快速结核分枝杆菌菌型鉴定方法的应用评估

目的评估MGIT 960液体培养分枝杆菌阳性时,免疫胶体金法MPB64抗原检测及荧光探针PCR法在结核分枝杆菌快速菌型鉴定中的应用价值。方法临床MGIT960TM液体培养得到203例分枝杆菌阳性菌株,平行采用上述两种方法进行结核分枝杆菌菌型鉴定。结果免疫胶体金MPB64抗原检测法灵敏度为97.7%(169/173×100%),特异度为100%(30/30×100%);荧光探针PCR法灵敏度为100%(173/173×100%),特异度为96.7%(29/30×100%)。结论免疫胶体金法检测MPB64抗原及荧光探针PCR法作为液体培养时结核杆菌菌型鉴定的方法均是快速可靠的。免疫胶体金法检测MPB64抗原由于操作简便,实验要求条件低,更易为临床TB实验室接受。     

涂片镜检结合胶体金法对结核杆菌复合群的鉴别价值

目的探讨结核分枝杆菌在BACTEC960中湿片镜检形态特征及胶体金法对结核杆菌复合群的鉴别价值。方法收集陕西省结核病防治院经BACTEC 960培养阳性920例,进行直接涂片湿片镜检、涂片抗酸染色、胶体金法菌群鉴定,并以PNB(对硝基苯甲酸)和TCH(噻吩-2-羧酸肼)鉴别培养基菌群检测为标准。结果结核分枝杆菌(MTB)在液体培养管中呈镜检呈索状排列98.3%(832/846);非结核分枝杆菌(NTM)镜检呈团状排列32.43%(24/74)、块状排列35.13%(26/74)、散在排列为24.32%(20/74)。胶体金法检测结核分枝杆菌的敏感性98.34%(832/846),特异性98.64%,阳性预测值99.87%,阴性预测值86.90%。结论湿片观察结核分枝杆菌在BACTEC 960培养管中形成索状排列,较涂片抗酸染色更简便、快速,对鉴定分枝杆菌有初筛作用。     

结核分枝杆菌RNA恒温扩增实时荧光检测技术检测肺泡灌洗液诊断肺结核的价值

收集陕西省结核病防治院2021年10月至2022年7月疑似肺结核住院患者的肺泡灌洗液,同时进行涂片抗酸杆菌染色、分枝杆菌BACTEC MGIT 960液体培养(简称“培养”)及菌种鉴定、GeneXpert MTB/RIF、结核分枝杆菌RNA恒温扩增实时荧光检测技术(simultaneous amplification and testing for Mycobacterium tuberculosis,SAT-TB),并对结果进行分析。以培养法(菌种鉴定结果为结核分枝杆菌复合群)为参考标准,SAT-TB诊断肺结核的敏感度为80.61%(399/495),特异度为87.74%(1259/1435),阳性预测值为69.39%(399/575),阴性预测值为92.92%(1259/1355),约登指数为0.68。SAT-TB技术具有敏感度和特异度较高的特点,对临床快速诊断活动性结核病具有一定的价值。     

荧光定量PCR和双抗原夹心胶体金免疫层析法检测结核分枝杆菌的对比观察

目的 比较荧光定量PCR和双抗原夹心胶体金免疫层析法检测结核分枝杆菌的诊断价值.方法 选取经过结核分枝杆菌培养阳性的70例肺结核患者,分别采取荧光定量PCR和双抗原夹心胶体金免疫层析法进行结核分枝杆菌的检测,观察比较两种检测法的敏感度、特异度及准确率.采用SPSS 12.0软件处理数据,以P＜0.05为差异有统计学意义.结果 以细菌培养结果作为金标准,双抗原夹心胶体金免疫层析法与荧光定量PCR法检测结果进行比较,前者检测假阳性率明显低于后者[前者:1.7％(1/59),后者:8.8％ (6/68);x2=5.46,P＜0.05],即前者特异度较高;前者检测假阴性率明显高于后者[前者:15.7％(11/70),后者:2.9％(2/70);x2=9.71,P＜0.05],即后者敏感度较高;两种检测方法的结果准确率比较差异无统计学意义[前者:82.9％(58/70),后者:88.6％(62/70);x2=1.33,P＞0.05].结论 两种检测方法皆是临床上迅速检测结核分枝杆菌的有效方法,其中荧光定量PCR敏感度高,应用在初筛中效果更为显著,而双抗原夹心胶体金免疫层析法特异度高,可进一步作为鉴别诊断的参考依据,各有利弊,可结合临床实际需要合理选用.     

