BacT/ALERT 3D全自动培养仪检测分枝杆菌的临床应用研究

目的探讨BacT/ALERT 3D全自动培养仪在结核病诊治中的应用价值。方法用BacT/ALERT 3D全自动培养仪(3D法)对临床送检的402份标本(其中结核病患者标本330份,非结核病患者标本72份)进行结核分枝杆菌分离培养,阳性者进行药物敏感性试验,同时与BACTE TB 460系统(Bactec法)和改良罗氏培养法(L-J法)进行比较。结果330份结核病患者标本中,3D法、Bactec法和L-J法的阳性分离率分别为42.1%、43.9%和31.2%;初分离平均阳性时间为16.1d、12.8d和25.6d,平均药敏时间12.9d1、2.4d和22.4d,总报告时间分别为29d、25.2d和48d。3D法在阳性分离率和平均报告时间均明显优于改良罗氏法(P<0.05)、与Bactec法相近(P>0.05)。3种方法污染率分别为4.0%6、.2%和3.5%;3D法低于Bactec法(P<0.05)、与L-J法相近(P>0.05)。3D法与Bactec法和L-J法药敏总符合率分别为97.28%和94.79%。在72份非结核病人标本中,3种方法培养均为阴性。结论BacT/ALERT3D全自动培养仪检测分枝杆菌具有阳性分离率高、快速、污染率低、安全可靠、自动化程度高,是一种比较理想的快速检测分枝杆菌的方法。

Evaluation of BacT/ALERT 3D System for Mycobacteria Isolates

Background: The rapid diagnosis of mycobacterial infections is essential to implement the adequate antimicrobial therapy. This study evaluates the performance of the BacT/ALERT 3D system for isolates and identification of mycobacteria from clinical samples. Methods: 1011 clinical specimens from nonsterile and sterile body sites were studied from August 2010 to December 2012 at the National Reference Laboratory of Tuberculosis, IPK, Cuba. The results obtained were compared with respect to time detection of mycobacteria and contamination rates, and performance indicators of BacT/ALERT 3D were calculated. Results: The time detection of growth (TDG) for Mycobacterium tuberculosis (Mtb) and nontuberculous mycobacteria (NTM) by BacT/ALERT 3D was 16,435 and 10,956, respectively;by LJ the TDG was 33.577 for Mtb and 35.952 for NTM. By culture method used the TDG for LJ was 33,577 and 6.435 by BacT/ALERT 3D, this difference being statistically significant. The overall contamination rate (CR) for BacT/ALERT 3D was 4.6% and 7.8% for LJ. Conclusions: BacT/ALERT 3D were a suitable method for recovering mycobacteria from clinical samples. It demonstrated a shorter time to detection of mycobacteria growth;it was very useful to provide faster treatment and a better prognosis in patients AFB smear negative with HIV. The use of LJ culture and BacT/ALERT 3D System was useful to assure a total mycobacterial recovery.

BacT/ALERT 3D技术在结核杆菌耐药检测中的应用研究

目的比较BacT/ALERT 3D法与传统罗氏(L-J)比例法在耐药结核分枝杆菌检测中的差异,评价BacT/ALERT 3D快速培养系统在结核分枝杆菌耐药检测中的应用价值。方法对219份固体培养结核杆菌阳性的培养物采用BacT/ALERT 3D液体培养技术和L-J比例法同时进行药敏试验,并进行比对分析。结果 BacT/ALERT 3D法平均检出时间(8.02±3.85)d,比L-J比例法检出时间平均缩短约20 d;BacT/ALERT 3D法检出耐药菌60株,L-J比例法检出耐药菌79株,差异无统计学意义(P>0.05);以L-J比例法结果为判定标准,BacT/ALERT 3D法对INH、RFP、EMB和SM 4种抗结核药耐药检测结果符合率分别为95.43%、92.69%、95.43%和92.24%。结论与L-J比例法比较,BacT/ALERT 3D药敏检测方法对结核杆菌的耐药检出结果有较高的一致性,BacT/ALERT 3D法检出时间明显短于L-J比例法。