Traore Hamidou, van Deun Armand, Shamputa Isdore Chola, Rigouts Leen, Portaels Françoise
Mycobacteriology Unit, Microbiology Department, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium.
J Clin Microbiol. 2006 Dec;44(12):4384-8. doi: 10.1128/JCM.01332-06. Epub 2006 Oct 11.
The INNO-LiPA.Rif TB test (LiPA) has only been applied to a limited number of clinical specimens. To assess the utility of this test for detecting Mycobacterium tuberculosis complex DNA and rifampin (RMP) resistance, 420 sputum samples comprising specimens from untreated (n=160) and previously treated (n=260) patients from 11 countries in Asia, Africa, Europe, and Latin America were tested. DNA was extracted from sputum samples by using a modification of the Boom's method, while the rpoB core region was amplified by nested PCR. The results were analyzed in conjunction with those obtained by Ziehl-Neelsen (ZN) microscopy and by culture on solid media. The LiPA test was positive for M. tuberculosis complex DNA in 389 (92.9%) specimens, including 92.0% (286 of 311) ZN-positive and 94.5% (103 of 109) ZN-negative specimens. Of these, 30.6% were RMP resistant. In contrast, 74.3% of the specimens were positive for M. tuberculosis by culture, and 30.8% of them were RMP resistant. LiPA detected M. tuberculosis complex DNA in 92.4% (110 of 119) of the culture-positive and 100.0% (41 of 41) of the culture-negative specimens from untreated patients. There was a 99.6% concordance between the RMP resistance as determined by culture and by the LiPA test. With an optimal DNA extraction method, LiPA allows rapid detection of M. tuberculosis complex DNA and RMP resistance directly from sputum specimens. LiPA can still provide useful information when culture fails for various reasons. The rapid availability of this information is necessary to adjust patient treatment and avoid the risk of amplification of drug resistance.
INNO-LiPA.Rif TB检测（LiPA）仅应用于数量有限的临床标本。为评估该检测在检测结核分枝杆菌复合群DNA和利福平（RMP）耐药性方面的效用，对来自亚洲、非洲、欧洲和拉丁美洲11个国家的420份痰标本进行了检测，其中包括未经治疗患者的标本（n = 160）和既往接受过治疗患者的标本（n = 260）。采用改良的Boom法从痰标本中提取DNA，同时通过巢式PCR扩增rpoB核心区域。将结果与齐-尼（ZN）显微镜检查及固体培养基培养所得结果结合进行分析。LiPA检测显示，389份（92.9%）标本的结核分枝杆菌复合群DNA呈阳性，其中包括92.0%（311份中的286份）ZN阳性标本和94.5%（109份中的103份）ZN阴性标本。其中，30.6%对RMP耐药。相比之下，74.3%的标本培养结果显示结核分枝杆菌呈阳性，其中30.8%对RMP耐药。LiPA在92.4%（119份培养阳性标本中的110份）和100.0%（41份培养阴性标本中的41份）未经治疗患者的标本中检测到结核分枝杆菌复合群DNA。培养法与LiPA检测法所确定的RMP耐药性之间的一致性为99.6%。采用优化的DNA提取方法时，LiPA可直接从痰标本中快速检测结核分枝杆菌复合群DNA和RMP耐药性。当因各种原因培养失败时，LiPA仍可提供有用信息。快速获取该信息对于调整患者治疗方案及避免耐药性扩增风险十分必要。
