Aktas Ayse Esin, Yigit Nimet, Ayyildiz Ahmet, Bastopcu Ayse
Department of Medical Microbiology, Ataturk University Faculty of Medicine, Erzurum, Turkey.
Department of Medical Laboratory, Ataturk University, Health Services Vocational School, Erzurum, Turkey.
Eurasian J Med. 2014 Jun;46(2):96-101. doi: 10.5152/eajm.2014.23.
Tuberculosis is an important public health problem in developed and, especially, developing countries. The incidence of multi-drug-resistant Mycobacterium tuberculosis (MDR-TB) has increased in recent years. Mycobacterial culture and susceptibility testing must be rapidly concluded for effective treatment and control of the disease. The present study evaluated the reliability of the Mycobacterium Growth Indicator Tube (MGIT) method for testing the susceptibility of M. tuberculosis to four first-line antimicrobial drugs by comparing MGIT results to those obtained by the method of proportion (MOP), which served as the reference method.
A total of 60 clinical isolates (28 sputum, 7 bronchoalveolar lavage, 7 cerebrospinal fluid, 3 gastric aspirates, 5 urine, 4 pleural fluid and 6 other specimens) of M. tuberculosis were tested for susceptibility to streptomycin (SM), isoniazid (INH), ethambutol (EMB) and rifampin (RIF). MOP was carried out according to National Committe for Clinical Laboratory Standards (NCCLS) on Löwenstein-Jensen medium. MGIT susceptibility testing was performed according to the protocol provided by the manufacturer.
Resistance was detected in 18.3% and 16.7% of the isolates for INH, 13.3% and 10.0% for RIF, 16.7% and 11.7% for SM and 6.7% and 8.3% for EMB by MOP and MGIT, respectively.
MOP remains the method of choice, however, the correlation between MOP and MGIT suggested that MGIT can also be used routinely and that it is a reliable method for testing susceptibility of M. tuberculosis strains to first-line anti-tuberculosis drugs.
结核病在发达国家尤其是发展中国家是一个重要的公共卫生问题。近年来,耐多药结核分枝杆菌(MDR-TB)的发病率有所上升。为有效治疗和控制该疾病,必须迅速完成分枝杆菌培养和药敏试验。本研究通过将分枝杆菌生长指示管(MGIT)法的结果与作为参考方法的比例法(MOP)所获结果进行比较,评估了MGIT法检测结核分枝杆菌对四种一线抗菌药物敏感性的可靠性。
共对60株结核分枝杆菌临床分离株(28份痰标本、7份支气管肺泡灌洗标本、7份脑脊液标本、3份胃抽吸物标本、5份尿液标本、4份胸水标本及6份其他标本)进行链霉素(SM)、异烟肼(INH)、乙胺丁醇(EMB)和利福平(RIF)的药敏试验。MOP按照美国国家临床实验室标准委员会(NCCLS)的方法在罗-琴培养基上进行。MGIT药敏试验根据制造商提供的方案进行。
采用MOP和MGIT法检测,分离株中INH的耐药率分别为18.3%和16.7%,RIF为13.3%和10.0%,SM为16.7%和11.7%,EMB为6.7%和8.3%。
MOP仍然是首选方法,然而,MOP与MGIT之间的相关性表明MGIT也可常规使用,且它是检测结核分枝杆菌菌株对一线抗结核药物敏感性的可靠方法。