在拉脱维亚，采用 INNO-LiPA Rif. TB®线探针分析快速检测耐多药结核病的实施情况。
Implementation of the INNO-LiPA Rif. TB® line-probe assay in rapid detection of multidrug-resistant tuberculosis in Latvia.
机构信息
State Agency Infectology Center of Latvia, Riga, Latvia.
出版信息
Int J Tuberc Lung Dis. 2011 Nov;15(11):1546-52, i. doi: 10.5588/ijtld.11.0067.
SETTING
In Latvia, 11% of tuberculosis (TB) patients have multidrug-resistant TB (MDR-TB). The INNO-LiPA Rif.TB ® line-probe assay (LPA) detects rifampin (RMP) resistance and may accelerate the time to effective MDRTB treatment.
OBJECTIVE
To determine the impact of LPA on time to diagnosis, initiation of treatment, sputum culture conversion and treatment outcome.
DESIGN
From October 2004 to September 2006, we performed LPA and drug susceptibility testing (DST) using BACTEC and Löwenstein-Jensen (LJ) media among all individuals at risk for MDR-TB compared to a 2003 cohort of 48 MDR-TB patients detected by BACTEC.
RESULTS
In a total of 107 sputum smear-positive individuals at risk for MDR-TB, Mycobacterium tuberculosis was isolated from 85; 23 were RMP-resistant on LJ compared to 22 on LPA (96% sensitivity). There was a significant difference in the mean time between specimen collection and LPA result (10.0 days) and BACTEC DST result (17.0 days, P = 0.0005) in the LPA cohort. The LPA cohort achieved culture conversion a median of 105 days after treatment initiation vs. a median of 88.5 days (P = 0.54) in the BACTEC cohort. There was no difference in the proportion achieving culture conversion (P = 0.54) or in treatment outcome ( P = 0.65).
CONCLUSION
LPA accelerated empiric treatment, but did not reduce the time to culture conversion or improve the rate of culture conversion or treatment outcome.
背景
在拉脱维亚，11%的肺结核（TB）患者患有耐多药结核（MDR-TB）。INNO-LiPA Rif.TB ® 线探针分析（LPA）可检测利福平（RMP）耐药性，并可能加速有效的 MDRTB 治疗时间。
目的
确定 LPA 对诊断时间、治疗开始时间、痰培养转换和治疗结果的影响。
设计
从 2004 年 10 月到 2006 年 9 月，我们对所有有 MDR-TB 风险的个体进行了 LPA 和药敏试验（DST），使用 BACTEC 和 Löwenstein-Jensen（LJ）培养基，与 2003 年 BACTEC 检测的 48 例 MDR-TB 患者的 2003 年队列进行了比较。
结果
在总共 107 例有 MDR-TB 风险的痰涂片阳性个体中，从 85 例中分离出结核分枝杆菌；23 例在 LJ 上对 RMP 耐药，而在 LPA 上有 22 例（96%的敏感性）。在 LPA 队列中，标本采集与 LPA 结果（10.0 天）和 BACTEC DST 结果（17.0 天，P = 0.0005）之间的平均时间存在显著差异。LPA 队列在治疗开始后 105 天中位数达到培养转换，而 BACTEC 队列中位数为 88.5 天（P = 0.54）。在获得培养转换的比例（P = 0.54）或治疗结果（P = 0.65）方面没有差异。
结论
LPA 加速了经验性治疗，但并未缩短培养转换时间或提高培养转换率或治疗结果。
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