BACTEC MGIT 960液体培养与金胺O抗酸染色对疑似结核病患者的诊断价值  

Diagnostic values of BACTEC MGIT 960 system and Auramine O fluorescent staining method for detection of Mycobacterium tuberculosis

作　　者：甄国东 茅利明[2] 赵斐[2] 李三验[2] 单平囡[2] ZHEN Guo-dong MAO Li-ming ZHAO Fei LI San-yan SHAN Ping-nan(Shaoxing Keqiao Women and Children ＇ s Hospital, Shaoxing 312030, China)

机构地区：[1]浙江省绍兴市柯桥区妇幼保健院检验科,312030 [2]中国医科大学绍兴医院检验科

出　　处：《结核病与肺部健康杂志》2016年第4期344-347,共4页Journal of Tuberculosis and Lung Health

摘　　要：选取2014年1月至2015年12月在中国医科大学绍兴医院检查的疑似结核病患者1570例,同时进行患者痰标本金胺O抗酸染色与BACTEC MGIT 960液体培养系统（简称“BACTEC MGIT 960”）检测分枝杆菌.疑似患者1570例痰标本经金胺O抗酸染色检测,阳性243例,阴性1327例,阳性率15.5％ （243/1570）.经BACTEC MGIT 960培养后,375例标本仪器报阳,经金胺O抗酸染色检测：阳性303例,阴性33例,液体培养污染39例.375例送浙江大学附属第一医院传染病研究所进行基因检测,结果显示MTB 270例,NTM 48例,阴性57例（包括液体培养污染39例,金胺O抗酸染色阴性10例,金胺O抗酸染色阳性8例）;其余1195例患者均为阴性,培养物未送检.BACTEC MGIT 960液体培养分枝杆菌检测的真阳性率为20.3％（318/1570）,污染率2.5％（39/1570）.痰标本中金胺O抗酸染色阴性但BACTEC MGIT 960液体培养及基因检测为阳性患者75例,金胺O抗酸染色漏检率为4.8％（75/1570）.NTM感染在分枝杆菌肺病中占15.1％（48/318）.BACTEC MGIT 960液体培养法阳性率高于金胺（）抗酸染色法,但操作过程中影响因素多,需要注意污染;金胺O抗酸染色法报告时间短且价格低廉,但其漏检率高,两种方法在分枝杆菌肺病诊断中各有长短,应相互补充.The sputum specimens were collected from 1570 patients who visited our hospital from January 2014 to December 2015 and were suspected to have tuberculosis （TB）. Then the sputum fluorescent staining by using Auramine O staining method and the liquid culture by using BACTEC MGIT 960 system were performed. Among 1570 TB suspects, 243 cases were smear positive while 1327 cases were smear negative by using Auramine O fluorescent staining method, and the positive rate was 15.5 % （243/1570）. The examination results of BACTEC MIGT 960 showed that 375 cases were culture positive and 1195 cases were culture negative. The sputum samples of 375 cases with culture positive were smeared again using Auramine O staining method, and the results showed that 303 cases were smear positive, 33 cases were smear negative and 39 cases were contaminated. Gene testing was performed to the 375 culture positive cases and the results were as follows.- 270 cases were detected as MTB, 48 ca- ses were NTM and 57 cases were negative （including 39 cases with culture contamination, as well as 10 cases with Auramine O smear negative and 8 cases with Auramine O smear positive）. Finally, 318 cases were confirmed to be true positive and they were all culture positive in MGIT 960 system testing, so the true positive rate of MGIT 960 was 20. 3% （318/1570） and the contamination rate of MGIT 960 was 2.5% （39/1570）. Among 318 true cases, 75 cases were smear negative by using Auramine O staining method, so the missing rate of Auramine O method was 4.8% （75/1570）. The rate of NTM in the true case with mycobacterium infection was 15.1% （48/318）. The sensitivity of MGIT 960 is higher than Auramine O staining method. However, Auramine O method can rapidly report the examination results and has a lower price. We could combine the application of those two methods for TB detection.

关 键 词：分枝杆菌 结核 分枝杆菌 非典型性 临床实验室技术 对比研究 

分 类 号：R52[医药卫生—内科学] R446.5[医药卫生—临床医学]