3种检测技术在结核菌利福平耐药性检测中的应用价值

发布时间：2018-04-17 05:10

本文选题：结核分枝杆菌 + 快速诊断　；参考：《中国地方病防治杂志》2016年11期

【摘要】：目的探讨Gene Xpert~汶MTB/RIF(Xpert)、Hain Geno Type~汶MTBDR plus(Hain)和基因芯片技术在结核分枝杆菌(MTB)对利福平(RFP)耐药性检测中的应用价值。方法随机选289例患者的涂阳痰标本,每例标本分成3份,分别进行Xpert检测、罗氏培养和MTB DNA提取,MTB DNA分别用于Hain技术和基因芯片技术检测RFP耐药性,罗氏培养阳性菌株作比例法药物敏感性试验。3种快速分子药敏检测结果不一致者,进一步作DNA测序分析。结果 RFP耐药性结果以比例法为金标准,Xpert、Hain和基因芯片分别与之比较,灵敏度、特异度、准确度、阳性预测值(PPV)、阴性预测值(NPV)均无显著差异(P均0.05,Kappa值均0.75)。3种快速分子药敏检测RFP结果完全相同的277例(192例敏感,85例耐药),总符合率95.85%。结论 Xpert、Hain、基因芯片与比例法比较,MTB RFP耐药性检测差异均无统计学意义且结果具有较高的一致性。
[Abstract]:Objective to investigate the value of Gene Geno Type-Type- plussam (Gene) and gene chip technique in the detection of rifampicin (rifampicin) resistance in Mycobacterium tuberculosis.Methods smear positive sputum samples of 289 patients were randomly selected. Each specimen was divided into 3 samples and were detected by Xpert. Roche culture and MTB DNA extraction were used to detect the drug resistance of RFP by Hain technique and gene chip technique, respectively.The positive strains of Roche culture were tested by proportional drug sensitivity test. 3 kinds of rapid molecular drug sensitivity test results were not consistent, and further DNA sequencing analysis was carried out.Results the results of drug resistance of RFP were compared with those of XpertHain and gene chip by proportional method, sensitivity, specificity, accuracy.There was no significant difference in the positive predictive value and the negative predictive value. There was no significant difference in the positive predictive value and the negative predictive value. The Kappa value was 0. 75% and 0. 75% respectively. The results of RFP detection were the same in 192 cases (85 cases), and the total coincidence rate was 95.85%.Conclusion there was no significant difference in drug resistance of RFP between gene microarray and proportion method, and the results were consistent with each other.
【作者单位】：贵阳市公共卫生救治中心;
【基金】：贵阳市科学技术局2014科技类计划(筑科合同[20141001]33号)
【分类号】：R446.5;R440

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