摘要
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、卷曲霉索、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。
Objective To test the drug susceptibilities in Mycobacterium tuberculosis by microscopic observation drug susceptibility （MODS） and evaluate the method for the detection susceptibility in secondline 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）, caprcomycin （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
出处
《中华检验医学杂志》
CAS
CSCD
北大核心
2010年第1期25-29,共5页
Chinese Journal of Laboratory Medicine
基金
中国全球基金结核病项目（TB07-051）
上海市科委重点专项科研基金资助项目（07JC14053）
上海研发公共服务平台建设项目（08DZ2291500）
上海市卫生局科研计划课题资助项目（2007Y59）
关键词
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
Mycobacterium tuberculosis
Antitubecular agents
Microbial sensitivity tests
Microscopy
Drug resistance, bacterial