荧光PCR溶解曲线法检测结核分枝杆菌氟喹诺酮类药物突变的临床应用价值

目的评估荧光PCR溶解曲线法诊断氟喹诺酮类药物耐药结核病的价值。方法用罗氏药敏法与溶解曲线法同时检测555株结核分枝杆菌临床分离株对氟喹诺酮类药物中左氧氟沙星(Levofloxacin,LFX)和莫西沙星(MoxifLoxacin,MFX)的耐药突变,并进行分析比较。结果罗氏药敏法与溶解曲线法检测LFX、MFX耐药性差异均具有统计学意义(P0.05))。以罗氏药敏为标准,溶解曲线法检测左氧氟沙星耐药突变敏感度、特异度、阳性预测值、阴性预测值、约登指数、符合率分别为85.37%(35/41),93.58%(481/514),51.47%(35/68)、98.76%(481/487)0.79,92.97%;溶解曲线法检测莫西沙星耐药突变敏感度、特异度、阳性预测值、阴性预测值、约登指数、符合率分别为84.38%(27/32),92.16%(482/523),39.71%(27/68),98.97%(482/487),0.77,91.97%。结论溶解曲线法检测结核分枝杆菌氟喹诺酮类药物突变敏感度、特异度较高、快速;有利于耐药结核病快速诊断和治疗。     

结核分枝杆菌特异性蛋白抗体检测在肺外结核病诊断中的价值

目的研究结核分枝杆菌特异性蛋白(TB-SA)抗体检测在肺外结核病诊断中的价值。方法对71例肺外结核病患者和40例健康志愿者进行血清结核分枝杆菌特异蛋白抗体检测,并对各种肺外结核病引流物标本进行AFB涂片和培养检查。结果结核分枝杆菌TB-SA抗体检测诊断菌阳肺外结核病敏感度为87.5%(7/8),诊断菌阴肺外结核的敏感度为63.5%(40/63),诊断肺外结核总体敏感度为66.2%(47/71),特异度为97.5%(39/40)。结论结核分枝杆菌TB-SA抗体检测诊断肺外结核病有较好的敏感性和特异性,是辅助诊断和鉴别诊断肺外结核病较为理想的免疫学方法之一。     

分泌蛋白MPT64鉴定结核分枝杆菌复合群的应用研究

v、牛分枝杆菌和非洲分枝杆菌为阳性,24株非MTB均为阴性;mpt64基因扩增的结果与ELISA法检测结果完全相符.ELISA法检测MTB临床分离株的敏感度为97.3%(110/113),57株非MTB均未检出MPT64蛋白,检测特异度为100.0%.基因扩增MTB中2株为阴性,非MTB均为阴性.结论 采用ELISA法检测分泌蛋白MPT64来鉴定MTB复合群,是一种准确、快速和简便的方法,值得临床推广应用.     

