噬菌体生物扩增法快速检测脊柱结核脓液中结核分枝杆菌

目的]探讨噬菌体生物扩增(PhaB)法快速检测脊柱结核脓液中结核分枝杆菌的临床应用价值.方法]应用直接涂片法,BACTEC MGIT-960法及PhaB法分别检测56例脊柱结核患者的56份脓液标本以及10株结核分枝杆菌标准株,15株非结核分枝杆菌及5株非分枝杆菌.结果]PhaB法检测10株结核分支杆菌标准株均为阳性,15株非结核分支杆菌和5株非分支杆菌均为阴性.46份BACTEC MGIT-960培养阳性和10份BACTEC MGIT-960培养阴性的标本中,PhaB法分别有42份(91.3%)、3份(30.0%)阳性,检出率分别为82.1%和80.4%(P＞0.05).涂片检查阳性仅13份(23.2%),阴性43份(76.8%),而应用PhaB法可以检测出45份(80.4%)阳性,其中有33份为涂片阴性的标本(P＜0.05).用PhaB法能在18～24 h内得出结果,较BACTEC MGIT-960法提前5～17 d.结论]PhaB法与直接涂片法、BACTEC MGIT-960法相比,可以简便、快速地检测结核分支杆菌,全程只需1 d,并且具有较高的敏感性和特异性.

Experimental Study of Rapid Detection of Mycobacterium Tuberculosis in Pott's Disease by Phage Amplified Biologically Assay

Objective] To study the clinical value of the phage amplified biologically assay(PhaB)on rapid detection of mycobacterium tuberculosis in pus of Pott's disease.Methods] All the specimens were collected during the operation on the principal of asepsis.10 clinical isolates of Mycobacterium tuberculosis,15 strains of non-mycobacterium tuberculosis,5 strains of non-mycobacterium and 56 pus specimens of pott's disease patients were detected with AFB test,rapid culture with BACTEC MGIT-960 system or PhaB respectively.Results] All the strains of mycobacterium tuberculosis clinical isolates detected with PhaB were positive,while all of the non-mycobacterium tuberculosis and non-mycobacterium strains were negative.46 pus specimens with BACTEC MGIT-960 culture positive and 10 pus specimens with BACTEC MGIT-960 negative were detected with PhaB,the number of positive specimens were 42(91.3%)and 3(30.0%)respectively(P>0.05).The positive rate were 82.1% and 80.4% respectively.The positive of smear was only 13 cases(23.2%),negative was 43(76.8).However,the number of positive specimens detected by PhaB was 45(80.4%),30 of them were negative detected by pus smear(P<0.05).The result of PhaB could be reported in 18~24 hours,and 5~17 days were advanced compared with BACTEC MGIT-960.Conclusion] The PhaB can detect the mycobacterium tuberculosis more easily and quickly with high sensitivity and specificity compared with direct smear and BACTEC MGIT-960.The whole process just need one day.