两种方法检测结核分枝杆菌利福平耐药性比较  

Comparison of Two Methods for the Detection of Rifampicin Resistance in Mycobacterium Tuberculosis

作　　者：姚银钗 梁启德 蒋敏 Yao Yinchai;Liang Qide;Jiang Min(Department of Laboratory Medicine,Guangzhou Chest Hospital,Guangzhou,Guangdong Province,510095 China)

机构地区：[1]广州市胸科医院检验科,广东广州510095

出　　处：《系统医学》2022年第7期59-62,共4页Systems Medicine

摘　　要：目的对比PCR熔解曲线与Gene Xpert MTB两种方法在结核分枝杆菌利福平耐药性检测中的效果。方法选取2020年8—12月该院肺结核患者151例及其他呼吸道疾病患者20例的痰液标本,通过PCR熔解曲线、Gene Xpert MTB对两组痰液标本开展检测,分析两种方式在检测结核分枝杆菌中的符合率,同时将BD快速药敏作为金标准,统计两种检测方式对利福平耐药性的检测准确度、敏感度、特异度情况。结果151例肺结核患者经Gene Xpert MTB法显示结核分枝杆菌阳性率92.72%,PCR熔解曲线显示阳性率93.38%。两种方法检测结果符合率96.69%。20例其他呼吸道病患者中2例经Gene Xpert MTB检测显示结核分枝杆菌均为阴性,经PCR熔解曲线显示为阳性。PCR熔解曲线对利福平耐药的检测准确度、敏感度及特异度为99.28%、95.45%、100.00%和Gene Xpert MTB法的98.55%、90.91%、100.00%比较,差异无统计学意义(χ^(2)=0.337、0.358、0.000,P>0.05)。结论经PCR熔解曲线与Gene Xpert MTB两种方法均能有效、准确地对结核分枝杆菌与利福平耐药性开展检测,在早期筛查耐药结核病中有重要作用。Objective To compare the effects of PCR melting curve and Gene Xpert MTB methods in the detection of rifampicin resistance in Mycobacterium tuberculosis.Methods The sputum samples of 151 patients with pulmonary tuberculosis and 20 patients with other respiratory diseases in the hospital from August to December 2020 were collected.The two groups of sputum samples were detected by PCR melting curve and Gene Xpert MTB.The coincidence rate of the two methods in the detection of Mycobacterium tuberculosis was analyzed.At the same time,BD rapid drug susceptibility was used as the gold standard,and the detection accuracy,sensitivity and specificity of the two detection methods for rifampicin resistance were counted.Results The positive rate of Mycobacterium tuberculosis in 151 patients with pulmonary tuberculosis was 92.72%by Gene Xpert MTB method,and the positive rate was 93.38%by PCR melting curve.The coincidence rate of the detection results of the two methods was 96.69%.Two of the 20 patients with other respiratory diseases were negative for Mycobacterium tuberculosis by Gene Xpert MTB test,and positive by PCR melting curve.The detection accuracy,sensitivity and specificity of PCR melting curve for rifampicin resistance were 99.28%,95.45%,100.00%,compared with the 98.55%,90.91%,100.00%of Gene Xpert MTB method,and the difference was not statistically significant(χ^(2)=0.337,0.358,0.000,P>0.05).Conclusion The two methods of PCR melting curve and Gene Xpert MTB can effectively and accurately detect the resistance of Mycobacterium tuberculosis and rifampicin.It plays an important role in early screening of drug-resistant tuberculosis.

关 键 词：结核分枝杆菌 PCR熔解曲线 Gene Xpert MTB 耐药性 敏感度 特异度 

分 类 号：R378.911[医药卫生—病原生物学]