三种实验室诊断技术对结核分枝杆菌复合群检出率及检测费用的比较研究

目的 评估液基夹层杯涂片法(采用集菌法;简称“涂片法”)、L-J固体培养法(简称“L-J培养法”)、结核分枝杆菌复合群核酸检测(采用恒温扩增法;简称“恒温扩增法”)对结核分枝杆菌复合群的检测效能。 方法 采用随机数字表法从湖南省120家结核病定点医院中抽取3家作为研究现场,分别为浏阳市人民医院、醴陵市湘东医院、桃江县人民医院。以3家医院2018年11月1日至12月31日就诊的存在可疑肺结核症状的628例患者为研究对象,对同一份痰标本同时采用涂片法、L-J培养法和恒温扩增法进行检测,分析3种检测方法对结核分枝杆菌复合群阳性检出率的差异;并依据《WS 288—2017 肺结核诊断》的诊断标准,以临床诊断肺结核作为参考标准,计算各种检测方法的敏感度、特异度、阳性预测值、阴性预测值、一致率;再以患者进行每项检测的实际支出费用为准,计算每种方法的检测费用。结核分枝杆菌复合群检出率在3种检测技术间的两两比较采用χ ²检验,检验水准α=0.05/3=0.017。 结果 628例疑似肺结核患者中,临床确诊为肺结核患者153例(24.4%),NTM肺病患者6例(1.0%)。3种技术检测结果显示,涂片法、L-J培养法和恒温扩增法的结核分枝杆菌复合群阳性检出率(排除6例NTM肺病患者)分别为13.5%(84/622)、14.0%(87/622)和12.2%(76/622),涂片法和L-J培养法,L-J培养法和恒温扩增法,涂片法和恒温扩增法之间比较,差异均无统计学意义(χ ²=1.32,P=0.359;χ ²=5.83,P=0.024;χ ²=4.00,P=0.077)。以临床诊断结果作为参考标准,排除6例非结核分枝杆菌肺病患者和32例培养污染的患者,涂片法、L-J培养法和恒温扩增法的敏感度分别为55.2%(80/145)、57.9%(84/145)、50.3%(73/145);特异度分别为99.6%(443/445)、99.3%(442/445)、99.8%(444/445);阳性预测值分别为97.6%(80/82)、96.6%(84/87)、98.6%(73/74);阴性预测值分别为87.2%(443/508)、87.9%(442/503)、86.0%(444/516);一致率分别为88.6%(523/590)、89.2%(526/590)、87.6%(517/590)。3种方法的检测费用,由低到高依次为L-J培养法[317.2元(29500/93)]、涂片法[813.8元(70800/87)]、恒温扩增法[1992.2元(153400/77)]。 结论 涂片法、L-J培养法、恒温扩增法的阳性检出率及其敏感度和特异度均未见差异。平均发现1例病原学阳性结核病患者的检测费用,L-J培养法较低,恒温扩增法较高。     

结核/非结核分枝杆菌核酸快速检测方法临床应用价值

目的 评价结核/非结核分枝杆菌核酸快速检测方法的临床应用价值。 方法 应用实时荧光PCR技术对420例标本进行临床试验研究,并与抗酸杆菌涂片和分枝杆菌培养方法对照比较。 结果 结核分枝杆菌核酸检测灵敏度为48.5%（其中菌阳标本灵敏度为95.8%,菌阴标本灵敏度为14.5%）,特异度99.3%,阳性预测值为99.1%,阴性预测值为55.5%;临床试验388例痰标本中检测出1例非结核分枝杆菌核酸阳性,经测序确认,准确率100%;同时对32例非结核分枝杆菌临床分离株进行核酸检测,并经测序确认,准确率100%。 结论 应用实时荧光PCR技术,能实现在1支管内同时进行结核分枝杆菌/非结核分枝杆菌的核酸检测。该方法具有简单快速、特异性好污染性少的特点。可作为实验室辅助检测结核/非结核分枝杆菌核酸方法之一。     

噬菌体生物扩增法检测痰结核分枝杆菌的临床研究

目的评价噬菌体生物扩增(PhaB)法检测痰中结核分枝杆菌的应用价值。方法分别应用PhaB法、直接涂片法、集菌涂片法和BACTECMGIT960快速培养法检测2005年8月至10月沈阳市胸科医院53例疑诊肺结核患者痰标本中结核分枝杆菌,并对检测结果进行比较。结果PhaB法、直接涂片法、集菌涂片法、BACTECMGIT960快速培养法检出阳性标本数分别为24,11,17和22份;以培养结果为评价标准,PhaB法的敏感性、特异性、阳性预测值、阴性预测值分别为86.4%,83.9%,79.2%和89.7%;集菌涂片法和PhaB法联合检测的敏感性为90.9%,特异性为83.9%,阳性、阴性预测值分别为80.0%和92.9%。结论PhaB法检测痰中结核菌操作简便,具有较高的敏感性和特异性,可作为临床结核分枝杆菌的快速检测方法;PhaB法联合集菌涂片法进行检测可进一步提高敏感性,减少漏诊率。     

