Aono Akio, Azuma Yuka, Mitarai Satoshi, Ogata Hideo
Department of Clinical Microbiology, Double-Barred Cross Hospital, Japan Anti-Tuberculosis Association, Tokyo 204-8533, Japan.
Diagn Microbiol Infect Dis. 2009 May;64(1):27-30. doi: 10.1016/j.diagmicrobio.2009.01.011.
A combination of a rapid culture system, BACTEC MGIT 960 (MGIT), and a commercial polymerase chain reaction (PCR) system for the detection of Mycobacterium tuberculosis was evaluated to predict final culture results within 2 weeks. A total of 79 sputum specimens were collected from 59 tuberculosis (TB) patients before anti-TB chemotherapy. Among the 22 specimens that were smear negative and culture positive, the COBAS Amplicor nucleic amplification method for sputum resulted in 13 positives (59.1%) before culturing. In contrast, 21 liquid culture specimens (95.5%) showed positive results by COBAS Amplicor after 7 days. Similarly, 8 specimens (80%) were positive for Mycobacterium avium complex (MAC) based on COBAS Amplicor, and 10 liquid culture specimens (100%) showed positive results after 7 days. Among the 26 specimens that took more than 7 days to become positive by MGIT, 25 specimens (96.1%) were positive using COBAS Amplicor with 7-day-old cultures. Of the 26 positives, 21 were M. tuberculosis, which took 11 to 38 days to appear positive (mean, 16.6 days), and 4 were MAC, which took 8 to 10 days (mean, 8.8 days). As a result, 96.8% (31/32) of the positives could be detected by MGIT with COBAS Amplicor by day 7, and the negative predictive value was 97.9%. A combination of MGIT and COBAS Amplicor on day 7 was demonstrated as a useful method for rapid diagnosis of positives and negatives, without waiting 42 days for confirmation.
对一种快速培养系统BACTEC MGIT 960（MGIT）和一种用于检测结核分枝杆菌的商业聚合酶链反应（PCR）系统的组合进行了评估，以预测2周内的最终培养结果。在抗结核化疗前，从59例结核病（TB）患者中总共收集了79份痰标本。在22份涂片阴性但培养阳性的标本中，痰标本的COBAS Amplicor核酸扩增法在培养前有13份呈阳性（59.1%）。相比之下，21份液体培养标本（95.5%）在7天后通过COBAS Amplicor显示阳性结果。同样，基于COBAS Amplicor，8份标本（80%）对鸟分枝杆菌复合群（MAC）呈阳性，10份液体培养标本（100%）在7天后显示阳性结果。在MGIT检测需要7天以上才呈阳性的26份标本中，25份标本（96.1%）使用7日龄培养物的COBAS Amplicor检测呈阳性。在这26份阳性标本中，21份为结核分枝杆菌，需要11至38天才能呈阳性（平均16.6天），4份为MAC，需要8至10天（平均8.8天）。结果，到第7天，96.8%（31/32）的阳性标本可通过MGIT结合COBAS Amplicor检测到，阴性预测值为97.9%。第7天MGIT和COBAS Amplicor的组合被证明是一种快速诊断阳性和阴性结果的有用方法，无需等待42天进行确认。
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