CAJ | 학술논문

目的：评价结核分枝杆菌鉴定试剂盒（分子杂交法）进行分枝杆菌菌种初筛的准确性，并探讨如何快速准确地鉴定结核分枝杆菌复合群（MTC）和非结核分枝杆菌（NTM）混合感染标本。方法采用分子杂交法对200株结核分枝杆菌临床分离株进行菌种鉴定。人工制备结核分枝杆菌和胞内分枝杆菌、结核分枝杆菌和脓肿分枝杆菌、结核分枝杆菌和偶发分枝杆菌的混合感染模型，评价基因测序法、芯片法和 Hain test 在检测分枝杆菌混合感染中的准确性。结果以对硝基苯甲酸（PNB）分离鉴定结果为参照，分子杂交法的敏感性和特异性分别为65．12％（65/86）和98．25％（112/114）。对于人工制备的13种不同比例混合的 H37Rv 和 NTM，芯片法和Hain test 均可以准确鉴定出混合感染标本中的混合菌种，而基因测序结果表明，H37Rv：偶发分枝杆菌的比例在10％～90％范围内才能区分出混合感染的类型。结论分子杂交法对于结核分枝杆菌诊断有较高的特异性，一旦经该法鉴定为 NTM，则具有很高的诊断意义。明确标本中存在混合感染后可以采用芯片法或 Hain test 对临床上高致病的分枝杆菌进行菌种水平的鉴定。
목적：평개결핵분지간균감정시제합（분자잡교법）진행분지간균균충초사적준학성，병탐토여하쾌속준학지감정결핵분지간균복합군（MTC）화비결핵분지간균（NTM）혼합감염표본。방법채용분자잡교법대200주결핵분지간균림상분리주진행균충감정。인공제비결핵분지간균화포내분지간균、결핵분지간균화농종분지간균、결핵분지간균화우발분지간균적혼합감염모형，평개기인측서법、심편법화 Hain test 재검측분지간균혼합감염중적준학성。결과이대초기분갑산（PNB）분리감정결과위삼조，분자잡교법적민감성화특이성분별위65．12％（65/86）화98．25％（112/114）。대우인공제비적13충불동비례혼합적 H37Rv 화 NTM，심편법화Hain test 균가이준학감정출혼합감염표본중적혼합균충，이기인측서결과표명，H37Rv：우발분지간균적비례재10％～90％범위내재능구분출혼합감염적류형。결론분자잡교법대우결핵분지간균진단유교고적특이성，일단경해법감정위 NTM，칙구유흔고적진단의의。명학표본중존재혼합감염후가이채용심편법혹 Hain test 대림상상고치병적분지간균진행균충수평적감정。
Objective To evaluate the accuracy of Mycobacterial species identification kit (molecular hybridization method),and to investigate the rapid and accurate approaches for the identification of mixed infection caused by Mycobacterium tuberculosis complex (MTC)and non-tuberculosis Mycobacterium(NTM).Methods A total of 200 clinical Mycobacterium isolates were identified by molecular hybridization method.The mixed infection was simulated by the mixture of Mycobacterium tuberculosis and Mycobacterium intracellular, Mycobacterium tuberculosis and Mycobacterium kansasii,Mycobacterium tuberculosis and Mycobacterium fortuitum.The gene sequencing,gene chip array and Hain test were used to evaluate the accuracy of Mycobacterium-mixed infection.Results As reference to pnitrobenzoic acid(PNB)tests,the sensitivity and specificity of molecular hybridization method were 65.1 2%(65 /86) and 98.25%(1 1 2 /1 1 4),respectively.Among 1 3 different proportions of Mycobacterium tuberculosis and NTM,gene chip array and Hain test accurately detected all of the mixed infections.Gene sequencing can only detect the mixed infection caused by Mycobacterium tuberculosis and Mycobacterium fortuitum at a range from 1 0% to 90%.Conclusions The specificity of molecular hybridization method for the identification of Mycobacterium tuberculosis is high.The kit following the method for NTM has a significant diagnosis value.Once the mixed infection is identified in the culture, gene chip array and Hain test can identify the species of mixed culture for the common pathogenic Mycobacterium.