结核分枝杆菌临床分离株利福平和异烟肼耐药性检测方法比较

发布时间：2018-08-09 09:00

【摘要】：目的探讨基因芯片法和改良罗氏培养及比例法药敏试验在结核分枝杆菌(MTB)利福平(RFP)和异烟肼(INH)耐药性测定中的应用价值。方法应用基因芯片法检测200株MTB临床分离株RFP耐药基因rpo B的6个位点、13种突变型,INH耐药基因kat G的1个位点、2个突变型和INH inh A基因启动子-15位、1个C→T突变型。同时对MTB菌株进行罗氏培养及比例法药敏试验,并比较测定结果的敏感性、特异性和符合率。结果基因芯片法检测敏感株152株、耐药株48株,罗氏比例法检测敏感株161株、耐药株39株。若以罗氏比例法测定结果为判断标准,基因芯片法检测RFP耐药性的敏感性、特异性和符合率分别为85.0%、98.8%和97.5%;检测INH耐药性的敏感性、特异性、符合率分别为82.8%、92.4%和91.0%。结论基因芯片法对结核菌耐药菌株可做出初筛,与结核菌药敏试验联合检测可提高诊断率。
[Abstract]:Objective to investigate the application value of gene chip method, modified Roche culture and proportional method in the determination of drug resistance of Mycobacterium tuberculosis (MTB) rifampicin (RFP) and isoniazid (INH). Methods the 6 loci of RFP resistance gene rpo B in 200 clinical isolates of MTB were detected by gene chip method. One locus of 13 mutants of kat G, two mutants and 15 positions of INH inh A gene promoter, and one C-T mutation were detected. At the same time, the MTB strains were cultured in Roche culture and tested by proportional method, and the sensitivity, specificity and coincidence rate of the results were compared. Results 152 susceptible strains, 48 drug-resistant strains, 161 sensitive strains and 39 drug-resistant strains were detected by microarray assay. Using the results of Roche scale method as the criterion, the sensitivity of gene chip assay for the detection of drug resistance of RFP was 85.0% and 97.5% respectively, the specificity and coincidence rates were 82.8% and 91.0%, respectively, and the sensitivity, specificity and coincidence rate for detection of drug resistance of INH were 82.8% and 91.0%, respectively. Conclusion the microarray method can be used to screen the drug-resistant strains of Mycobacterium tuberculosis, and the diagnostic rate can be improved by combined detection with the drug sensitivity test of tuberculous bacteria.
【作者单位】：山东省青岛市胸科医院结核科;山东省青岛市胸科医院检验科;山东省青岛市胸科医院;山东省青岛市第九人民医院内科;山东省无棣县佘家镇卫生院;
【基金】：青岛市科技局公共领域科技支撑计划课题(No:13-1-3-65-nsh)
【分类号】：R440

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