基因分型（®）检测对常见分枝杆菌/其他分枝杆菌种类在结核分枝杆菌复合群与不同种类非结核分枝杆菌之间进行快速鉴别中的作用
Role of GenoType(®) Mycobacterium Common Mycobacteria/Additional Species Assay for Rapid Differentiation Between Mycobacterium tuberculosis Complex and Different Species of Non-Tuberculous Mycobacteria.
作者信息
Singh Amresh Kumar, Maurya Anand Kumar, Umrao Jyoti, Kant Surya, Kushwaha Ram Awadh Singh, Nag Vijaya Laskshmi, Dhole Tapan N
机构信息
Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India ; Department of Pulmonary Medicine, King George Medical University, Lucknow, Uttar Pradesh, India.
出版信息
J Lab Physicians. 2013 Jul;5(2):83-9. doi: 10.4103/0974-2727.119847.
BACKGROUND
Mycobacterium tuberculosis complex (MTBC) and non-tuberculous mycobacteria (NTM) may or may not have same clinical presentations, but the treatment regimens are always different. Laboratory differentiation between MTBC and NTM by routine methods are time consuming and cumbersome to perform. We have evaluated the role of GenoType(®) Mycobacterium common mycobacteria/additional species (CM/AS) assay for differentiation between MTBC and different species of NTM in clinical isolates from tuberculosis (TB) cases.
MATERIALS AND METHODS
A total of 1080 clinical specimens were collected from January 2010 to June 2012. Diagnosis was performed by Ziehl-Neelsen staining followed by culture in BacT/ALERT 3D system (bioMerieux, France). A total of 219 culture positive clinical isolates (BacT/ALERT(®) MP cultures) were selected for differentiation by p-nitrobenzoic acid (PNB) sensitivity test as and BIO-LINE SD Ag MPT64 TB test considering as the gold standard test. Final identification and differentiation between MTBC and different species of NTM were further confirmed by GenoType(®) Mycobacterium CM/AS assay (Hain Lifescience, Nehren, Germany).
RESULTS
Out of 219 BacT/ALERT(®) MP culture positive isolates tested by PNB as 153 MTBC (69.9%) and by GenoType(®) Mycobacterium CM/AS assay as 159 (72.6%) MTBC and remaining 60 (27.4%) were considered as NTM species. The GenoType(®) Mycobacterium CM/AS assay was proved 99.3% sensitive and 98.3% specific for rapid differentiation of MTBC and NTM. The most common NTM species were; Mycobacterium fortuitum 20 (33.3%) among rapid growing mycobacteria and Mycobacterium intracellulare 11 (18.3%) among slow growing mycobacteria.
CONCLUSION
The GenoType(®) Mycobacterium assay makes rapid and accurate identification of NTM species as compared with different phenotypic and molecular diagnostic tool and helps in management of infections caused by different mycobacteria.
背景
结核分枝杆菌复合群（MTBC）和非结核分枝杆菌（NTM）可能有相同的临床表现，也可能没有，但治疗方案总是不同的。通过常规方法在实验室区分MTBC和NTM既耗时又繁琐。我们评估了GenoType®分枝杆菌常见分枝杆菌/其他菌种（CM/AS）检测在结核病（TB）病例临床分离株中区分MTBC和不同NTM菌种的作用。
材料与方法
2010年1月至2012年6月共收集1080份临床标本。通过萋尼氏染色进行诊断，随后在BacT/ALERT 3D系统（法国生物梅里埃公司）中培养。共选择219份培养阳性的临床分离株（BacT/ALERT® MP培养物），通过对硝基苯甲酸（PNB）敏感性试验以及将BIO-LINE SD Ag MPT64 TB试验视为金标准试验进行区分。MTBC与不同NTM菌种之间的最终鉴定和区分通过GenoType®分枝杆菌CM/AS检测（德国海因生命科学公司，内伦）进一步确认。
结果
在通过PNB检测的219份BacT/ALERT® MP培养阳性分离株中，153株（69.9%）为MTBC，通过GenoType®分枝杆菌CM/AS检测，159株（72.6%）为MTBC，其余60株（27.4%）被视为NTM菌种。GenoType®分枝杆菌CM/AS检测在快速区分MTBC和NTM方面的敏感性为99.3%，特异性为98.3%。最常见的NTM菌种为；快速生长分枝杆菌中的偶然分枝杆菌20株（33.3%）以及缓慢生长分枝杆菌中的胞内分枝杆菌11株（18.3%）。
结论
与不同的表型和分子诊断工具相比，GenoType®分枝杆菌检测能够快速准确地鉴定NTM菌种，并有助于管理由不同分枝杆菌引起的感染。
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