利用Xpert MTB/RIF检测结核分枝杆菌及利福平耐药性的研究

目的初步评价Xpert结核分枝杆菌/利福平(Mycobacterium tuberculosis/Rifampicin,MTB/RIF)技术对不同类型临床标本进行结核分枝杆菌及其耐药性的检测中的应用价值。方法对627例结核病患者标本分别采用Xpert MTB/RIF、涂片及培养法检测,对结果进行比较。结果 (1)经统计学分析,总体Xpert MTB/RIF法阳性率41.78%(287/627)高于涂片法阳性率24.56%(154/627),差异有统计学意义(χ~2=261.87,P0.01);Xpert MTB/RIF法阳性率高于培养法阳性率26.63%(167/627),差异有统计学意义(χ~2=249.72,P0.01);涂片法与培养法间差异无统计学意义(χ~2=20.71,P0.05)。(2)Xpert MTB/RIF和比例法药敏试验检测RFP的耐药率分别为21.43%(33/154)、20.78%(32/154),二者间差异无统计学意义(χ~2=20.02,P0.05);二种方法所得结果一致率96.75%(149/154)。结论 Xpert MTB/RIF法具有快速、简单、敏感度高、便于操作、对生物安全要求不高等优点,能同时检测出结核分枝杆菌和是否对利福平耐药,具有广泛的应用前景。

Identification of Mycobacterium tuberculosis and rifampin-resistant strains by Xpert MTB/RIF test

Objective To assess the value of Xpert MTB/ RIF assay on detection of different types of clinical specimens of Mycobacterium tuberculosis(MTB)and drug-resistant. Methods 627 cases of tuberculosis were de-tected by Xpert MTB/ RIF assay,acid-fast stain,and culture respectively,and the results were compared. Results By statistical analysis,the positive rate of Xpert MTB/ RIF assay for all samples were higher than that of acid-fast stain and culture method,and the difference was statistically significant(χ2 = 261. 87,49. 72,P < 0. 01),and there was no significant difference between the acid-fast stain and culture method(χ2 = 20. 71,P > 0. 05). The RFP re-sistant rate from Xpert MTB/ RIF test(21. 43%(33 / 154))had no significant difference with those(20. 78%(32 /15))from standard drug susceptibility testing(χ2 = 20. 02,P > 0. 05). The coincidence rate of MTB resistance to RFP was 96. 75%(149 / 154). Conclusion The advantage of Xpert MTB/ RIF was rapid,simple,accurate and easy to operate,less demanding on biological safety,and it can simultaneously detect Mycobacterium tuberculosis and whether rifampicin has broad application prospects.