3种常规结核分枝杆菌及耐药突变检测方法的对比研究

doi:10.3969/j.issn.1007-3205.2020.06.021

河北医科大学学报

3种常规结核分枝杆菌及耐药突变检测方法的对比研究

1.河北省胸科医院检验科，河北石家庄 050041；2.河北省胸科医院分子生物室，河北石家庄 050041；
3.河北省胸科医院超声室，河北石家庄 050041；4.河北女子职业技术学院护理系，河北石家庄 050091

出版日期:2020-06-25 发布日期:2020-06-29
作者简介:薛建昌（1977-），男，河北唐县人，河北省胸科医院主管检验师，医学硕士，从事微生物诊断研究。
基金资助:
河北省医学科学重点课题（20170424）

A comparative study of three different detection methods for Mycobacterium tuberculosis and drug-resistant mutations

1.Department of Laboratory, Hebei Chest Hospital, Shijiazhuang 050041， China; 2.Molecular
Biology Laboratory, Hebei Chest Hospital, Shijiazhuang 050041, China; 3.Department of
Ultrasound, Hebei Chest Hospital, Shijiazhuang 050041,China; 4.Department of
Nursing, Hebei Women′s Vocational College, Shijiazhuang 050091, China

Online:2020-06-25 Published:2020-06-29

摘要/Abstract

摘要： 目的评价3种实验室常规检测方法用于诊断肺结核患者结核分枝杆菌（Mycobacterium tuberculosis，MTB）及耐药突变情况的应用价值。
方法回顾性分析经临床确诊的肺结核患者246例，应用Gene Xpert MTB/RIF技术（Xpert法）、BD960液体快速培养法（BD960法）联合快速药物敏感试验（药敏试验）、MTB核酸检测联合MTB耐药基因（DNA芯片法）检测诊断 MTB及耐药突变检出情况。
结果 BD960法对MTB的阳性检出率低于MTB核酸检测和Xpert法，差异有统计学意义（P＜0.05）。药敏试验、MTB耐药基因检测和Xpert法利福平耐药检出率差异无统计学意义（P＞0.05）。与药敏试验利福平耐药结果相比，MTB耐药基因检测和Xpert法的敏感度、特异度、阳性预测值、阴性预测值、准确度和约登指数分别为91.30%、95.32%、84.00%、97.60%、94.47%、86.63%和95.65%、93.57%、80.00%、98.77%、94.01%、89.22%，X-pert 法和MTB耐药基因检测利福平耐药结果高度一致（Kappa值=0.833，0.840）。药物敏感试验和MTB耐药基因检测异烟肼耐药检出率差异无统计学意义（P＞0.05）。
结论 BD960法、Xpert法和MTB核酸检测均能准确检测样本中的MTB，药敏试验、MTB耐药基因检测和Xpert法能分析MTB利福平（异烟肼）耐药情况，MTB耐药基因检测和Xpert法且具有较高的敏感度和特异度，可结合实际需求在耐多药结核病防治中应用。

关键词: 结核分枝杆菌, 耐药, 临床实验室技术

Abstract: Objective To evaluate the application value of three routine detection methods in the laboratory for the diagnosis of Mycobacterium tuberculosis(MTB) and drug-resistant mutations in patients with tuberculosis.
Methods A retrospective study of 246 patients with tuberculosis who were positive for MTB was made. Gene Xpert MTB/RIF(Xpert method), BD960 liquid rapid culture method(BD960 method) combined with rapid drug sensitivity test(drug sensitivity test), and mycobacterial nucleic acid test(TB-DNA method) combined with MTB drug resistance gene test(DNA chip method) tests were performed to assess the detection of three MTB and drug-resistant mutations.
Results The positive detection rate of MTB by BD960 method was lower than that of TB-DNA method and Xpert method, the difference was statistically significant(P＜0.05). There was no significant difference in drug sensitivity test, MTB resistance gene detection and Xpert rifampicin resistance detection rate(P＞0.05). Compared with the rifampicin resistance test results, the sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and Youden index of the DNA chip method and Xpert method were 91.30%, 95.32%, 84.00%, 97.60%, 94.47%, 86.63% and 95.65%, 93.57%, 80.00%, 98.77%, 94.01%, 89.22%, The results of rifampin resistance detected by X-Pert and MTB are highly consistent(Kappa value=0.833, 0.840). There was no significant difference in the detection rate of isoniazid resistance between drug sensitivity test and MTB resistance gene detection(P＞0.05).
Conclusion The BD960 method, Xpert method and TB-DNA method can accurately detect MTB in samples. Drug susceptibility test, DNA chip method and Xpert method can analyze the resistance of MTB rifampicin(isoniazid). MTB resistance gene detection and Xpert method have high sensitivity and specificity, which can be applied in MDR-TB control according to the actual needs.

