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  

Value of linear probe resistance technique in evaluation of difference in drug susceptibility resting results of Mycobacterium tuberculosis cultured by MGIT 960liquid method and proportion method

作　　者：马莲英[1,2] 于维莉[1] 谢祎[1] 李雪 张丽霞[3] 

机构地区：[1]天津市海河医院预防科,天津300350 [2]国家中医药管理局中医药防治传染病重点实验室,天津300350 [3]天津市海河医院检验科,天津300350

出　　处：《中华医院感染学杂志》2016年第10期2229-2231,共3页Chinese Journal of Nosocomiology

基　　金：天津市卫生局基金资助项目(2014KZ035)

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。OBJECTIVE To investigate the conformance of drug susceptibility testing results of the Mycobacterium tuberculosis cultured by MGIT 960 liquid method and proportion method to rifampicin and isoniazid,explore the causes of the inconsistency,and assess the value of linear probe resistance technique in clinical diagnosis.METHODS A total of 29 strains of M.tuberculosis that were not consistent to the drug susceptibility testing results were screened from 378 clinical M.tuberculosis isolates,then linear probe resistance technique was used to detect the gene mutations of eight loci on rifampicin and isoniazid resistance-associated rpoB,katGand inhAgenes in the M.tuberculosis.The coincidence rates were compared among the three.RESULTS The coincidence rate of the BACTEC MGIT 960 liquid method and the proportion method was 89.1%in the drug susceptibly testing for rifampicin,88.9%in the drug susceptibility testing for isoniazid;the coincidence rate of the linear probe resistance technique and the BACTEC MGIT 960 liquid method was 100.00%in the drug susceptibility testing for rifampicin,94.44%in the drug susceptibility testing for isoniazid;the coincidence rate of the linear probe resistance technique and the proportion method was 87.5%in the drug susceptibility testing for rifampicin,82.35%in the drug susceptibility testing for isoniazid.The linear probe resistance analysis showed that of the 29 strains of M.tuberculosis,12 may be heterogeneously resistant to antibiotics.CONCLUSIONThe coincidence rate of the linear probe resistance technique and the BACTEC MGIT 960 liquid method is significantly higher than that of the linear probe resistance technique and the proportion method in the drug susceptibility testing for rifampicin and isoniazid.The linear probe resistance technique is more accurate,rapid,and sensitive than the phenotype drug resistance,and it is of great significance to the surveillance of drug resistance of M.tuberculosis and establishment of programs for early treatment.

关 键 词：线性探针耐药检测技术 BACTEC MGIT 960液体法 比例法 

分 类 号：R446.5[医药卫生—诊断学]