Barman Purabi, Gadre Deepa
Department of Microbiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi- 10095.
Indian J Tuberc. 2007 Jan;54(1):36-40.
Tuberculosis (TB) is a leading infectious disease in India. Diagnosis of TB has always been a problem due to slow rate of growth of Mycobacterium tuberculosis. In this study we have compared the conventional tools for diagnosis of TB with the new Fast Plaque TB TM MATERIAL AND METHODS: Two hundred and twelve clinically suspected cases of TB were enrolled for the study. Three consecutive early morning sputum samples were collected from each patient. Sputum smears were examined after staining with ZN stain and the sputum samples were later subjected to culture and phage assay.
It was seen from the study that out of the total 212 cases, 106 were phage positive and 106 were phage negative. Sensitivity of the phage test with respect to AFB smear is 94.34% and specificity of the phage test is 93.88%. A total of 120 specimens grew on LJ media, of which 112 were Mycobacterium tuberculosis, 2 were Mycobacterium Kansasii, 4 were Mycobacterium avium complex and 2 grew Mycobacteriumfortuitum group. Out of these 120 specimens which grew on LJ, 104 were also positive for phage assay. All the 8 Non-Tubercular Mycobacteria were negative by the Fast Plaque Assay. Out of the 92 which were negative on LJ, 2 were positive by phage assay. Sensitivity and specificity of phage assay with respect to growth on LJ was 92.86% and 97.83% respectively.
The study showed that phage assay is a rapid, reliable and cost effective method in diagnosing pulmonary tuberculosis from clinical samples.
结核病是印度主要的传染病。由于结核分枝杆菌生长速度缓慢,结核病的诊断一直是个问题。在本研究中,我们将结核病的传统诊断工具与新型快速结核斑TM进行了比较。
招募了212例临床疑似结核病病例进行研究。从每位患者收集连续3份清晨痰液样本。痰液涂片经ZN染色后进行检查,随后痰液样本进行培养和噬菌体检测。
研究发现,在总共212例病例中,106例噬菌体检测呈阳性,106例呈阴性。噬菌体检测相对于抗酸杆菌涂片的敏感性为94.34%,噬菌体检测的特异性为93.88%。共有120份标本在罗-琴培养基上生长,其中112份为结核分枝杆菌,2份为堪萨斯分枝杆菌,4份为鸟分枝杆菌复合群,2份为偶然分枝杆菌属。在这120份在罗-琴培养基上生长的标本中,104份噬菌体检测也呈阳性。所有8份非结核分枝杆菌经快速结核斑检测均为阴性。在罗-琴培养基上呈阴性的92份标本中,2份经噬菌体检测呈阳性。噬菌体检测相对于在罗-琴培养基上生长的敏感性和特异性分别为92.86%和97.83%。
该研究表明,噬菌体检测是一种从临床样本中诊断肺结核的快速、可靠且经济有效的方法。