Sapkota Bishwa Raj, Ranjit Chaman, Macdonald Murdo
Leprosy Mission Nepal, Anandaban Hospital, Kathmandu, Nepal.
Nepal Med Coll J. 2007 Mar;9(1):12-6.
Differentiation of M tuberculosis and M leprae by polymerase chain reaction (PCR), when acid-fast bacilli (AFB) were present in sputum from patients at Anandaban hospital, was carried out. Thirty sputum samples microscopy positive for AFB were collected and were subjected to culture. Bacterial DNA was extracted and PCR was performed using primers specific for Mycobacterium tuberculosis and Mycobacterium leprae DNA. Twenty samples were from patients with clinical TB and 10 from patients with clinical leprosy. Fifteen of the TB samples were positive in both TB PCR and culture, among the reminders four were TB PCR negative and one was positive for TB PCR. All TB samples were negative for leprosy PCR. Of the leprosy samples, five were TB PCR and culture positive, and negative for leprosy PCR. The remaining five samples were negative for both TB PCR and culture but positive in leprosy PCR. Five often clinical leprosy samples were positive for tuberculosis. This indicates that AFB in the sputum of leprosy patients might be M. tuberculosis or M. leprae. Thus PCR can be used for rapid differentiation of M. tuberculosis and M. leprae present in sputum where AFB microscopy is inconclusive.
当阿南达班医院患者的痰液中存在抗酸杆菌(AFB)时,通过聚合酶链反应(PCR)对结核分枝杆菌和麻风分枝杆菌进行鉴别。收集了30份显微镜检查显示AFB呈阳性的痰液样本并进行培养。提取细菌DNA,并使用针对结核分枝杆菌和麻风分枝杆菌DNA的引物进行PCR。20份样本来自临床结核病患者,10份来自临床麻风病患者。15份结核病样本在结核PCR和培养中均呈阳性,其余样本中4份结核PCR呈阴性,1份结核PCR呈阳性。所有结核病样本的麻风PCR均为阴性。在麻风病样本中,5份结核PCR和培养呈阳性,但麻风PCR呈阴性。其余5份样本结核PCR和培养均为阴性,但麻风PCR呈阳性。10份临床麻风病样本中有5份结核病呈阳性。这表明麻风病患者痰液中的AFB可能是结核分枝杆菌或麻风分枝杆菌。因此,在AFB显微镜检查结果不明确的情况下,PCR可用于快速鉴别痰液中存在的结核分枝杆菌和麻风分枝杆菌。