线性探针耐药技术对两种方法培养的结核分枝杆菌药敏结果差异评价

发布时间：2018-09-01 16:10

【摘要】：目的比较BACTEC MGIT 960液体培养法和比例法培养出的结核分枝杆菌(MTB)对利福平(RFP)和异烟肼(INH)药敏结果的符合性,探讨不同方法下药敏结果不一致的原因和线性探针耐药技术对临床诊断的价值。方法从378例临床分离结核分枝杆菌中筛选出29株两种方法药敏结果不一致菌株,再用线性探针耐药检测技术检测MTB对RFP和INH耐药相关的rpoB、katG和inhA基因8个位点的基因突变判断其耐药性,比较三者结果的符合率。结果 BACTEC MGIT 960液体法和比例法药物敏感性试验检测MTB对RFP、INH耐药性符合率分别为89.1%和88.9%;线性探针耐药法和BACTEC MGIT 960液体法对RFP、INH耐药性符合率分别为100.00%和94.44%;线性探针耐药法和比例法和对RFP、INH耐药性符合率分别为87.5%和82.35%;线性探针耐药法分析29株MTB中发现有12株可能存在异质性耐药。结论线性探针耐药法和BACTEC MGIT 960液体法对RFP、INH耐药性符合率明显高于线性探针耐药法和比例法;线性探针耐药检测技术比表型耐药更具精确、快速、敏感性高的特点,对结核分枝杆菌的耐药监测和早期治疗方案的确立具有重要意义。
[Abstract]:Objective To compare the susceptibility of Mycobacterium tuberculosis (MTB) to rifampicin (RFP) and isoniazid (INH) cultured by BACTEC MGIT 960 liquid culture and proportioning method, and to explore the reasons for the inconsistency of drug susceptibility under different methods and the value of linear probe resistance technique in clinical diagnosis. Twenty-nine strains with inconsistent drug susceptibility between the two methods were screened, and the drug resistance of MTB to RFP and INH-related rpoB, katG and inhA gene mutations at eight loci were detected by linear probe drug resistance test. The coincidence rate of the results of the three methods was compared. The coincidence rates of resistance to RFP and INH were 89.1% and 88.9% respectively; the coincidence rates of resistance to RFP and INH were 100.00% and 94.44% respectively by linear probe method and BACTEC MGIT 960 liquid method; the coincidence rates of resistance to RFP and INH were 87.5% and 82.35% by linear probe method and proportion method respectively; 12 of 29 MTB strains were found to exist by linear probe method. Conclusion The coincidence rate of INH resistance to RFP by linear probe method and BACTEC MGIT 960 liquid method is significantly higher than that by linear probe method and proportional method. Legislation is of great significance.
【作者单位】：天津市海河医院预防科;国家中医药管理局中医药防治传染病重点实验室;天津市海河医院检验科;
【基金】：天津市卫生局基金资助项目(2014KZ035)
【分类号】：R446.5

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