Key words: mycobacterium tuberculosis, drug-resistant, clinical laboratory techniques

薛建昌1，邸红芹2，吴海峰1，郑浩3*，郑立恒1，梁冰锋4. 3种常规结核分枝杆菌及耐药突变检测方法的对比研究[J]. 河北医科大学学报, doi: 10.3969/j.issn.1007-3205.2020.06.021.

XUE Jian-chang1, DI Hong-qin2, WU Hai-feng1, ZHENG Hao3*, ZHENG Li-heng1, LIANG Bing-feng4. A comparative study of three different detection methods for Mycobacterium tuberculosis and drug-resistant mutations[J]. Journal of Hebei Medical University, doi: 10.3969/j.issn.1007-3205.2020.06.021.

[1]	高静韬, 刘宇红. 《德拉马尼临床应用专家共识》解读 [J]. 河北医科大学学报, 2023, 44(5): 497-501,511.
[2]	张文超, 赵梦川, 何宝花, 贾肇一, 李梅, 郭映辉. 血流感染患儿流感嗜血杆菌流行特征及耐药性 [J]. 河北医科大学学报, 2023, 44(12): 1467-1471.
[3]	翟文静, 仇永乐, 刘珊珊, 刘铁军, 吕飞飞. miRNA对口腔鳞状细胞癌化疗耐药性的调控机制研究 [J]. 河北医科大学学报, 2023, 44(10): 1133-1140.
[4]	刘星, 董长征, 周笋, 康进生, 马万东. 迷走神经刺激术治疗难治性癫痫的临床效果及对认知功能的影响 [J]. 河北医科大学学报, 2022, 43(7): 792-795,826.
[5]	张艳, 赵淑珍, 何静, 张婷. 绿原酸、c-di-GMP、人杀菌肽LL-37对铜绿假单胞菌生物被膜耐药性的影响 [J]. 河北医科大学学报, 2022, 43(6): 721-726.
[6]	刘泽世, 呼瑞, 李靖, 殷鉴, 耿燕, 白露. 胶体金免疫层析法快速检测血培养肠杆菌目细菌碳青霉烯酶的对比研究[J]. 河北医科大学学报, 2022, 43(2): 218-222.
[7]	蔺晓萱1，谢立新2（综述），霍炳杰3，王常乐3*（审校）. 嗜麦芽窄食单胞菌耐药机制及治疗策略的研究#br#[J]. 河北医科大学学报, 2020, 41(9): 1112-1116.
[8]	贾晨光，刘丰胜，姚晓伟，高建国，白洪忠*. 骨关节结核不同类型标本进行Xpert MTB/RIF技术检测的研究[J]. 河北医科大学学报, 2020, 41(6): 650-653,679.
[9]	李梅1，陈正立2*，张文超1，周珊珊1，徐茜茹1，郭映辉1. 石家庄地区儿童急性中耳炎病原菌临床分布特征和主要病原菌耐药性分析[J]. 河北医科大学学报, 2020, 41(3): 319-323.
[10]	刘凯军1，李茂恒1，王文涛2，魏〓娉3. 胃癌组织中TPX2与肿瘤细胞铂类药物耐药的关系及意义[J]. 河北医科大学学报, 2019, 40(6): 671-674,678.
[11]	王黎一1，曹旭华2*，史利克1，王〓悦1. 下呼吸道鲍曼不动杆菌感染患者对亚胺培南、美罗培南和头孢哌酮舒巴坦耐药的易感因素分析[J]. 河北医科大学学报, 2019, 40(3): 332-338.
[12]	薛建昌1，吴海峰1，郑浩2*，张建武1，张金艳3，王国英4. 3种结核分枝杆菌耐药检测方法的对比研究#br#[J]. 河北医科大学学报, 2019, 40(11): 1312-1316.
[13]	杨宝财1，苗勤2*，刘海涛2，方玲2，于大巍2，何敬堂3. 我院ICU多重耐药鲍曼不动杆菌聚集性病例与环境污染调查分析[J]. 河北医科大学学报, 2019, 40(11): 1317-1321.
[14]	李志荣1，赵建宏1，2，杨靖1，单保恩3，李继红2，时东彦2*. 2016—2017年河北省三级医院血培养分离细菌分布及耐药性分析[J]. 河北医科大学学报, 2019, 40(11): 1322-1326,1331.
[15]	苗勤1，刘海涛1*，何敬堂2，方玲1，于大巍1，白泽梅3. 多重耐药目标菌主动筛查联合模拟防控训练的干预效果研究[J]. 河北医科大学学报, 2019, 40(11): 1327-1331.

3种常规结核分枝杆菌及耐药突变检测方法的对比研究

A comparative study of three different detection methods for Mycobacterium tuberculosis and drug-resistant mutations

HTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价