PCR-荧光探针法检测临床痰标本结核分枝杆菌的可靠性研究

目的 评价PCR-荧光探针法快速检测Mtb和非结核分枝杆菌（NTM）的临床应用价值。方法 应用分枝杆菌核酸检测试剂对1015 例痰标本和56株临床分离株进行检测,与Mtb核酸扩增（PCR）荧光（目前临床上认可惟一同类产品）检测结果进行比较。采用SPSS 11.5统计软件进行数据统计处理,采用χ²检验,以P＜0.05为差异有统计学意义。结果 PCR-荧光探针法检测痰标本分枝杆菌灵敏度50.3%（373/741）,特异度98.9%（271/274）;菌阳肺结核标本检测灵敏度97.0%（257/265）,菌阴肺结核标本检测灵敏度24.4%（116/476）;1015份痰标本中检测出11例非结核分枝杆菌（NTM）核酸阳性标本（占1.1%）,经16S rDNA 测序确认,准确率100.0%。随机数字量表法抽取138例标本重复进行第2次检测,符合率100.0%。对56株临床分离株（1株Mtb临床分离株,55株NTM临床分离株）检测,准确率100.0%。对临床需要的226份标本同时与达安公司试剂盒检测结果比较,总体符合率95.1%（215/226）,经统计学分析,两者之间差异无统计学意义（χ²=2.98,P=0.226）。结论 PCR-荧光探针法可快速检测和区分痰标本Mtb与NTM,具有临床推广应用价值。     

双抗原夹心胶体金免疫层析法快速检测结核分枝杆菌抗体的研究

目的 建立一种简易、快速和准确的双抗原夹心胶体金免疫层析法,用于检测结核病患者血清中的抗MTB抗体.方法 采用胶体金标记相对分子质量分别为6000、16 000和38 000的重组MTB早期分泌抗原靶蛋白(ESAT),成为重组MTB融合蛋白ESAT-16-38,研制出双抗原胶体金免疫层析检测卡,对浙江省德清县疾病预防控制中心2007-2009年临床确诊的结核病患者血清163份(其中肺结核痰MTB阳性57份、痰MTB阴性64份和肺外结核42份)和对照血清573份(其中体检者血清224份、急性肺炎和支气管炎患者血清217份、肺吸虫患者血清132份)样本进行检测,并与MTB蛋向芯片抗体法的检测结果进行比较.检出率的比较采用χ2检验.结果 双抗原法和蛋白芯片法检测结核病患者血清的阳性符合率分别为73.0%(120/163)和72.4%(118/163),差异无统计学意义(χ2=0.062,P＞0.05);检测对照血清的阴性检出率分别为93.9%(538/573)和92.0%(527/573),差异无统计学意义(χ2=0.635,P＞0.05);未见与肺吸虫患者血清有交叉反应,双抗原法对痰MTB阳性血清的检出率高达87.7%(50/57).结论 重组ESAT-6和ESAT-16双抗原胶体金免疫层析检测卡具有较高的敏感度和特异度,与蛋白芯片法的检测结果相似,且方法简便、快速,有很好的重现性和稳定性.

