液体MGIT培养与改良罗氏培养方法在HIV感染与AIDS患者结核病筛查中的对比研究  

Compare liquid MGIT culture and modified L-J culture in detection of mycobacterium in HIV/AIDS patients

作　　者：覃慧芳[1] 林玫[1] 崔哲哲[1] 罗丹[1] 区进[1] 叶婧[1] 黄莉雯[1] 蓝如束[1] 

机构地区：[1]广西壮族自治区疾病预防控制中心结核病防制所,南宁530028

出　　处：《中国防痨杂志》2016年第10期832-837,共6页Chinese Journal of Antituberculosis

基　　金：广西医药卫生适宜技术推广项目（S201310-04）;广西卫生厅课题（Z2015446,Z2015447）

摘　　要：目的比较液体分枝杆菌培养管（MGIT）培养与改良罗氏培养方法在HIV感染与AIDS患者中检测分枝杆菌的效果。方法2013年1月至2015年12月在广西壮族自治区南宁市、来宾市和贵港市就诊的HIV感染与AIDS患者中，选取未服用过抗结核药物的1684例HIV感染与AIDS患者，对所收集到的3368份痰标本同时使用液体MGIT培养与改良罗氏培养进行分枝杆菌分离培养。对两种培养方法的痰标本阳性检出率、污染率，结核分枝杆菌复合群、非结核分枝杆菌（NTM）感染患者的阳性检出率，以及在无肺结核主要临床症状、胸片无异常，但是痰培养结果为阳性的患者及活动性肺结核患者的阳性检出率的差异进行比较。结果在1684例患者的3368份痰标本中，液体MGIT培养分枝杆菌阳性检出率（15．5％，522／3368）高于改良罗氏培养法（11．6％，392／3368），差异有统计学意义（χ^2=95．64，P=0．000）；液体MGIT培养污染率（7．0％，235／3368）高于改良罗氏培养法（3．4％，115／3368），差异有统计学意义（χ^2=85．31，P=0．000）；液体MGIT培养在结核分枝杆菌复合群感染患者中阳性检出率为88．7％（149／168），在NTM感染患者中阳性检出率为91．30（115／126），均高于改良罗氏培养[分别为78．6％（132／168）和62．7％（79／126）]，差异均有统计学意义（χ^2=4．66，P=0．031；χ^2=21．12，P=0．000）；液体MGIT培养在无肺结核主要临床症状和胸片无异常、但是痰培养结果为阳性的患者及诊断为活动性肺结核的患者中阳性检出率分别为8．0％（63／785）和62．0％（176／284），均高于改良罗氏培养[分别为5．7％（45／785）和48．2％（137／284）]，差异均有统计学意义（χ^2=9．63，P=0．002；χ^2=28．31，P=0．000）。结论在HIV感染与AIDS患者中进行结核病筛查，液体MGIT培养方法阳性检出率优于改良罗氏培养，但Objective To compare the effect of liquid MGIT culture with modified L-J culture in detection of mycobacterium in HIV/AIDS patients. Methods A total of 1684 HIV/AIDS patients without treatment of anti- tuberculosis from Nanning, Laibin and Guigang of Guangxi between January, 2013 and December 2015 were selected, and 3368 sputum from the patients were treated with both liquid MGIT culture and modified L-J culture in detection of mycobacteriurn, Positive and pollution rates of sputum samples, Mycobacterium tuberculosis complex group, positive rate of non-tuberculosis mycobacterium （NTM） were collected, positive rates of culture positive paitents without clinical symptoms or abmormal X-ray imaging and active pulmonary tuberculosis were compared. Results of the 3368 sputum specimen from 1684 patients, the positive rate o[ liquid MGIT culture （15.5%, 522/3368） was significantly higher than that of modified L-J culture （11.6%, 392/3368） （χ^2=95.64, P=0. 000） ; the culture pollution rate of liquid MGIT culture （7.0%, 235/3368） was also significantly higher than that of modi- fied L-J culture （3.4%, 115/3368） （χ^2=85.31, P=0. 000）. Using liquid MGIT culture, the positive rates of patients with Mycobacterium tuberculosis complex group infection （88.7%, 149/168） and patients with NTM infection （91.3%, 115/126） were significantly higher than those using modified L-J culture （78.6% （132/168） and 62.7% （79/126）, respectively） （χ^2=4. 66, P=0. 031; χ^2=21.12, P=0. 000）; so were positive rates of culture positivepaitents without clinical symptoms or abmormal X-ray imaging and active pulmonary tuberculosis （8. 0% （63/785） vs. 5.7% （45/785）,χ^2=9.63, P=0. 002; 62.0% （176/284） vs. 48.2% （137/284）, χ^2 =28.31, P=0. 000）. Conclusion Positive rate and pollution rate of liquid MGIT culture were higher than modified L-J culture in detection of mycobacterium among HIV/AIDS patients. Combination of the two methods could improve the positive rate of tuberculosis

关 键 词：分枝杆菌 结核 HIV感染 重叠感染 细菌学技术 对比研究 

分 类 号：R378.911[医药卫生—病原生物学]