Department of Infectious Diseases, Chinese Academy of Medical Sciences, Beijing, China.
Chin Med J (Engl). 2012 Sep;125(18):3292-7.
Gene chip array can differentiate isolated mycobacterial strains using various mycobacterium specific probes simultaneously. Gene chip array can evaluate drug resistance to isoniazid and rifampin of tuberculosis strains by detecting drug resistance related gene mutation. This technique has great potential for clinical application. We performed a retrospective study to investigate the capability of gene chip array in the rapid differentiation of species and detection of drug resistance in mycobacterium, and to evaluate its clinical efficacy.
We selected 39 patients (54 clinical mycobacterium isolates), used gene chip array to identify the species of these isolates and detect drug resistance to isoniazid and rifampin in Mycobacterium tuberculosis isolates. Meanwhile, these patients' clinical data were analyzed retrospectively.
Among these 39 patients whose mycobacterium culture were positive, 32 patients' isolates were identified as Mycobacterium tuberculosis, all of them were clinical infection. Seven patients' isolates were identified as non-tuberculosis mycobacterium. Analyzed with their clinical data, only two patients were considered as clinical infection, both of them were diagnosed as hematogenous disseminated Mycobacterium introcellulare infection. The other five patients' isolates were of no clinical significance; their clinical samples were all respiratory specimens. Clinical manifestations of tuberculosis and non-tuberculous mycobacterial infections were similar. Isoniazid resistance was detected in two tuberculosis patients, while rifampin resistance was detected in one tuberculosis patient; there was another patient whose Mycobacterium tuberculosis isolate was resistant to both isoniazid and rifampin (belongs to multidrug resistance tuberculosis). The fact that this patient did not respond to routine anti-tuberculosis chemotherapy also confirmed this result.
Gene chip array may be a simple, rapid, and reliable method for the identification of most mycobacterial species and detection of drug resistance in Mycobacterium tuberculosis. It is useful in diagnosis, treatment, and hospital infection control of mycobacterial infections, and it may have a great potential for clinical application.
基因芯片阵列可以同时使用各种分枝杆菌特异性探针来区分分离的分枝杆菌菌株。基因芯片阵列可以通过检测耐药相关基因突变来评估结核分枝杆菌菌株对异烟肼和利福平的耐药性。该技术具有很大的临床应用潜力。我们进行了一项回顾性研究，以调查基因芯片阵列在快速区分物种和检测分枝杆菌耐药性方面的能力，并评估其临床疗效。
我们选择了 39 名（54 株临床分枝杆菌分离株）患者，使用基因芯片阵列鉴定这些分离株的种属，并检测结核分枝杆菌分离株对异烟肼和利福平的耐药性。同时，回顾性分析这些患者的临床资料。
在分枝杆菌培养阳性的 39 名患者中，32 名患者的分离株鉴定为结核分枝杆菌，均为临床感染。7 名患者的分离株鉴定为非结核分枝杆菌。根据其临床资料分析，只有 2 名患者被认为是临床感染，均诊断为血源性播散性细胞内分枝杆菌感染。另外 5 名患者的分离株无临床意义；其临床标本均为呼吸道标本。肺结核和非结核分枝杆菌感染的临床表现相似。2 名肺结核患者检测到异烟肼耐药，1 名肺结核患者检测到利福平耐药；还有 1 名患者的结核分枝杆菌分离株对异烟肼和利福平均耐药（属于耐多药肺结核）。该患者对常规抗结核化疗无反应的事实也证实了这一结果。
基因芯片阵列可能是一种简单、快速、可靠的方法，可用于大多数分枝杆菌物种的鉴定和结核分枝杆菌耐药性的检测。它有助于分枝杆菌感染的诊断、治疗和医院感染控制，具有很大的临床应用潜力。