Abstract：

Objective To establish a simple,fast and accurate double antigen colloidal gold immunochromatographic technique for detecting Mycobacterium tuberculosis antibody from tuberculosis patients.Methods The fusion protein ESAT-6-16-38 was constructed by using gene cloning technique for the 6,16 and 38 kDa early secreted antigenic target from Mycobacterium tuberculosis.The ESAT-6-16-38 fusion protein was marked to colloidal gold to eatablish the double antigen colloidal gold immunochromatographie assay.Serum samples from 163 patients with tuberculosis,including 57 sputumpositive cases,64 sputum-negative cases,and 42 cases with extrapulmonary tuberculosis,were collected during 2007and 2009 from the Disease Prevention and Control Center of Deqing County.In addition,573 controls(224 healthy volunteers,217 patients with acute pneumonia and bronchitis,132 patients with paragonimiasis)were recruited for comparison.Mycobacterium tuberculosis specific antibodies were detected by using immunochromatographic and protein chip technique.Detection rate was compared with Chi-square test. Results Among the 163 tuberculosis patients,the positive rates of immunochmmatographic detection and protein chip were 73.0%(120/163)and 72.4%(118/163)respectively;the difference was not statistically significant(χ2=0.062,P＞0.05).Among the 573 controls,the negative rates of immunochromatographic detection and protein chip were 93.9%(538/573)and 92.0%(527/573)respectively;the difference was not statistically significant(χ2=0.635,P＞0.05).There was no cross reaction in the paragonimiasis patients.The positive rate of the immunoehromatographie assay was as high as 87.7%(50/57)in the sputmn-positive patients.Conclusions The double antigen immunoehromatographie technique is an easy to operate, rapid,highly sensitive, specific, and reproducible method for the detection of Mycobacterium tuberculosis antibodies.     

实时荧光核酸恒温放大检测（SAT）法对肺结核诊断价值的研究

目的 检测实时荧光核酸恒温放大检测（SAT）法对结核病诊断的作用。 方法 收集172例疑似肺结核患者的痰液标本2份/例,1份进行涂涂片金-胺染色,另一份进行罗氏培养基培养与菌种鉴定及SAT法检测结核分枝杆菌,如SAT法和培养结果不符合则使用痰荧光定量PCR法（FQ-PCR)进行复核。 结果 172例入组患者中有156例根据临床及实验室结果确诊为肺结核病。如果以Mtb培养鉴定结果和荧光PCR结果作为判定金标准,SAT检测的敏感度和特异度分别为97.8%（89/91）和97.5%（79/81）。如以临床诊断为标准,SAT诊断结核的敏感度为58.3%（91/156）,特异度为100.0％（16/16）。对于痰菌阳性肺结核患者,SAT 阳性率为84.9%（79/93）;对于痰菌阴性患者,SAT的阳性率为19.0%（12/63）。 结论 SAT法可以作为临床对结核病的辅助诊断方法。     

A ten-year experience with fiberoptic bronchoscopy for mycobacterial isolation. Impact of the Bactec system

From January 1974 to December 1983, positive mycobacterial isolates from all sources were reviewed to determine the impact of fiberoptic bronchoscopy (FB) on retrieval and identification of these organisms. There were 112 patients with positive cultures obtained during FB, 25 with Mycobacterium tuberculosis and 87 with mycobacteria other than tuberculosis (MOTT). We reviewed the results of prebronchoscopy and postbronchoscopy sputum specimens, bronchial washings, brushings, and transbronchial biopsy to determine the yield from each specimen in patients with M. tuberculosis. The bronchial washings provided positive cultures in 24 of 25 and were exclusively positive in 10 of 25 (40%). We also reviewed the clinical presentation, chest roentgenogram, bronchoscopy findings, and culture data for the 87 patients with MOTT isolated. The isolation of MOTT from bronchoscopy specimens increased throughout the study, most notably with the introduction of a rapid radiometric method (the Bactec system) for the recovery of mycobacteria to our laboratory in June 1983. Active disease could be established in only 13 of 87 cases (15%). Our findings confirm the sensitivity of Bactec in the isolation of MOTT from bronchoscopic specimens. The Bactec system, on the other hand, does not differentiate saprophytic colonization from clinical disease. To avoid expensive, time-consuming biochemical identification necessary to evaluate these MOTT isolates, careful selection of patients prior to obtaining mycobacterial cultures during FB is a critical factor.     

