3种结核分枝杆菌耐药检测方法的对比研究  

Comparative study on three methods for detecting drug resistance of Mycobacterium tuberculosis

作　　者：薛建昌 吴海峰[1] 郑浩[2] 张建武[1] 张金艳[3] 王国英 XUE Jian-chang;WU Hai-feng;ZHENG Hao;ZHANG Jian-wu;ZHANG Jin-yan;WANG Guo-ying(Department of Laboratory,Hebei Chest Hospital,Shijiazhuang 050041,China;Department of Ultrasound,Hebei Chest Hospital,Shijiazhuang 050041,China;Department of Laboratory,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China;Department of Medical Imaging,the People′s Hospital of Tangxian,Hebei Province,Tanxian 072350,China)

机构地区：[1]河北省胸科医院检验科,河北石家庄050041 [2]河北省胸科医院超声科,河北石家庄050041 [3]河北医科大学第四医院检验科,河北石家庄050011 [4]河北省唐县人民医院影像科,河北唐县072350

出　　处：《河北医科大学学报》2019年第11期1312-1316,共5页Journal of Hebei Medical University

基　　金：河北省医学科学研究重点课题(20170424)

摘　　要：目的比较BACTEC MGIT 960药敏法(BD960)、噬菌体生物扩增法(pha B)、荧光定量PCR探针熔解曲线法(PCR法)3种方法检测结核分枝杆菌耐药的临床效能,并评估其应用价值。方法收集结核分枝杆菌阳性的临床分离株,采用BD960法、pha B法和PCR法检测抗结核一线药物耐药情况,比较3种方法的检测结果。结果pha B法和PCR法平均报告时间明显短于BD960法,PCR法平均报告时间明显短于pha B法,差异有统计学意义(P<0.05)。3种方法对80株临床分离株进行链霉素(streptomycin,SM)、异烟肼(isoniazid,INH)、利福平(rifampin,RFP)和乙胺丁醇(ethambutol,EMB)耐药检测,耐药检出结果差异均无统计学意义(P>0.05)。以BD960法检测结果作为对照,pha B法对SM、INH和RFP耐药检测结果均为高度一致,对EMB检测结果为中度一致;PCR法对INH和RFP耐药检测结果高度一致,对SM和EMB检测结果为中度一致。结论应用PCR法和pha B能快速筛查结核分枝杆菌对一线抗结核药物的耐药情况。Objective To compare the clinical efficacy of BACTEC MGIT 960 drug sensitivity method(BD960),bacteriophage biological amplification(pha B)and fluorescence quantitative PCR probe melting curve method in detecting drug resistance of Mycobacterium tuberculosis,and to evaluate its application value.Methods The clinical isolates were identified as the positive clinical isolates of Mycobacterium tuberculosis.The results of the three methods were compared and analyzed by using the BD960,pha B and PCR at the same time.Results The average reporting time of pha B method and PCR method was significantly shorter than that of BD960 method,and PCR method was significantly shorter than that of pha B method,and the difference was statistically significant(P<0.05).At the same time,the resistance of 80 clinical isolates were detected by streptomycin,isoniazid,rifampicin and ethambutol,and there was no significant difference between the three methods(P>0.05).BD960 method was used as the control,the resistance of streptomycin(SM),isoniazid(INH)and rifampin(RFP)by phaB was highly consistent,and that of ethambutol(EMB)was moderate.The results of PCR resistance to INH and RFP were highly consistent and that of SM and EMB were moderate.Conclusion The resistance of Mycobacterium tuberculosis to first-line antituberculosis drugs can be quickly screened by fluorescence quantitative PCR probe melting curve and bacteriophage biological amplification.

关 键 词：结核分枝杆菌 抗药性 对比研究 

分 类 号：R378.911[医药卫生—病原生物学]