Comparative analysis of Melting Curve Method and Micro-MIC Method in the Detection of Drug Resistance of Mycobacterium Tuberculosis
Objective:To compare the application value,advantages and disadvantages of melting curve method and micro MIC method in the detection of drug resistance of first-line and second-line anti-tuberculosis drugs.Methods:A total of 160 culture-positive strains were collected from inpatients and outpatients in the Department of Pulmonary Medicine of the First Affiliated Hospital of Xiamen University from January 2020 to January 2021.Seven common anti-tuberculosis drugs,isoniazid,streptomycin,ethambutol,amikacin,capreomycin,rifampicin and fluoroquinolone,were selected for treatment.With Roche ratio method as the gold standard,the sensitivity,specificity and reliability of drug resistance of tuberculosis patients to each drug were detected based on melting curve method and micro-MIC method.Results:With the results of Roche proportional method as the reference standard,the sensitivity of isoniazid resistance detected by melting curve method and micro-MIC method was 91.5%and 100%respectively,the specificity was 94.7%and 96.5%,and the Kappa value was 0.851 and 0.941.The sensitivity of streptomycin resistance was 82.4%and 91.2%,the specificity was 94.4%and 97.6%,and the Kappa value was 0.760 and 0.888.The sensitivity of ethambutol resistance was 80%and 60%,the specificity was 95%and 99.3%,and the Kappa value was 0.705 and 0.697.The sensitivity of amikacin resistance was 100%,the specificity was 99.4%and 98.1%,and the Kappa value was 0.854 and 0.658.The sensitivity of capreomycin resistance was 42.9%and 71.4%,the specificity was 99.3%,and the Kappa value was 0.531 and 0.760.The sensitivity of rifampicin resistance was 94.9%and 89.7%,the specificity was 96.7%and 97.5%,and the Kappa value was 0.900 and 0.880.The sensitivity of fluoroquinolone resistance was 95.2%and 61.2%,the specificity was 100%and 97.8%,and the Kappa value was 0.972 and 0.665.Conclusion:The detection efficiency of the melting curve method for the resistance of isoniazid,amikacin,rifampicin and fluoroquinolones was completely consistent with the gold standard,and the detection efficiency of streptomycin,capreomycin and ethambutol was highly consistent with the gold standard.The drug resistance detection efficiency of trace MIC method for isoniazid,streptomycin and rifampicin was completely consistent with the gold standard,and the drug resistance detection efficiency for ethambutol,amikacin,capreomycin and fluoroquinolone was highly consistent with the gold standard.Both methods are accurate,rapid and efficient,and can replace the gold standard to a certain extent in clinical practice.
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