首页|肉汤微量稀释法对耐多药结核分枝杆菌敏感性检测的评价

肉汤微量稀释法对耐多药结核分枝杆菌敏感性检测的评价

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  • 国家科技期刊平台
  • NETL
  • NSTL
  • 万方数据
目的 评价肉汤微量稀释(BMD)法在耐多药结核分枝杆菌(MDR-MTB)敏感性检测中的应用效果。方法 采用罗氏比例法和BMD法对海南省108株MDR-MTB 及 11株非MDR-MTB菌株进行药敏试验，并对两种药敏方法检测结果不一致菌株进行全基因组测序(WGS)。结果 罗氏比例法和BMD法药敏结果平均判读时间分别为28。0、8。5 d。罗氏比例法检测异烟肼、利福平、乙胺丁醇、卡那霉素和卷曲霉素的耐药率高于BMD法(均P＜0。001);BMD法检测丙硫异烟胺和对氨基水杨酸的耐药率高于罗氏比例法(均P＜0。001)。以罗氏比例法药敏结果为金标准，BMD法检测耐药性的灵敏度和特异度分别为50。00％～100％、95。69％～100％，除EMB(87。39％)、INH(94。96％)外，BMD法检测其他药物的耐药性符合率均≥95％。罗氏比例法药敏结果与WGS总符合率为76。19％(32/42)，BMD法药敏结果与WGS总符合率为23。81％(10/42)，差异具有统计学意义(x2=23。048，P＜0。001)。两种药敏方法检测结果不一致的MTB共34株，罗氏比例法耐药+BMD法敏感的26株MTB中，22株(84。62％)相关耐药基因发生突变;罗氏比例法敏感+BMD法耐药的11株MTB中，5株(45。45％)相关耐药基因发生突变。结论 BMD法是一种准确、快速的MDR-MTB敏感性检测方法，但仍需要进一步改进和优化，耐药性与相关耐药基因的突变密切相关。
Susceptibility detection of multidrug-resistant Mycobacterium tuberculosis by broth microdilution method
Objective To evaluate the application effect of broth microdilution(BMD)method in susceptibility testing of multidrug-resistant Mycobacterium tuberculosis(MDR-MTB).Methods The Roche's proportion method and BMD method were adopted in drug susceptibility testing on 108 MDR-MTB strains and 11 non-MDR-MTB strains in Hainan Province.Whole genome sequencing(WGS)was performed on strains with inconsistent results by the above two methods.Results The average time to acquire drug susceptibility testing results by Roche's propor-tional method and BMD method were 28.0 and 8.5 days,respectively.Roche's proportional method showed higher resistance rates to isoniazid(INH),rifampicin(RFP),ethambutol(EMB),kanamycin(KM),and capreomycin(CPM)than BMD method(all P＜0.001).BMD method showed higher resistance rates to protionamide(PTO)and para-aminosalicylic acid(PAS)than Roche's proportional method(both P＜0.001).Taking Roche's proportional method as the gold standard,the sensitivity and specificity of BMD method for testing drug resistance were 50.00％-100％and 95.69％-100％,respectively.Except EMB(87.39％)and INH(94.96％),the consistency rates of the BMD method in testing drug resistance of other drugs were all ≥95.00％.The overall consistency rate between Roche's proportional method and WGS was 76.19％(32/42),while the consistency rate between BMD method and WGS was 23.81％(10/42),difference was statistically significant(x2=23.048,P＜0.001).34 MTB strains showed inconsistent results by two drug susceptibility testing methods.Among the 26 MTB strains that were resis-tant in Roche's proportion method but sensitive in BMD method,22 strains(84.62％)had mutations in relevant re-sistance genes.Among the 11 MTB strains that were sensitive in Roche's proportion method but resistant in BMD method,5 strains(45.45％)had mutations in relevant resistance genes.Conclusion BMD method is an accurate and rapid MDR-MTB susceptibility testing method,but further improvement and optimization are still needed.Drug resistance is closely related to mutations in relevant resistance genes.

multidrug-resistant Mycobacterium tuberculosisRoche's proportional methodbroth microdilution methodminimum inhibitory concentrationantimicrobial susceptibility testing

钟业腾、王洁莹、陈灼霖、许玉妮、邱文华、裴华

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海南医学院第二附属医院检验科,海南海口 570216

耐多药结核分枝杆菌 罗氏比例法 肉汤微量稀释法 最低抑菌浓度 药物敏感试验

海南省重点研发项目海南省自然科学基金项目海南省自然科学基金项目海南省卫生健康行业科研项目海南省卫生健康行业科研项目

ZDYF2022SHFZ100822RC844820MS14422A20027222A200271

2024

10.12138/j.issn.1671-9638.20244901

中国感染控制杂志
中南大学

中国感染控制杂志

CSTPCD北大核心
影响因子：2.112
ISSN：1671-9638
年,卷(期)：2024.23(7)