结核菌罗氏培养基药敏试验结果判读时间分析
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摘要
目的分析结核菌罗氏培养基药敏试验结果的合理判读时间,从而使药敏实验的准确性得到提高。方法选择2013年4月—2016年12月期间淮安市疾病预防控制中心收治的2 371例肺结核患者作为研究对象,其中新涂阳初治患者2 136例,复治涂阳患者235例。患者痰标本均在实验室质控下完成检测,作为标准结果,同时在本院进行罗氏培养基药敏试验,分别培养4周和6周后,将检测结果与标准结果进行对比分析,分别统计比对培养4周和6周的结果准确率。结果初治患者培养4周药敏试验结果准确率异烟肼(98.60%)、链霉素(95.22%)、利副平(96.54%)、乙胺丁醇(95.88%)与培养6周准确率(94.48%、96.54%、97.94%、97.24%)比较,差异均有统计学意义(P<0.05)。复治患者培养4周异烟肼药敏试验准确率(98.30%)与培养6周准确率(93.62%)比较差异具有统计学意义(P<0.05);培养4周链霉素(94.89%)、利副平(96.60%)、乙胺丁醇(96.32%)药敏试验准确率与培养6周准确率(95.74%、97.87%、97.02%)比较,差异均无统计学意义(P>0.05)。初治和复治患者:4周和6周的准确率比较差异无统计学意义。结论结核菌罗氏培养基药敏试验结果准确性与判读时间存在一定联系,应根据具体药物选择具体时间。
Objective To analyze the reasonable time of drug sensitivity test of TB Roche culture medium,to improve theaccuracy of drug susceptibility test.Methods Totally 2 371 cases of pulmonary tuberculosis patients in Huaian MunicipalCenter for Disease Control and Prevention during the period of April 2013 to December 2016 as the research object, amongthem, 2 136 patients were treated with the initial treatment, and 235 cases were retreated, sputum specimens of patientsunderwent complete testing in the laboratory, as a result of standards, at the same time, the Roche medium of drug sensitivitytest in our hospital, were cultured for 4 weeks and 6 weeks, the detection results and the statistical alignment accuracy ofresults were compared with standard results, respectively.Results With 4 weeks of incubation, the sensitivity test accuracyrate of initial treatment patients of isoniazid(98.60%) and streptomycin(95.22%), rifampicin(96.54%), ethambutol(95.88%)were compared with 6 weeks of incubation(94.48%, 96.54%, 97.94%, 97.24%), the difference were statistically significant(P<0.05). The isoniazid accuracy rate(98.30%) of re-treated cases compared with the 6-week accuracy(93.62%), and thedifference was statistically significant(P<0.05). Cultivation 4 weeks of drug sensitive test accuracy of streptomycin(94.89%),rifampicin(96.60%), ethambutol(96.32%), compared with accuracy of six weeks(95.74%, 97.87%, 97.02%), there were nostatistically significant difference(P> 0.05). Initial and re-treated patients: drug sensitive test accuracy of 4 and 6 weeks, therewas no statistically significant difference. Conclusion There is a certain relationship between the accuracy of TBsusceptibility test and the time of interpretation, and the specific time should be chosen according to the specific drug.
Objective To analyze the reasonable time of drug sensitivity test of TB Roche culture medium,to improve theaccuracy of drug susceptibility test.Methods Totally 2 371 cases of pulmonary tuberculosis patients in Huaian MunicipalCenter for Disease Control and Prevention during the period of April 2013 to December 2016 as the research object, amongthem, 2 136 patients were treated with the initial treatment, and 235 cases were retreated, sputum specimens of patientsunderwent complete testing in the laboratory, as a result of standards, at the same time, the Roche medium of drug sensitivitytest in our hospital, were cultured for 4 weeks and 6 weeks, the detection results and the statistical alignment accuracy ofresults were compared with standard results, respectively.Results With 4 weeks of incubation, the sensitivity test accuracyrate of initial treatment patients of isoniazid(98.60%) and streptomycin(95.22%), rifampicin(96.54%), ethambutol(95.88%)were compared with 6 weeks of incubation(94.48%, 96.54%, 97.94%, 97.24%), the difference were statistically significant(P<0.05). The isoniazid accuracy rate(98.30%) of re-treated cases compared with the 6-week accuracy(93.62%), and thedifference was statistically significant(P<0.05). Cultivation 4 weeks of drug sensitive test accuracy of streptomycin(94.89%),rifampicin(96.60%), ethambutol(96.32%), compared with accuracy of six weeks(95.74%, 97.87%, 97.02%), there were nostatistically significant difference(P> 0.05). Initial and re-treated patients: drug sensitive test accuracy of 4 and 6 weeks, therewas no statistically significant difference. Conclusion There is a certain relationship between the accuracy of TBsusceptibility test and the time of interpretation, and the specific time should be chosen according to the specific drug.
引文
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[2]杜安玲.初治肺结核患者的菌型鉴定与耐药性分析[J].中国实用医药,2015,10(15):194-195.
[3]郑惠文,赵雁林.结核分枝杆菌的临床和实验室诊断[J].中华临床实验室管理电子杂志,2016(3):129-133.
[4]叶鹏.全自动实时荧光定量PCR系统在肺结核诊断和药敏试验检测中的应用价值[J].中国预防医学杂志,2017,18(4):307-310.
[5]武栋.痰罗氏培养结核菌阳性、血T-spot TB阴性常见原因分析[J].长春中医药大学学报,2016,32(3):616-617.
[6]曹英迪.BACTEC MGIT-960结核菌快速培养800例分析[J].河南预防医学杂志,2017,28(3):186-187.
[7]白广红,朱蕾,高漫.7种实验方法诊断结核病的临床应用价值[J].临床荟萃,2014,29(6):608-611,720.
[8]谢兵.BACTEC Micro MGIT系统在结核菌快速培养中的应用评价[J].社区医学杂志,2014,12(16):32-33.
[9]蔡常辉,梁连辉,曾桂云,等.实时荧光PCR与BACTEC MGIT960快速培养在初治痰涂片阴性未受抗结核治疗的肺结核诊断中的应用[J].放射免疫学杂志,2012,25(1):68-70.
[10]成诗明.我国耐多药结核病防治现状与建议[J].中国热带医学,2017,17(3):213-215.
[11]于丹,刘宁.结核感染T细胞斑点试验在疑似结核病患者诊断中的价值[J].热带医学杂志,2016,16(1):45-47,54.
[12]易平,田芳,郭旭丽,等.外周血T细胞抗原刺激试验(T-SPOT)在结核病检测中的应用[J].实用预防医学,2017,24(3):260-264.