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在尼日利亚伊巴丹使用GenoType MTBDRplus 96检测法对耐多药结核病进行分子诊断。

Molecular diagnosis of MDR-TB using GenoType MTBDRplus 96 assay in Ibadan, Nigeria.

作者信息

Kehinde A O, Adebiyi E O

机构信息

Department of Medical Microbiology and Parasitology, College of Medicine, University of Ibadan, Ibadan.

出版信息

Niger J Physiol Sci. 2013 Dec 20;28(2):187-91.

Abstract

Multidrug resistant Mycobacterium tuberculosis (MDR-TB) is of great public health importance worldwide. This three month laboratory- based study (1st September-30th November, 2011) was carried out at the TB laboratories of the University College Hospital, Ibadan, Nigeria to determine the magnitude of MDR-TB using molecular based GenoType MTBDRplus 96 assay. Two sputum samples were collected from each subject. These were processed using Ziehl -Neelsen (ZN) reagents. The sputa were cultured on Loewenstein-Jensen egg -based medium and incubated at 370C for eight weeks. Mycobacterium tuberculosis complex (MTBC) was confirmed by colonial morphology and repeat ZN staining. All the Acid-fast bacill (AFB) positive smears and culture positive isolates were tested for genetic identification and drug susceptibility testing (DST) using PCR- based GenoType MTBDRplus 96 assay (HAINs Lifesciences, GmbH, Nehren, Germany) according to manufacturers' instructions. Of the 68 samples processed, 11 (16.2%) were AFB positive while six (8.8%) were positive for culture. Eleven (64.7%) out of the 17 samples tested for genetic identification were MTBC while six were Non Tuberculosis Mycobacteria (NTM). All NTM were from AFB positive sputum while none was from culture positive isolates. Of the six culture isolates tested for DST, three (33.3%) were susceptible to isoniazid and rifampicin; one (16.7%) showed mono-resistance to isoniazid while two (30.0%) were resistant to the two drugs. This study shows that MDR-TB is present in Ibadan. There is a need to make DST diagnostic facilities more available and accessible in Nigeria.

摘要

耐多药结核分枝杆菌(MDR-TB)在全球范围内具有重大的公共卫生意义。这项为期三个月的基于实验室的研究(2011年9月1日至11月30日)在尼日利亚伊巴丹大学学院医院的结核病实验室进行,以使用基于分子的GenoType MTBDRplus 96检测法确定耐多药结核的流行程度。从每个受试者收集两份痰标本。使用齐-尼(ZN)试剂对其进行处理。痰液在基于罗-琴鸡蛋的培养基上培养,并在37℃下孵育八周。通过菌落形态和重复ZN染色确认结核分枝杆菌复合群(MTBC)。根据制造商的说明,使用基于PCR的GenoType MTBDRplus 96检测法(德国内伦市HAINs生命科学有限公司)对所有抗酸杆菌(AFB)阳性涂片和培养阳性分离株进行基因鉴定和药敏试验(DST)。在处理的68份样本中,11份(16.2%)AFB阳性,6份(8.8%)培养阳性。在检测基因鉴定的17份样本中,11份(64.7%)为MTBC,6份为非结核分枝杆菌(NTM)。所有NTM均来自AFB阳性痰液,而培养阳性分离株中无一例为NTM。在检测DST的6份培养分离株中,3份(33.3%)对异烟肼和利福平敏感;1份(16.7%)对异烟肼单耐药;两份(30.0%)对这两种药物耐药。本研究表明,伊巴丹存在耐多药结核。尼日利亚需要使药敏试验诊断设施更易获得和使用。

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