四种不同方法对结核分枝杆菌的检测结果比较及其耐药情况分析  

Comparison of four different methods for mycobacterium tuberculosis and analysis of drug resistance in bacterial culture

作　　者：施维 李宗光[2] 宇芙蓉[1] 陈谨[1] 杨凯 SHI Wei;LI Zong-guang;YU Fu-rong;CHEN Jin;YANG Kai(Anhui Medical College,Hefei 230601,Anhui;Anqing Municipal Hospital,Anqing 246003,Anhui)

机构地区：[1]安徽医学高等专科学校,安徽合肥230601 [2]安庆市立医院检验科,安徽安庆246003

出　　处：《安徽医专学报》2025年第1期83-85,90,共4页Journal of Anhui Medical College

基　　金：安徽省教育厅重点自然科学基金(编号:KJ2020A0863);安徽省高等学校质量工程项目(编号:2022jnds028,2023kcsz152)。

摘　　要：目的:探讨传统和现代分子生物学等四种检测方法对结核杆菌的检测及耐药性分析的价值。方法:收集587例疑似肺结核的患者,利用抗酸染色法、罗氏培养法、恒温核酸检测法、结核分枝杆菌及利福平耐药基因检测(Gene Xpert MTB/RIF)4种方法对患者痰液进行检测和对阳性菌株进行药敏实验。结果:587例疑似患者标本中,经临床诊断为结核病患者468例,非结核病患者119例,其中抗酸染色法、罗氏培养法、恒温核酸检测法、Gene Xpert MTB/RIF检测法的阳性检出率和敏感度分别为20.10%、25.21%;49.57%、62.18%;56.90%、71.37%;70.87%、88.89%。对罗氏培养的291株结核分枝杆菌进行药敏实验,其中耐药株共58株,耐药率最高的前三位药物分别为异烟肼(14.09%)、链霉素(11.34%)、利福平(8.25%)。确诊结核患者总耐药率为19.93%,单耐药率为5.15%,多耐药率为6.87%,耐多药率为7.90%。结论:分子生物学法优于传统方法,且有统计学意义。安庆地区耐多药率和多耐药率较高,应加强耐药性结核的管理和规范化治疗。Objective:To explore the detection of Mycobacterium tuberculosis and the analysis of its drug resistance using both traditional and molecular biology approaches.Method:A total of 587 patients suspected of having pulmonary tuberculosis were enrolled.Sputum samples were collected and examined by four methods,namely sputum smear acid-fast staining,Lowenstein-Jensen culture medium,constant temperature nucleic acid detection technology,and GeneXpert MTB/RIF assay.Simultaneously,drug sensitivity tests were performed on the positive strains.Results:Among the 587 patients,468 were clinically diagnosed with tuberculosis and 119 were non-tuberculosis cases.The positive and sensitivity rate of sputum smear,Roche culture method,the constant temperature nucleic acid detection method and Gene Xpert MTB/RIF assay were 20.1%and 25.21%;49.57%and 62.18%;56.90%and 71.37%;70.87%and 88.89%,respectively.A drug sensitivity test was conducted on 291 strains of Mycobacterium tuberculosis cultured in Roche,among which 58 strains were resistant.The top three drugs with the highest resistance rates were isoniazid 14.09%,streptomycin 11.34%,and rifampicin 8.25%,respectively.The total drug resistance rate of confirmed tuberculosis patients was 19.93%,the single drug resistance rate was 5.15%;poly-drug resistance rate rate was 6.87%and multi-drug resistance rate is 7.90%.Conclusion:Molecular biology methods are superior to traditional ones,and has statistical significance.The poly-drug resistance rate and multi-drug resistant rate are relatively high in Anqing area.Therefore,the management and standardized treatment of drug-resistant tuberculosis should be strengthened.

关 键 词：结核分枝杆菌 耐药性 Gene X-pert MTB/RIF检测 罗氏培养 恒温核酸 

分 类 号：R378.911[医药卫生—病原生物学]