结核菌及其耐药性不同检测方法的临床应用评价

发布时间：2018-07-10 10:20

  本文选题：结核分枝杆菌 + 罗氏培养法　； 参考：《广东医学》2017年02期

【摘要】：目的对目前临床上用于检测结核分枝杆菌(MTB)及其耐药性的传统及分子生物学方法进行系统评价,为设计合理的诊断路径提供指导意义。方法对标准菌株(H37Rv)、敏感、单耐及耐多药MTB进行梯度浓度稀释后,作为评估的实验样本,从检测结果的准确性、检测周期、最低检出限方面对不同方法进行评价。结果MTB检测方面,XpertMTB/RIF检测MTB的检出下限(3×10~2cfu)与培养法相当,比基因芯片和GenoType~汶 MTBDRplus的检出下限低;耐药性检测方面,在MTB含量不足(≤3×10~2cfu)的情况下XpertMTB/RIF对利福平(RFP)的检测存在假阳性结果,GenoType~汶 MTBDRplus检测3×10~4cfu链霉素耐药MTB时出现RFP和异烟肼(INH)耐药的假阳性结果;检测周期方面,XpertMTB/RIF在2 h内可完成报告,基因芯片和GenoType~汶 MTBDRplus在当天8 h内可完成报告,培养及比例法药敏需4~8周可报告结果。结论目前不同的MTB及耐药检测方法各有优缺点,在临床应用方面应综合考虑患者的病情、经济状况等选取合理的诊断路径。
[Abstract]:Objective to systematically evaluate the traditional and molecular biological methods for the detection of Mycobacterium tuberculosis (MTB) and its drug resistance, and to provide guidance for the design of a reasonable diagnostic pathway. Methods the standard strain (H37Rv), sensitive, single resistant and multidrug resistant MTB were diluted with gradient concentration, and evaluated from the accuracy of test results, detection period and minimum detection limit. Results the detection limit (3 脳 10~2cfu) of XpertMTB / RIF was similar to that of culture, and lower than that of gene chip and genotype MTB DRplus. Under the condition of insufficient MTB content (鈮，

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