Solis L A, Shin S S, Han L L, Llanos F, Stowell M, Sloutsky A
Instituto Nacional de Salud, Lima, Peru.
Int J Tuberc Lung Dis. 2005 Jul;9(7):760-4.
Treatment of multidrug-resistant tuberculosis (MDR-TB) is often based on drug susceptibility testing (DST) results; for this reason, rapid, simple DST methods are sought which could be applied in resource-poor countries. One such method is a nitrate reductase colorimetric assay known as the Griess method. In Peru, where the incidence rate of TB is among the highest in South America, the National Institute of Health recently undertook the validation and implementation of the direct Griess method.
To describe the process of validation and implemention of the direct Griess method at the Peruvian National Institute of Health.
Prospective study comparing the sensitivity and specificity of the direct Griess method with the Löwenstein-Jensen proportion method in determining resistance to isoniazid (INH) and rifampin (RMP) among clinical isolates.
Among 192 specimens, the sensitivity and specificity of the Griess method for detection of INH resistance was 99.1% and 100%, respectively. For identification of RMP resistance, the sensitivity and specificity was 93.5% and 100%, respectively.
In addition to its high sensitivity and specificity and rapid turn around time, the Griess method uses simple, inexpensive reagents and requires minimal laboratory space and technical expertise, thus providing an ideal screening tool for resource-poor settings with high rates of MDR-TB.
耐多药结核病（MDR-TB）的治疗通常基于药敏试验（DST）结果；因此，人们一直在寻找可在资源匮乏国家应用的快速、简单的DST方法。其中一种方法是一种名为格里斯（Griess）法的硝酸还原酶比色测定法。在结核病发病率居南美洲前列的秘鲁，国家卫生研究院最近对直接格里斯法进行了验证和实施。
描述秘鲁国家卫生研究院直接格里斯法的验证和实施过程。
一项前瞻性研究，比较直接格里斯法与罗氏培养基比例法在确定临床分离株对异烟肼（INH）和利福平（RMP）耐药性方面的敏感性和特异性。
在192份标本中，格里斯法检测INH耐药性的敏感性和特异性分别为99.1%和100%。对于RMP耐药性的鉴定，敏感性和特异性分别为93.5%和100%。
除了具有高敏感性、特异性和快速周转时间外，格里斯法使用简单、廉价的试剂，所需实验室空间和技术专长最少，因此为耐多药结核病发病率高的资源匮乏地区提供了一种理想的筛查工具。