Identification of mycobacterium species in contaminated cultures by polymerase chain reaction

STUDY OBJECTIVES: The detection of Mycobacterium sp on a culture remains the "gold standard" technique for the diagnosis of mycobacterial infections. A small percentage of these cultures, however, may be contaminated by other nonfastidious microorganisms, making accurate diagnosis difficult. We evaluated the use of a polymerase chain reaction (PCR) protocol that was specific for the genus Mycobacterium, and specifically for Mycobacterium tuberculosis, Mycobacterium avium, and Mycobacterium intracellulare, for the identification of Mycobacterium sp growing on contaminated cultures. DESIGN: This prospective study was designed to identify Mycobacterium sp growing on mycobacterial cultures contaminated with other microorganisms.Samples and patients: Twenty-six samples, taken from 23 patients with probable mycobacterial disease, that resulted in Mycobacterium growth but were contaminated during their processing were evaluated in this study. Clinical data and the clinical status of each patient were used to ascertain the final diagnosis. RESULTS: All samples studied here exhibited Mycobacterium growth on solid media but were contaminated by nonfastidious bacteria, compromising the biochemical identification of the Mycobacterium sp. PCR correctly identified the genus Mycobacterium in all samples. M tuberculosis was identified in 14 samples, and M avium in 10 samples. No amplification of M intracellulare was obtained, and in two samples there was amplification only for the genus Mycobacterium. In the cultures of those patients in whom a mycobacterial infection was evident, PCR identified M avium and M tuberculosis in samples from 6 and 12 patients, respectively. However, PCR identified M avium (two patients) and M tuberculosis (two patients) in the cultures of four patients for whom a mycobacterial disease could not be confirmed by our case definition. Finally, in two samples from one patient only the genus Mycobacterium was amplified by PCR. CONCLUSION: PCR, with its advantages of greater speed and effectiveness than conventional detection methods, was successfully used to identify the Mycobacterium sp growing on contaminated cultures.     

结核分枝杆菌散在分布重复单位基因型分型法的应用研究

目的 建立结核分枝杆菌散在分布重复单位(mycobacterial interspersed repetitive units，MIRU)基因型分型法，评估该方法在我国应用的可行性。方法 采用简单数字表法随机抽取上海地区2000年至2002年保存的菌株，对其进行MIRU分型，并与间隔区寡核苷酸分型法(Spoligotyping)的结果进行比较。结果 用Spoligotyping方法对随机抽样的91株临床菌株进行基因型分型，得到20种基因型，其中81株(89％)属于北京基因型菌株，而用MIRU分型方法可将这些菌株分为46种基因型。81株北京基因型菌株可以分为39种不同的MIRU基因型。12个MIRU位点的多态性分析表明各位点有较大的区别，其中位点26显示了较高的多态性，位点16、31、40显示了中等程度的多态性。结论 MIRU分型方法简单快速，其数字化结果清晰可靠，是一种有效的结核分枝杆菌基因型分型方法。     

