荧光定量PCR在结核分枝杆菌耐药性检测中的应用价值

目的 探究和分析荧光定量PCR检测技术在结核分枝杆菌耐药性检测方面的价值。方法 随机选取苏州市第五人民医院门诊或者住院病人的痰培养阳性标本菌株,并提取核酸。应用荧光定量PCR扩增试剂盒对菌株标本的链霉素、利福平、异烟肼、乙胺丁醇、阿米卡星以及莫西沙星的耐药情况进行检测分析,并将检测结果与传统的罗氏药敏比例法进行比对分析。结果 与罗氏药敏比例法相比较,荧光定量PCR检测法对链霉素、利福平、异烟肼、乙胺丁醇、阿米卡星以及莫西沙星的耐药检测符合率分别为90.48%、82.14%、83.33%、88.09%、89.29%、89.28%。Kappa检验结果显示,两种方法对链霉素的检测结果一致性较高,Kappa值为0.815;对利福平、异烟肼、乙胺丁醇、莫西沙星的检测结果一致性一般,Kappa值分别为0.637、0.631、0.623、0.578;对阿米卡星的检测结果一致性较差,Kappa值为0.279。结论 荧光定量PCR检测技术对于结核分枝杆菌耐药性的快速检测均有很好的应用价值,对于临床上的精准用药具有一定的指导意义。

Application value of fluorescence quantitative PCR in detection of drug resistance of Mycobacterium tuberculosis

Objective To explore and analyze the value of fluorescence quantitative PCR in the detection of drug resistance of Mycobacterium tuberculosis. Methods Sputum cultures from outpatient or inpatient patients were randomly selected, and to extract the nucleic acid. The drug resistance of streptomycin, rifampicin, isoniazid, ethambutol, amikacin and moxifloxacin were detected and analyzed by fluorescence quantitative PCR amplification kit, the results were compared with the traditional Roche solid culture method. Results Compared with Roche solid culture proportion method the detection compliance rate of fluorescence quantitative PCR detection for streptomycin, rifampicin, isoniazid, ethambutol, amikacin and moxifloxacin were respectively 90.48%, 82.14%, 83.33%, 88.09%, 89.29% and 89.28%. The Kappa test results showed that the two methods had a high consistency in the detection results of streptomycin, and the Kappa value was 0.815. The test results of rifampicin, isoniazid, ethambutol and moxifloxacin were generally consistent, and the Kappa values were 0.637, 0.631, 0.623 and 0.578, respectively. The consistency of the detection results of amikacin was poor, and the Kappa value was 0.279. Conclusion Fluorescence quantitative PCR detection technology has a good application value for the detection of mycobacterium tuberculosis drug resistance, and has a certain guiding significance for clinical precision medicine.