高强度荧光分枝杆菌噬菌体Ф2GFP10检测结核分枝杆菌对抗结核药物耐药性的价值  

Evaluation of a High-intensity Fluorescent Fluorophage Method for Diagnosis of Drug-resistance in Tuberculosis

作　　者：罗晶晶 于霞[1] 马异峰 赵立平[1] 尚媛媛[1] 付育红[1] 黄海荣[1] 

机构地区：[1]首都医科大学附属北京胸科医院北京市结核病胸部肿瘤研究所耐药结核病研究北京市重点实验室,101149

出　　处：《结核病与胸部肿瘤》2017年第4期250-255,共6页Tuberculosis and Thoracic Tumor

基　　金：首都卫生科研发展专项青年项目（2016-4-1042）

摘　　要：目的探讨高强度荧光分枝杆菌噬菌体Ф2GFP10检测MTB对抗结核药物耐药性的价值。方法选取北京胸科医院2014年4-6月疑诊耐药结核病患者的MTB临床分离株128株，用Ф2GFP10噬菌体法测定其对异烟肼、利福平和链霉素的敏感度，并以罗氏药敏试验结果为对照评价其诊断价值。采用SPSS17．0软件绘制荧光酶标仪法的受试者工作曲线，并确定临界值。结果Ф2GFP10荧光噬菌体法检测异烟肼、利福平和链霉素的敏感度分别为100．0％（62／62）、98．1％（53／54）和92．6％（50／54），特异度分别为84．8％（56／66）、91．9％（68／74）和91．9％（68／74）。噬菌体法和传统检测方法对异烟肼、利福平和链霉素耐药性检测的一致性分别为0．92、0．95和0．92。噬菌体法检测利福平和链霉素的耐药性2d即可获得结果，而异烟肼为3d。结论Ф2GFP10噬菌体法检测利福平、异烟肼和链霉素耐药的敏感度和特异度较高，且耗时短、成本低，有望成为一种快速、简便、经济的耐药结核病筛选方法。Objective To evaluate the high-intensity green fluorescent protein fluorophage Ф2GFP10 method for drug susceptibility testing of tuberculosis for isoniazid （INH）, rifampin （RIF）, and streptomycin （SM）. Methods A total of 128 clinical M. tuberculosis strains were isolated from patients with suspected drug-resistant tuberculosis visiting Beijing Chest Hospital （Beijing, China） from April to June 2014.A11 of the isolates were tested by the phage assay, while conventional drug susceptibility tests were performing on Lwenstein-Jensen culture medium as reference. Results The sensitivities of Ф2GFP10 assay for INH, RIF, and SM resistance detection were 100.0%, 98.1% （53/54）, and 92.6% （50/54）, respectively, while their speeificities were 84.8% （56/66）, 91.9% （68/74）, and 91.9% （68/74）, respectively. The agreement between the phage assay and the conventional assay for detecting 1NH, RIF, and SM resistance was 0.92, 0.95 and 0.92, respectively. The Ф2GFP10-hage assay could be done within 2 days for RIF and SM, and 3 days for INH. Conclusions The Ф2GFP10-phage method for drug susceptibility test is very sensitive and specific. The method has the potential to be a valuable, rapid and economical screening method for detecting drug-resistant tuberculosis.

关 键 词：分枝杆菌 结核 分枝杆菌噬菌体 

分 类 号：R378.91[医药卫生—病原生物学]