MPB64分泌蛋白检测鉴定结核分枝杆菌复合群的应用研究

目的 对应用MPB64分泌蛋白检测鉴定结核分枝杆菌复合群进行方法学评价.方法 对临床分离菌株,取BacT/ALERT 3D系统的液体培养液或改良罗氏固体培养基分离培养菌落室温静置约2 h、浊度为1麦氏单位的生理盐水菌悬液0.1 ml为检测样本,应用胶体金标记抗MPB64单克隆抗体采用免疫层析色谱法进行MPB64分泌蛋白检测,而后与菌种鉴定结果相比较.对参考菌株,则同时采用两种样本进行检测.结果 对23株分枝杆菌参考菌株、267株临床分离菌株进行了检测.①对于参考菌株的两种样本,MPB64检测结果均为:结核分枝杆菌、牛分枝杆菌、田鼠分枝杆菌菌株阳性,其他20株非结核分枝杆菌为阴性.分群鉴定准确度为100%.②在111株BacT/ALERT 3D系统分离培养临床株中,55株为结核分枝杆菌,其中51株MPB64检测阳性;56株为非结核分枝杆菌,其中54株MPB64检测阴性.分群鉴定准确度为94.59%.③在156株改良罗氏培养基分离培养临床菌株中,121株为结核分枝杆菌,其中115株MPB64检测阳性;35株为非结核分枝杆菌,MPB64检测全部阴性.分群鉴定准确度为96.15%.④对于所有研究样本,应用MPB64分泌蛋白检测鉴定结核分枝杆菌复合群的敏感度、特异度与准确度分别为94.41%、98.20%和95.86%.结论 应用MPB64分泌蛋白检测鉴定结核分枝杆菌复合群是一种准确、快速、简便而又不需要任何仪器设备的实用型方法,值得临床推广应用.     

非结核分枝杆菌病的实验室诊断技术进展

目前,非结核分枝杆菌（NTM)病的发病率在全球逐年提高,NTM与结核分枝杆菌均可引起肺部以及其他部位病变,而且临床症状相似,鉴别诊断困难,所以分枝杆菌菌种鉴定对于疾病的诊断、治疗及预后意义重大。传统生化鉴定方法费力耗时,不能很好地满足临床需要。近年来,以免疫层析技术为基础的MPB64抗原胶体金法、以色谱技术为基础的气相及高效液相色谱法、以基因探针、限制性片段长度多态性聚合酶链反应（PCR-RFLP）及PCR-基因测序方法为代表的分子生物学技术等各种新技术的引入,为NTM的菌种鉴定提供了更为科学的方法。作者就上述3种技术为基础开展的菌种鉴定方法,综合国内外近年来的文献,介绍了各种方法的原理、应用情况、性能指标等,同时对方法的优点及局限性进行初步评价。相信随着新技术不断完善,能够逐步形成快速可靠、成本低廉的标准化NTM菌种鉴定体系。     

Bovine tuberculosis in India: potential basis for zoonosis

Our laboratory has designed a specific nested-PCR (N-PCR) assay, based on the hupB gene of Mycobacterium tuberculosis (Rv2986c) and Mycobacterium bovis (Mb3010c) as a method to differentiate these closely related species. The present paper deciphers the utility of this assay for identification of pathogenic Mycobacteria in clinical samples. Extra-pulmonary clinical samples obtained from cattle and humans were investigated. Pre-dominance of M. tuberculosis (15.7%) and M. bovis (26.8%) was seen in humans and cattle, respectively. However, more importantly, both mycobacterial pathogens (mixed infection) were identified in a number of samples. In humans 8.7% of the samples and 35.7% in cattle were classified as mixed infection. The detection of mixed infection with the mycobacterial pathogenic duo in humans and bovines denotes the prospect of potential transmission of these pathogens from humans to cattle (zoonosis) and vice versa (reverse zoonosis).     

两种免疫学检验方法对于结核病的临床价值比较

目的 探讨蛋白芯片法与胶体金法两种方法检测结核抗体对结核病的临床诊断价值.方法 91例分为活动性结核和非结核两组,活动性结核组分为肺结核组和结核性胸腹膜炎组.均采用两种方法测结核抗体,两种方法对照比较.结果 两种检测方法在肺结核组中有显著差异,P〈0.005;蛋白芯片法和胶体金法在肺结核中的阳性率分别为72.3%、44.7%,在结核性胸腹膜炎中的阳性率分别为42.1%、26.3%;蛋白芯片法在结核组中总的阳性率为63.6%,胶体金法总的阳性率为39.4%,联合两种方法检测灵敏度71.2%,特异度48.0%,假阴性率28.8%,假阳性率62.0%,约登指数0.192,符合率64.8%.结论 蛋白芯片法对活动性肺结核尤其是涂阴肺结核诊断有一定参考价值;胶体金法诊断结核价值有限,特别是单一方法检测时价值较小.