摘要
目的:利用结核分枝杆菌/利福平耐药荧光定量核酸扩增检测技术(Xpert MTB/RIF,简称Xpert检测)中各探针的检测结果,判断在对利福平(RFP)耐药的菌株中,是否同时对利福布汀(RFB)耐药。方法:收集2018年6月至2021年5月在深圳市第三人民医院就诊的耐药结核患者共548例。收集患者的各类标本,包括痰、支气管肺泡灌洗液、胸水、脑脊液、尿液、脓液、病理组织及穿刺物等进行分枝杆菌培养。然后对培养物分别进行Xpert检测及结核快速药敏试验(绝对浓度法)。以绝对浓度法为金标准,将Xpert检测提示耐药的结果与金标准中RFB的结果进行对照分析。结果:Xpert检测结果任何一个探针阳性,提示对RFB交叉耐药的检验综合符合率在51.64%。Xpert检测中A、C、D+E探针阳性的菌株,提示对RFP存在耐药,但对RFB全部敏感,其他探针对药物灵敏度的指示意义不大。以绝对浓度法结果作为金标准,Xpert检测各探针对RFB耐药性的检测结果具有不同的灵敏度与特异度。结论:Xpert检测结果部分探针阳性,可以用来作为耐RFP患者选取RFB替代的指示性标志。
Objective To explore the application value of Xpert MTB/RIF test probes in rifampicin-resistant patients.Methods A total of 548 specimens collected from the third people’s Hospital of Shenzhen were analyzed,including sputum,bronchoalveolar lavage fluid,pleural and ascites,cerebrospinal fluid,urine and so on(2018.6 to 2021.5).The Xpert MTB/RIF assay and absolute concentration susceptibility test were performed simultaneously.Through the analysis of the two results,the relationship between the probes of Xpert MTB/RIF assay and the resistance of rifampin and rifampin was obtained.Results The Xpert test result is positive for any probe,which indicates that the comprehensive coincidence rate of the RFB cross-resistance test is 51.64%.The strains with positive A,C,D+E probes in the Xpert test indicate that they are resistant to RFP,but are all sensitive to RFB.Other probes are of little significance as an indicator of drug sensitivity.Using the absolute concentration method as the gold standard,the Xpert detection results for the resistance of each probe to RFB have different sensitivity and specificity.Conclusion The Xpert test results are positive for some probes,which can be used as an indicator for RFP-resistant patients to select RFB replacement.
作者
刘国辉
张丽娜
詹森林
袁静
王平
LIU Guo-hui;ZHAN Li-na;ZHAN Sen-lin;YUAN Jing;WANG Ping(Shenzhen Third People's Hospital,Guangdong Shenzhen 518000)
出处
《深圳中西医结合杂志》
2021年第17期80-83,共4页
Shenzhen Journal of Integrated Traditional Chinese and Western Medicine
基金
广东省高水平临床重点专科项目资助课题(SZGSP010,SZGSP011)
深圳市医学重点学科(2020-2024年)建设经费项目课题(SZXK076,SZXK079)。
关键词
结核分枝杆菌
结核分枝杆菌/利福平耐药荧光定量核酸扩增检测技术
耐多药肺结核
利福平
利福布汀
Mycobacterium tuberculosis
Mycobacterium tuberculosis/rifampicin-resistant fluorescent quantitative nucleic acid amplification detection technology
Multidrug-resistant tuberculosis
Rifampin
Rifabutin
