中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
CHINESE JOURNAL OF LABORATORY MEDICINE
2013年
7期
620-624
,共5页
郭建%范齐文%卢水华%邓桂林%吴文娟
郭建%範齊文%盧水華%鄧桂林%吳文娟
곽건%범제문%로수화%산계림%오문연
分枝杆菌,结核%RNA,核糖体%细菌分型技术%聚合酶链反应
分枝桿菌,結覈%RNA,覈糖體%細菌分型技術%聚閤酶鏈反應
분지간균,결핵%RNA,핵당체%세균분형기술%취합매련반응
Mycobacterium tuberculosis%RNA,ribosomal%Bacterial typing techniques%Polymerase chain reaction
目的 应用结核分枝杆菌rRNA直接检测(MTD)和多位点PCR菌株分型方法,检测肺外结核标本中的结核分枝杆菌,评价其在肺外结核感染的快速检测和菌株分型中的应用价值.方法 回顾性分析2010年6月至2011年12月上海市公共卫生临床中心47例儿童肺外结核、75例成人肺外结核以及48例非结核病患者的脑脊髓液、穿刺液等标本.用涂片法、L-J固体培养法、MGIT960液体培养法和MTD法进行平行检测,对培养阳性菌株应用MPT64胶体金初筛.MPT64阴性菌株采用多位点PCR菌株分型方法进行快速分型,并用化学法确认.采用SPSS16.0进行统计分析.结果 涂片法、L-J固体培养法、MGIT960液体培养法和MTD法检测肺外结核的敏感度依次为:10.7％(13/122),11.5％ (14/122),16.4％ (20/122)和37.7％(46/122),特异度均为100.0％.20株培养阳性的菌株,其中6例儿童患者临床分离菌株为MPT64胶体金检测阴性,经多位点PCR菌株分型方法、化学法分型鉴定为卡介苗菌株.多位点PCR菌株分型方法与传统化学法结果一致,但可在4h内完成检测.结论 与传统病原学检测方法比较,MTD法检测结核分枝杆菌快速简便,结果灵敏可靠；同时应用多位点PCR菌株分型方法,可对儿童肺外结核患者进行快速的早期鉴别诊断.
目的 應用結覈分枝桿菌rRNA直接檢測(MTD)和多位點PCR菌株分型方法,檢測肺外結覈標本中的結覈分枝桿菌,評價其在肺外結覈感染的快速檢測和菌株分型中的應用價值.方法 迴顧性分析2010年6月至2011年12月上海市公共衛生臨床中心47例兒童肺外結覈、75例成人肺外結覈以及48例非結覈病患者的腦脊髓液、穿刺液等標本.用塗片法、L-J固體培養法、MGIT960液體培養法和MTD法進行平行檢測,對培養暘性菌株應用MPT64膠體金初篩.MPT64陰性菌株採用多位點PCR菌株分型方法進行快速分型,併用化學法確認.採用SPSS16.0進行統計分析.結果 塗片法、L-J固體培養法、MGIT960液體培養法和MTD法檢測肺外結覈的敏感度依次為:10.7％(13/122),11.5％ (14/122),16.4％ (20/122)和37.7％(46/122),特異度均為100.0％.20株培養暘性的菌株,其中6例兒童患者臨床分離菌株為MPT64膠體金檢測陰性,經多位點PCR菌株分型方法、化學法分型鑒定為卡介苗菌株.多位點PCR菌株分型方法與傳統化學法結果一緻,但可在4h內完成檢測.結論 與傳統病原學檢測方法比較,MTD法檢測結覈分枝桿菌快速簡便,結果靈敏可靠；同時應用多位點PCR菌株分型方法,可對兒童肺外結覈患者進行快速的早期鑒彆診斷.
목적 응용결핵분지간균rRNA직접검측(MTD)화다위점PCR균주분형방법,검측폐외결핵표본중적결핵분지간균,평개기재폐외결핵감염적쾌속검측화균주분형중적응용개치.방법 회고성분석2010년6월지2011년12월상해시공공위생림상중심47례인동폐외결핵、75례성인폐외결핵이급48례비결핵병환자적뇌척수액、천자액등표본.용도편법、L-J고체배양법、MGIT960액체배양법화MTD법진행평행검측,대배양양성균주응용MPT64효체금초사.MPT64음성균주채용다위점PCR균주분형방법진행쾌속분형,병용화학법학인.채용SPSS16.0진행통계분석.결과 도편법、L-J고체배양법、MGIT960액체배양법화MTD법검측폐외결핵적민감도의차위:10.7％(13/122),11.5％ (14/122),16.4％ (20/122)화37.7％(46/122),특이도균위100.0％.20주배양양성적균주,기중6례인동환자림상분리균주위MPT64효체금검측음성,경다위점PCR균주분형방법、화학법분형감정위잡개묘균주.다위점PCR균주분형방법여전통화학법결과일치,단가재4h내완성검측.결론 여전통병원학검측방법비교,MTD법검측결핵분지간균쾌속간편,결과령민가고；동시응용다위점PCR균주분형방법,가대인동폐외결핵환자진행쾌속적조기감별진단.
[Abstract] Objective To evaluate the effect of Mycobacterium tuberculosis Direct Assay (MTD) for rapid detecting Mycobacterium tuberculosis rRNA and Multi-locus PCR for M.bovis BCG strain typing in patients with suspected extra-pulmonary tuberculosis.Methods From June 2010 to December 2011,47 children and 75 adult patients with suspected extra-pulmonary tuberculosis in Shanghai public health clinical center were recruited.Also 48 non-tuberculosis patients were taken as a negative control.Clinical specimens from these patients were collected.Acid fast stain,solid culture,liquid culture,and MTD were used to detect all clinical specimens simultaneously.Screen tuberculosis strains of the culture isolates by MPT64 antigen assay and use Multi-locus PCR for the BCG strain genotyping of the isolates without MPT64 antigen.SPSS16.0 was used to analyse the results.Results The sensitivity for acid fast stain,solid culture,liquid culture and MTD test was 10.7％ (13/122),11.5％ (14/122),16.4％ (20/122) and 37.7％ (46/122),respectively.And the specificity of MTD was 100.0％.Six clinical isolates from children were identified as BCG by Multi-locus PCR typing,the same with chemical tests.Conclusions The MTD assay and the MGIT960 liquid culture are effective and reliable method for diagnosing extra-pulmonary tuberculosis.And Multi-locus PCR can be assisted for the early diagnosis of extra-pulmonary tuberculosis patients with suspected BCG infection.
