Hain和Xpert MTB/RIF技术对结核分枝杆菌药物敏感性的检测

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目的应用线性探针耐多药检测技术(Hain)和利福平耐药实时荧光定量核酸扩增检测技术(Xpert MTB/RIF)分析辽宁地区耐多药结核分枝杆菌(multiple-drug resistant Mycobacterium tuberculosis,MDR-TB)的检出情况,为本地区结核病的控制及临床诊断治疗提供科学依据。方法收集193株结核分枝杆菌菌株应用Hain、Xpert MTB/RIF和比例法鉴定利福平(rifampin,RFP)和异烟肼(isoniazid,INH)的耐药性;以比例法为金标准,分析另外两种方法检测耐药结核分枝杆菌的敏感性和特异性。结果 Hain检测利福平耐药的灵敏度为81.8%(72/88),特异度为87.6%(92/105);Hain检测异烟肼耐药的灵敏度为81.2%(82/101),特异度为70.7%(65/92);Hain检测MDR-TB的灵敏度为76.7%(46/60),特异度为81.2%(108/133);Xpert MTB/RIF检测利福平耐药的灵敏度为90.9%(80/88),特异度为81.9%(86/105)。Hain、Xpert MTB/RIF两种检测方法与比例法相比差异均无统计学意义(P>0.05)。结论 Hain和Xpert MTB/RIF是快速有效地检测结核分枝杆菌耐药的方法,适用于辽宁地区结核病患者耐药性检测。 Objective To evaluate the detection of multiple-drug resistant Mycobacterium tuberculosis (MDR) in Liaoning by Hiline and Xpert MTB / RIF, , MDR-TB) detection, provide a scientific basis for the control and clinical diagnosis and treatment of tuberculosis in the region. Methods 193 strains of Mycobacterium tuberculosis strains were collected and identified by Hain, Xpert MTB / RIF and ratio method to determine the drug resistance of rifampin (RFP) and isoniazid (INH) Two other methods detect the sensitivity and specificity of drug-resistant Mycobacterium tuberculosis. Results The sensitivity of Hain test for rifampicin resistance was 81.8% (72/88) and the specificity was 87.6% (92/105). The sensitivity of Hain test for isoniazid resistance was 81.2% (82/101). The specificity Was 70.7% (65/92). The sensitivity of Hain in detecting MDR-TB was 76.7% (46/60) and the specificity was 81.2% (108/133). The sensitivity of Xpert MTB / RIF assay for rifampicin resistance was 90.9 % (80/88), specificity was 81.9% (86/105). Hain, Xpert MTB / RIF two detection methods compared with the proportion method was no significant difference (P> 0.05). Conclusion Hain and Xpert MTB / RIF is a rapid and effective method to detect drug resistance of Mycobacterium tuberculosis and is suitable for the detection of drug resistance in TB patients in Liaoning Province.
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