【作者】 蒋俊； 张娟； 张红； 贾琳； 魏成翠； 石莲； 马静红； 杨立军；

【Author】 Jiang Jun,Zhang Jua Zhang Hong,Jia Lin,Wei Chengcui,Shi Lian,Ma Jinghong,* Yang Lijun. (TB laboratory of Shenyang Chest hospital,Shenyang 110044;Tuberculosis control institution of Liaoning province,Shenyang 110005)

【机构】 辽宁省沈阳市胸科医院结核病实验室；

【摘要】 目的与传统罗氏(L-J)培养方法比对,评价全自动BACTEC MGIT 960系统在结核分枝杆菌(TB)二线抗结核药物(SLD)药敏试验中的实用性。方法按国家疾病预防控制中心(CDC)-碧迪项目辽宁工作方案要求和国际标准WS288-2009《肺结核诊断标准》纳入临床病例。本实验纳入病例435例,其中男性319例,女性116例,平均年龄52.3岁(10-86岁)。该纳入病例均通过痰涂片抗酸染色(萋-尼法)镜检,L-J固体和MGIT 960液体培养及鉴定,共筛查阳性菌株212例。应用L-J比例法将筛查的212例阳性菌株分别进行一线抗结核药物异烟肼(INH)、利福平(RIF)、链霉素(STR)和乙胺丁醇(EMB)的耐药性试验,其中耐药菌株(所有耐药株)118例。以118例耐药株作为SLD药敏试验的实验株,再应用L-J和MGIT 960两种方法分别进行卷曲霉素(CPM)、卡那霉素(KAN)、氧氟沙星(OFLX)和乙硫异烟胺(ETH)的药物敏感性试验并计算出两方法药敏试验所需的时间和符合率。结果 MGIT 960药敏试验所需时间平均10.2d(3360/118),L-J法所需时间平均28.5(1183/118)d,两者相差18.3(28.5-10.2)d。MGIT 960与L-J法的SLD CPM、KAN、OFLX和ETH敏感(S)及耐药(R)率分别为88.13%(104/118)、95.76%(113/118)、91.53%(108/118)和71.19%(84/118)。结论 MGIT 960系统液体培养法SLD药敏试验快速、准确,具有很高的实用价值。更多还原

【Abstract】 Objective Comparing MGIT960 with traditional L-J to evaluate the practicality of automatic BACTEC MG1T960 system in Mycobacterium tuberculosis(TB) second-line anti-TB drugs(SLD).Method We collected the clinical cases according to the requirements of CDC-Becton Dickinson Liaoning project work and international standards WS288-2009 TB diagnostic criteria In this study,we have 435 cases,including 319 male patients and 116 female patients with average age 52.3 years(10～86 years.) Each case of sputum respectively smear samples for acid-fast staining,(Luxuriant-Nephi) microscopy,L-J solid and MGIT960 liquid culture and identification,screening 212 cases of positive strains.The 212 positive strains screened by L-J proportion respectively take resistance test of first-line anti-TB drugs isoniazid(INH),rifampicin(RIF),streptomycin(STR) and ethambutol(EMB),which including 118 cases of resistant strains(all persister).The 118 persisters as experimental strain of SLD susceptibility testing,then,respectively taken the drug susceptibility of capreomycin(CPM),kanamycin(KAN),ofloxacin(OFLX) and ethionamide(ETH) by L-J and MGIT960,calculating the requirement time and compliance reates of the two methods.Result The requirement time of MGIT960 susceptibility test is average 10.2 days(3360/118),L-J method is average 28.5 days(1183/118),difference of 18.3 days(28.5-10.2) between two methods.The sensitive(s) and resistant(R) rates of CPM,KAN,OFLX and ETH of MG1T960 and L-J SLD were 88.13%(104/118),95.76%(113/118),91.53%(108/118) and 71.19%(84/118).Conclusion The MGIT960 liquid culture SLD susceptibility test is fast,accurate and has the high practical value.更多还原