中华预防医学杂志
中華預防醫學雜誌
중화예방의학잡지
CHINESE JOURNAL OF
2009年
1期
25-27
,共3页
金文国%郑瑞娟%王洁%杨华%丁元生%付佑辉%胡忠义
金文國%鄭瑞娟%王潔%楊華%丁元生%付祐輝%鬍忠義
금문국%정서연%왕길%양화%정원생%부우휘%호충의
分枝杆菌,结核%抗药性%微生物敏感性试验%显微镜检查
分枝桿菌,結覈%抗藥性%微生物敏感性試驗%顯微鏡檢查
분지간균,결핵%항약성%미생물민감성시험%현미경검사
Mycobacterium tuberculosis%Drug resistance%Microbial sensitivity tests%Microscopy
目的 探讨显微镜观察药物敏感性试验(MODS)同时快速检测结核杆菌对4种一线抗结核药物耐药性的效果.方法 用24孔细胞培养板进行结核分枝杆菌(MTB)液体药敏检测,并对最佳检测条件进行探讨;将建立的MODS技术用于测定66株MTB临床分离株对链霉素、异烟肼、利福平、乙胺丁醇的耐药性,并与传统罗氏药敏结果 进行比较,对两法检测结果 不符的菌株进行最低抑菌浓度(MIC)测定.结果 MODS检测链霉素、异烟肼、利福平、乙胺丁醇药敏结果 与罗氏药敏结果 符合率分别为97.0%、90.9%、95.5%、86.4%.如以传统罗氏药敏结果 为判断标准,则MODS检测链霉素的敏感度为96.0%、特异度为97.6%、阳性和阴性预测值(PPV、NPV)及准确性分别为96.0%、97.6%和97.0%;检测异烟肼、利福平和乙胺丁醇的敏感度、特异度、PPV、NPV及准确性分别为100%、85.4%、81.0%、100%、90.9%;96.2%、95.0%、92.6%、97.4%、95.5%和73.7%、91.5%、77.8%、89.6%、86.4%.共有16株菌的20个药敏结果 MODS与传统罗氏药敏结果 不符,MIC检测结果 有14株16个药敏结果 与MODS结果 一致,4株菌4个药敏结果 与罗氏药敏结果 一致.结论 MODS同时检测链霉素、异烟肼、利福平、乙胺丁醇药敏结果 具有快速、操作简便、价廉等优点,与传统罗氏药敏结果 有较高的符合率,可作为MTB耐药性的快速检测方法 之一.
目的 探討顯微鏡觀察藥物敏感性試驗(MODS)同時快速檢測結覈桿菌對4種一線抗結覈藥物耐藥性的效果.方法 用24孔細胞培養闆進行結覈分枝桿菌(MTB)液體藥敏檢測,併對最佳檢測條件進行探討;將建立的MODS技術用于測定66株MTB臨床分離株對鏈黴素、異煙肼、利福平、乙胺丁醇的耐藥性,併與傳統囉氏藥敏結果 進行比較,對兩法檢測結果 不符的菌株進行最低抑菌濃度(MIC)測定.結果 MODS檢測鏈黴素、異煙肼、利福平、乙胺丁醇藥敏結果 與囉氏藥敏結果 符閤率分彆為97.0%、90.9%、95.5%、86.4%.如以傳統囉氏藥敏結果 為判斷標準,則MODS檢測鏈黴素的敏感度為96.0%、特異度為97.6%、暘性和陰性預測值(PPV、NPV)及準確性分彆為96.0%、97.6%和97.0%;檢測異煙肼、利福平和乙胺丁醇的敏感度、特異度、PPV、NPV及準確性分彆為100%、85.4%、81.0%、100%、90.9%;96.2%、95.0%、92.6%、97.4%、95.5%和73.7%、91.5%、77.8%、89.6%、86.4%.共有16株菌的20箇藥敏結果 MODS與傳統囉氏藥敏結果 不符,MIC檢測結果 有14株16箇藥敏結果 與MODS結果 一緻,4株菌4箇藥敏結果 與囉氏藥敏結果 一緻.結論 MODS同時檢測鏈黴素、異煙肼、利福平、乙胺丁醇藥敏結果 具有快速、操作簡便、價廉等優點,與傳統囉氏藥敏結果 有較高的符閤率,可作為MTB耐藥性的快速檢測方法 之一.
목적 탐토현미경관찰약물민감성시험(MODS)동시쾌속검측결핵간균대4충일선항결핵약물내약성적효과.방법 용24공세포배양판진행결핵분지간균(MTB)액체약민검측,병대최가검측조건진행탐토;장건립적MODS기술용우측정66주MTB림상분리주대련매소、이연정、리복평、을알정순적내약성,병여전통라씨약민결과 진행비교,대량법검측결과 불부적균주진행최저억균농도(MIC)측정.결과 MODS검측련매소、이연정、리복평、을알정순약민결과 여라씨약민결과 부합솔분별위97.0%、90.9%、95.5%、86.4%.여이전통라씨약민결과 위판단표준,칙MODS검측련매소적민감도위96.0%、특이도위97.6%、양성화음성예측치(PPV、NPV)급준학성분별위96.0%、97.6%화97.0%;검측이연정、리복평화을알정순적민감도、특이도、PPV、NPV급준학성분별위100%、85.4%、81.0%、100%、90.9%;96.2%、95.0%、92.6%、97.4%、95.5%화73.7%、91.5%、77.8%、89.6%、86.4%.공유16주균적20개약민결과 MODS여전통라씨약민결과 불부,MIC검측결과 유14주16개약민결과 여MODS결과 일치,4주균4개약민결과 여라씨약민결과 일치.결론 MODS동시검측련매소、이연정、리복평、을알정순약민결과 구유쾌속、조작간편、개렴등우점,여전통라씨약민결과 유교고적부합솔,가작위MTB내약성적쾌속검측방법 지일.
Objective To evaluate the effects of microscopic observation drug susceptibility (MODS) in detecting susceptibility of Mycobacterium tuberculosis (MTB) onto four first line anti-tuberculosis drugs.Method The 24-hole cell culture plates were used to test drug susceptibility of MTB on liquid medium,and the best detecting condition of MODS assay was probed;66 clinical isolates susceptibility to streptomycin (S),isoniazid (H),rifampin (R) and ethambatal (E) were evaluated by using MODS assay and Lowenstein-Jensen(L-J).thereafter,all the inconcordance of isolates between MODS and L-J were tested for the minimal inhibitory concentrations (MIC).Results Concordance rate of the susceptibility to S,H,R and E in 66 clinical isolates detected bv MODS and L-J was 97.0%,90.9%,95.5% and 86.4% respectively.If the results obtained by L-J were taken as a golden standard,the sensitivity,specificity,positive and negative predictive value (PPV and NPV) as well as accuracy of susceptibility test to S detected by MODS was 96.0%,97.6%,96.0%,97.6% and 97.0%;100%,85.4%,81.0%,100% and 90.9% to H;96.2%,95%,92.6%,97.4% and 95.5% to R;73.7%,91.5%,77.8%,89.6% and 86.4% to E.There were 20 inconsistent results of 16 isolates by comparing MODS with L-J.and MIC yielded 16 results of those 14 isolates showing identical results with those of the MODS,while 4 results of other 4 isolates identical with LJ.Condusion MODS method simultaneously provides drug susceptibility to S,H,R and E.MODS might be one of the rapid tools to diagnosing muhidrug-resistant tuberculosis as it is rapid,simple,inexpensive and has high concordance with L-J drug susceptibility test.
