中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
CHINESE JOURNAL OF LABORATORY MEDICINE
2010年
1期
25-29
,共5页
付佑辉%郑瑞娟%王洁%金文国%胡忠义
付祐輝%鄭瑞娟%王潔%金文國%鬍忠義
부우휘%정서연%왕길%금문국%호충의
分枝杆菌%结核%抗结核药%微生物敏感性试验%显微镜检查%抗药性%细菌
分枝桿菌%結覈%抗結覈藥%微生物敏感性試驗%顯微鏡檢查%抗藥性%細菌
분지간균%결핵%항결핵약%미생물민감성시험%현미경검사%항약성%세균
Mycobacterium tuberculosis%Antitubecular agents%Microbial sensitivity tests%Microscopy%Drug resistance,bacterial
目的 探讨MODS同时快速检测4种二线抗结核药耐药性的效果.方法 用24孔细胞培养板建立显微镜观察药物敏感性技术,进行二线抗结核药物耐药性检测,并对最佳检测条件进行探讨.将该技术用于上海市肺科医院2007-2008年住院肺结核患者痰标本分离60株结核分枝杆菌对丙硫异烟胺、阿米卡星、卷曲霉素、左氧氟沙星耐药性检测,并与传统罗氏药敏结果进行比较,对2种方法检测结果不符的菌株进行MIC测定.结果 MODS检测丙硫异烟胺、阿米卡星、卷曲霉素、左氧氟沙星药敏结果与罗氏药敏结果符合率分别为96.7%(58/60)、98.3%(59/60)、91.7%(55/60)、96.7%(58/60).以传统罗氏药敏结果为判断金标准,MODS检测敏感度、特异度、阳性预测值和阴性预测值及准确性丙硫异烟胺分别为100%、87.5%、87.5%、100%、96.7%,阿米卡星分别为100%、90.0%、90.0%、100%、98.3%,卷曲霉素分别为76.9%、95.7%、83.3%、93.8%、91.7%,左氧氟沙星分别为100%、96.0%、83.3%、100%、96.7%.结论 MODS检测丙硫异烟胺、阿米卡星、卷曲霉素、左氧氟沙星耐药性具有快速、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MODS同時快速檢測4種二線抗結覈藥耐藥性的效果.方法 用24孔細胞培養闆建立顯微鏡觀察藥物敏感性技術,進行二線抗結覈藥物耐藥性檢測,併對最佳檢測條件進行探討.將該技術用于上海市肺科醫院2007-2008年住院肺結覈患者痰標本分離60株結覈分枝桿菌對丙硫異煙胺、阿米卡星、捲麯黴素、左氧氟沙星耐藥性檢測,併與傳統囉氏藥敏結果進行比較,對2種方法檢測結果不符的菌株進行MIC測定.結果 MODS檢測丙硫異煙胺、阿米卡星、捲麯黴素、左氧氟沙星藥敏結果與囉氏藥敏結果符閤率分彆為96.7%(58/60)、98.3%(59/60)、91.7%(55/60)、96.7%(58/60).以傳統囉氏藥敏結果為判斷金標準,MODS檢測敏感度、特異度、暘性預測值和陰性預測值及準確性丙硫異煙胺分彆為100%、87.5%、87.5%、100%、96.7%,阿米卡星分彆為100%、90.0%、90.0%、100%、98.3%,捲麯黴素分彆為76.9%、95.7%、83.3%、93.8%、91.7%,左氧氟沙星分彆為100%、96.0%、83.3%、100%、96.7%.結論 MODS檢測丙硫異煙胺、阿米卡星、捲麯黴素、左氧氟沙星耐藥性具有快速、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 탐토MODS동시쾌속검측4충이선항결핵약내약성적효과.방법 용24공세포배양판건립현미경관찰약물민감성기술,진행이선항결핵약물내약성검측,병대최가검측조건진행탐토.장해기술용우상해시폐과의원2007-2008년주원폐결핵환자담표본분리60주결핵분지간균대병류이연알、아미잡성、권곡매소、좌양불사성내약성검측,병여전통라씨약민결과진행비교,대2충방법검측결과불부적균주진행MIC측정.결과 MODS검측병류이연알、아미잡성、권곡매소、좌양불사성약민결과여라씨약민결과부합솔분별위96.7%(58/60)、98.3%(59/60)、91.7%(55/60)、96.7%(58/60).이전통라씨약민결과위판단금표준,MODS검측민감도、특이도、양성예측치화음성예측치급준학성병류이연알분별위100%、87.5%、87.5%、100%、96.7%,아미잡성분별위100%、90.0%、90.0%、100%、98.3%,권곡매소분별위76.9%、95.7%、83.3%、93.8%、91.7%,좌양불사성분별위100%、96.0%、83.3%、100%、96.7%.결론 MODS검측병류이연알、아미잡성、권곡매소、좌양불사성내약성구유쾌속、조작간편、개렴등우점,여전통라씨약민결과유교고적부합솔,가작위MTB내약성적쾌속검측방법지일.
Objective To test the drug susceptibilities in Mycobacterium tuberculosis by microscopic observation drug susceptibility(MODS)and evaluate the method for the detection susceptibility in second-line drugs.Methods To set up the MODS method.the drug susceptibilities of 4 second-line drugs in Mycobacterium tuberculosis were tested in 24 well plates.The test conditions were discussed.The resistance to protionamide(PTH),amikacin(AMK),capreomycin(CPM)and levofloxacin(LVF)of 60 MTB isolated from 2007 to 2008 in Shanghai Pulmonary Hospital were detected and compared with that of L-J method.The isolates were tested by minimum inhibitory concentration(MIC)method when the drug susceptibilities were not consistent.Results Among the 60 Mycobacterium tuberculosis clinical isolates.the results of drug susceptibility were confirmed by MODS,absolute concentration method and the accordance rate of PTH,AMK,CPM and LVF were 96.7%(58/60),98.3%(59/60),91.7%(55/60)and 96.7%(58/60),respectively.If the result of absolute concentration method was as the standard.the sensitivity.specificity.positive and negative predictive value as well as accuracy were 100%,87.5%,87.5%,100%and 96.7%in PTH;100%,90.0%,90.0%,100%and 98.3% in AMK;76.9%,95.7%,83.3%,93.8%,91.7% in CPM;100%,96.0%,83.3%,100% and 96.7% in LVF respectively detected by MODS assay.Conclusion MODS is a rapid and simple method for susceptibility testing of second-line drug in Mycobacterium tuberculosis.
