线性探针快速诊断耐药结核的应用价值评价

发布时间：2018-07-25 12:32

【摘要】：目的评价线性探针法快速诊断耐药结核的应用价值。方法对99株结核分枝杆菌分离株采用Geno Type MTBDRplus和MTBDRsl试剂盒进行利福平、异烟肼、氧氟沙星、卡那霉素、乙胺丁醇五种药物的耐药快速检测,与传统药物敏感性试验结果比较,评价其诊断试验的真实性。结果 Geno Type MTBDRplus检测利福平、异烟肼耐药的灵敏度和特异度分别为100%和50%、86.11%和47.06%。Geno Type MTBDRsl检测氧氟沙星、卡那霉素、乙胺丁醇耐药的灵敏度分别为94.74%、62.50%、58.82%,特异度分别为92.59%、98.81%、91.67%。结论线性探针法Geno Type MTBDRplus用于检测利福平耐药具有较高的灵敏度,Geno Type MTBDRsl用于检测氧氟沙星耐药的灵敏度和特异度均较满意,可用于对疑似耐药患者进行早期快速检测。对异烟肼耐药的检测结果与其他报导差异较大,需要进一步验证后决定是否适合推广。卡那霉素和乙胺丁醇耐药机制不完全明确,线性探针的灵敏度较低,尚不适宜广泛应用于临床。
[Abstract]:Objective to evaluate the application value of linear probe method in rapid diagnosis of drug-resistant tuberculosis. Methods 99 strains of Mycobacterium tuberculosis were tested for resistance to rifampicin, isoniazid, ofloxacin, kanamycin and ethambutanol by Geno Type MTBDRplus and MTBDRsl kit. To evaluate the authenticity of the diagnostic test. Results the sensitivity and specificity of Geno Type MTBDRplus for the detection of rifampicin and isoniazid resistance were 100% and 50%, respectively. The sensitivity of 47.06%.Geno Type MTBDRsl for the detection of ofloxacin, kanamycin and ethambutanol were 94.7474, 62.50 and 58.82, respectively. The specificity of isoniazid resistance was 92.59% and 91.67%, respectively. Conclusion Geno Type MTBDRplus has high sensitivity in detecting rifampicin resistance. Geno Type MTBDRsl has satisfactory sensitivity and specificity in detecting ofloxacin resistance, and can be used for early rapid detection of suspected drug resistance. The results of isoniazid resistance test are different from other reports, and need further verification to decide whether it is suitable for popularization. The mechanism of kanamycin and ethambutanol resistance is not completely clear, and the sensitivity of linear probe is low, so it is not suitable for clinical application.
【作者单位】：南京医科大学公共卫生学院流行病学系;连云港市疾病预防控制中心慢性传染病防制科;江苏省疾病预防控制中心慢性传染病防制所;健康领域社会风险预测治理协同创新中心;
【基金】：国家自然科学基金(81473027) 江苏高校哲学社会科学研究基金(2014SJB164) 江苏省青蓝工程(2014) 江苏省六大人才高峰(2014-YY-023) 美国中华医学基金会中国卫生技术评估联合项目(CMB13-153)
【分类号】：R52

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