线性探针技术诊断HIV/结核分枝杆菌感染者结核菌耐药性效能评价  

Evaluating the performance of line probe assay in the diagnosis of drug-resistant Mycobacterium tuberculosis in HIV/MTB co-infection patients

作　　者：韦善求 麻秋英 罗顺达 倪祖彥 韦善君[2] WEI Shan-qiu;MA Qiu-ying;LUO Shun-da;NI Zu-yan;WEI Shan-jun(Laboratcry Medicine,the Fourth People's Hospital of Nanning,Guangxi AIDS Clinical Treatment Center Nanning Infectious Disease Hospital Affiliated to Guangxi Medical University,530023,China)

机构地区：[1]南宁市第四人民医院、广西艾滋病临床治疗中心、广西医科大学附属南宁市传染病医院检验科,530023 [2]中央民族大学生命与环境学院,北京100081

出　　处：《传染病信息》2018年第6期558-562,共5页Infectious Disease Information

基　　金：南宁市科学研究与技术开发计划项目(20143146)

摘　　要：目的评价线性探针技术(line-probe assay, LipA)检测HIV/结核分枝杆菌(Mycobacterium tuberculosis, MTB)感染者耐药结核菌的效能,并探讨耐药结核菌基因突变特征。方法采用LipA和药物敏感(药敏)试验绝对浓度法检测HIV/MTB感染者涂阳痰标本和临床分离株中MTB对利福平(rifampicin, RFP)及异烟肼(isoniazid, INH)的耐药性,以药敏试验结果为标准评价LipA的检测效能,统计耐药MTB基因突变型。结果 LipA对涂阳痰标本和临床分离株中MTB耐RFP的检测结果与药敏试验结果完全一致,对耐INH的检测结果与药敏试验结果比较,kappa=0.969(P <0.05),耐RFP株及耐INH株的主要基因突变位点分别是rpoB S531L(80.00%)和katG 315(82.76%)。结论 LipA检测HIV/MTB感染者MTB耐RFP和INH的诊断与药敏试验结果一致,主要基因突变位点与结核病总体人群相似,适用于HIV/MTB感染者耐多药结核病的快速筛查。Objective To evaluate the performance of line probe assay(LipA)in the diagnosis of drug-resistant Mycobacterium tuberculosis(MTB)and analyze the mutation characters of MTB in HIV/MTB co-infection patients.Methods LipA and drug sensitivity test(DST)performed by absolute concentration method were used to detect the rifampicin(RFP)and isoniazid(INH)tolerant mutants in smear-positive sputum samples and clinical MTB isolates.The performance of LipA in the detection of drug-resistant MTB was evaluated based on the DST results,and the gene characters of MTB mutants were analyzed.Results The detection results between LipA and DST were completely identical for RFP-resistant MTB in smear-positive sputum samples and clinical MTB isolates,and showed a kappa value of0.969(P<0.05)for INH-resistant mutants.rpoB S531L(80.00%)and katG315(82.76%)were the main mutation sites in RFP-and INH-resistant strains.Conclusions The performance of LipA is highly consistent with the DST in detecting RFP-and INH-resistant MTB for the HIV/MTB co-infection.The main mutation sites from the HIV/MTB co-infection are similar to those from normal tuberculosis cases.LipA is a reliable tool to detect multi-drug resistant tuberculosis for HIV/MTB co-infection rapidly.

关 键 词：人类免疫缺陷病毒 结核分枝杆菌 线性探针 耐药 

分 类 号：R52[医药卫生—内科学]