噬菌体法检测结核分枝杆菌乙胺丁醇耐药性的研究  

Comparison between bacteriophage-based assay and BACT/ALLET3D system in detection of etham butol resistance in Mycobacterium tuberculosis

作　　者：吴俐健[1] 张含玉[1] 陈述元[1] 王笑歌[1] 

机构地区：[1]中国医科大学附属第四医院,辽宁沈阳110032

出　　处：《临床内科杂志》2010年第10期672-674,共3页Journal of Clinical Internal Medicine

摘　　要：目的 建立噬菌体生物扩增法（PhaB法）快速测定乙胺丁醇耐药性的实验体系,探讨PhaB法在测定结核分枝杆菌乙胺丁醇耐药性的应用价值.方法 应用PhaB法测定115株临床分离结核分枝杆菌耐药性,并与BacT/ALERT 3D药敏试验结果相比较,对耐药性测定结果不一致的菌株测定其最低抑菌浓度.结果 115株结核分枝杆菌临床分离株中经BacT/ALERT 3D测定敏感89株,耐药26株;PhaB法测定敏感93株,耐药22株.两种方法测定均为敏感87株,均为耐药20株,两种方法测定药敏结果相符率为93.0%;结果不符8株,不符合率6.96%.如以BacT/ALERT 3D药敏结果为判断标准,则PhaB法检测乙胺丁醇耐药性的敏感性为76.9%（20/26）,特异性为97.8%（87/89）,阳性预测值为90.9%（20/22）,阴性预测值为93.5%（87/93）,准确性为93.0%（107/115）.结论 PhaB法检测结核分枝杆菌乙胺丁醇耐药性只需3天时间,操作简便,不需特殊仪器设备,可作为结核分枝杆菌乙胺丁醇耐药性快速筛选方法之一.Objective To set up phage amplified biologically assay（PhaB） for rapid detection etham butol（EMB） resistance and to evaluate the use of PhaB in the detection of EMB resistance of Mycobacterium tuberculosis （MTB）. Methods To detect the EMB resistance of 115 clinical isolates of MTB by PhaB and compare it with the results of BACT/ALLET3D system. The minimal inhibitory concentration （MIC） was detected for all zhe discrepant isolates. Results Of all the 115 strains of MTB clinical isolates 89 strains were EMB-susceptible and 26 strains were EMB - resistant with BACT/ALLET3D system while 93 strains were EMB-susceptible and 22 strains were EMB-resistant with PhaB. 87 Of the 115 strains were EMB-susceptible and 20 strains were EMB- resistant with the two methods. The concordant isolates indeter- mination of EMB resistance were 107 strains in the two methods and the concordance rate was 93.0%. The disconcordant isolates were 8 strains and the discrepancy rate was 6.96%. The sensitivity, specificity, posi- tive and negative predictive value as well as overall accuracy for the PhaB assay was 76.9% （20/26） , 97.8% （87/89）, 90.9% （ 20/22 ）, 93.5% （ 87/93 ）, 93.0% （ 107/115 ） respectively if the judgment standard was adopted by BACT/ALLET3D method. Conclusions The PhaB assay can be used for detection of EMB resistance in isolates of MTB easily and quickly in three days. This method do not need special instrument and may be used in rapid screening method for resistance of MTB.

关 键 词：分枝杆菌 结核 微生物敏感试验 噬菌体 乙胺丁醇 

分 类 号：R521[医药卫生—内科学]