页
目的探讨涂片抗酸染色、TB-DNA、Xpert MTB/RIF、结核菌培养等4种检测方法对骨结核诊断的价值对比。方法对骨外科1 a内住院骨质破坏患者的病灶周围脓液,用4种检测方法进行检测,并对结果进行统计分析,指标包括:灵敏度、特异度、阳性预测... 目的探讨涂片抗酸染色、TB-DNA、Xpert MTB/RIF、结核菌培养等4种检测方法对骨结核诊断的价值对比。方法对骨外科1 a内住院骨质破坏患者的病灶周围脓液,用4种检测方法进行检测,并对结果进行统计分析,指标包括:灵敏度、特异度、阳性预测值、阴性预测值。结果研究对象中以临床诊断为金标准,脓液涂片查抗酸杆菌灵敏度为31.75%,特异度为100.00%,阳性预测值100.00%,阴性预测值53.74%,约登指数为0.32;TB-DNA灵敏度为88.89%,特异度为98.00%,阳性预测值98.25%,阴性预测值87.50%,约登指数为0.87;Xpert MTB/RIF灵敏度为95.23%,特异度为68.00%,阳性预测值78.95%,阴性预测值91.90%,约登指数为0.63;脓液结核菌培养灵敏度为41.27%,特异度为100.00%,阳性预测值100.00%,阴性预测值57.47%,约登指数为0.41,(χ^(2)=77.354,P<0.005)4种检测方法差异具有统计学意义。结论4种检测方法中,TB-DNA灵敏度和特异度较好,Xpert MTB/RIF灵敏度较好,TB-DNA和Xpert MTB/RIF的真实性较好,同时阳性预测值和阴性预测值较高,对骨结核的诊断具有较好的价值。 展开更多
关键词 涂片抗酸染色 结核分枝杆菌基因 结核分枝杆菌及利福平耐药检测 结核菌培养 骨结核
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结核菌培养联合结核分枝杆菌-DNA检测对菌阴肺结核诊断效能的研究
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作者 陈菊 陈建仁 吴修宇 《中国医药科学》 2024年第17期152-155,共4页
目的探究结核菌培养联合结核分枝杆菌-DNA检测对菌阴肺结核的诊断效能。方法选取2021年9月至2022年9月阳江市公共卫生医院收治的188例疑似菌阴肺结核患者,均进行结核菌培养、结核分枝杆菌-DNA检测。以组织培养及病理检查为“金标准”。... 目的探究结核菌培养联合结核分枝杆菌-DNA检测对菌阴肺结核的诊断效能。方法选取2021年9月至2022年9月阳江市公共卫生医院收治的188例疑似菌阴肺结核患者,均进行结核菌培养、结核分枝杆菌-DNA检测。以组织培养及病理检查为“金标准”。比较结核菌培养、结核分枝杆菌-DNA检测单独检测、联合检测菌阴肺结核的诊断结果以及诊断效能。结果188例疑似菌阴肺结核患者中132例确诊为阳性,结核菌培养检测检出阳性115例,阴性73例;结核分枝杆菌-DNA检测检出阳性107例,阴性81例;联合检测检出阳性134例,阴性54例。结核菌培养联合结核分枝杆菌-DNA检测对菌阴肺结核的灵敏度、阴性预测值、准确率(91.67%、79.63%、87.23%)高于结核菌培养检测(78.79%、61.64%、79.26%)、结核分枝杆菌-DNA检测(75.00%、59.26%、78.19%),差异有统计学意义(P<0.05)。结核菌培养联合结核分枝杆菌-DNA检测对菌阴肺结核的特异度、阳性预测值(76.79%、90.30%)与结核菌培养检测(80.36%、90.43%)、结核分枝杆菌-DNA检测(85.71%、92.52%)比较,差异无统计学意义(P>0.05)。结论结核菌培养联合结核分枝杆菌-DNA检测对菌阴肺结核进行诊断,有利于提升诊断灵敏度、阴性预测值、准确率,诊断效能较高。 展开更多
关键词 结核菌培养 结核分枝杆菌-DNA检测 菌阴肺结核 诊断效能
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