耐利福平作为筛选耐多药结核病指标的评估

目的探讨耐利福平作为耐多药结核病筛选指标的可行性。方法对结核分枝杆菌临床分离株采用美国BD公司BACTEC MGIT 960全自动快速分枝杆菌培养鉴定药敏仪进行药敏试验,并对数据进行分析。应用诊断性试验评价指标评价耐利福平作为耐多药结核病筛选指标的科学性。结果在621株结核分枝杆菌临床分离株中,177株对利福平菌耐药,其中172株至少同时对异烟肼耐药,结核分枝杆菌的耐多药率为27.7%。若以至少同时耐异烟肼和利福平作为诊断MDR-TB的参考标准,以耐利福平作为MDR-TB筛选指标的敏感性为100%、特异性为98.9%、准确度为99.2%、阳性预测值为97.2%、阴性预测值为100%、阳性似然比为34.4、阴性似然比为0。结论我市耐多药结核病发生率高;耐利福平可以作为耐多药结核病的初步筛选指标。

Evaluation of rifampicin resistance as the screening indicator for multi-drug resistant tuberculosis

Objective To study the feasibility of using rifampicin resistance （Rif-resistance） as the screening indicators for muhi-drug resistance tuberculosis （MDR-TB）. Methods The drug sensitivity of Mycobaeterium tubereulosis clinical strains were tested by BACTEC MGIT 960 System. The results were carried out to give statistical analysis. Results There were 177 rifampicin-resistant strains in 621 strains of Myeobacterium tuberculosis, 172 of which were isoniazid-resistant at the same time. The multi-drug resistance of these strains was 27.7%. If taken resistance to both INH and REP as the standard of MDR-TB diagnosis, the aeeuraey, sensitivity and specificity of Rif-resistance as multi-drug resistance tuberculosis diagnosis were 99.2% , 100% and 98.9% respectively. Negative predic- tive value and positive predictive value were 100% and 97.2% respectively. Positive likelihood ratio and negative likelihood ratio were 34.4 and 0 respectively. Conclusion As the incidence of multi-drug resistance tuberculosis is high in our city, Rif-resistance can be used as preliminary screening indicator for multi-drug resistant tuberculosis.