Chien Jung-Yien, Chang Tsung-Chain, Chiu Wei-Yih, Yu Chong-Jen, Hsueh Po-Ren
Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Chest Hospital, Ministry of Health and Welfare, Tainan, Taiwan.
Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
PLoS One. 2015 May 4;10(5):e0125016. doi: 10.1371/journal.pone.0125016. eCollection 2015.
The performance of the BluePoint MycoID plus kit (Bio Concept Corporation, Taichung, Taiwan), which was designed to simultaneously detect Mycobacterium tuberculosis (MTB), rifampin- and isoniazid-resistant MTB, and nontuberculous mycobacteria (NTM) was first evaluated with 950 consecutive positive cultures in Mycobacterium Growth Indicator Tube (MGIT) system (BACTEC, MGIT 960 system, Becton-Dickinson, Sparks) from clinical respiratory specimens. The discrepant results between kit and culture-based identification were finally assessed by 16S rRNA gene sequencing and clinical diagnosis. The accuracy rate of this kit for identification of all Mycobacterium species was 96.3% (905/940). For MTB identification, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the kit were 99.7%, 99.3%, 99.0% and 99.8%, respectively. For rifampicin-resistant MTB identification, the sensitivity, specificity, PPV, and NPV of the kit were 100.0%, 99.4%, 91.3%, and 100.0%, respectively, while the corresponding values of isoniazid-resistant MTB identification were 82.6%, 99.4%, 95.0%, and 97.6%, respectively. In identifying specific NTM species, the kit correctly identified 99.3% of M. abscessus (147/148) complex, 100% of M. fortuitum (32/32), M. gordonae (38/38), M. avium (39/39), M. intracellulare (90/90), M. kansasii (36/36), and M. avium complex species other than M. avium and M. intracellulare (94/94). In conclusions, the diagnostic value of the BluePoint MycoID plus kit was superior to culture method for recoveries and identification of NTM to species level. In addition, the diagnostic accuracy of BluePoint MycoID plus kit in MTB identification was similar to conventional culture method with high accuracy rate of rifampicin-resistant M. tuberculosis identification.
BluePoint MycoID plus试剂盒(台湾台中生物概念公司)旨在同时检测结核分枝杆菌(MTB)、耐利福平及异烟肼的MTB和非结核分枝杆菌(NTM),本研究首次采用BACTEC MGIT 960系统(美国BD公司)对950份临床呼吸道标本连续培养阳性的样本进行评估。试剂盒与基于培养的鉴定结果之间的差异最终通过16S rRNA基因测序和临床诊断进行评估。该试剂盒鉴定所有分枝杆菌属的准确率为96.3%(905/940)。对于MTB鉴定,试剂盒的灵敏度、特异性、阳性预测值(PPV)和阴性预测值(NPV)分别为99.7%、99.3%、99.0%和99.8%。对于耐利福平MTB鉴定,试剂盒的灵敏度、特异性、PPV和NPV分别为100.0%、99.4%、91.3%和100.0%,而耐异烟肼MTB鉴定的相应值分别为82.6%、99.4%、95.0%和97.6%。在鉴定特定NTM菌种时,该试剂盒正确鉴定出99.3%的脓肿分枝杆菌复合群(147/148)、100%的偶然分枝杆菌(32/32)、戈登分枝杆菌(38/38)、鸟分枝杆菌(39/39)、胞内分枝杆菌(90/90)、堪萨斯分枝杆菌(36/36)以及除鸟分枝杆菌和胞内分枝杆菌之外的鸟分枝杆菌复合群菌种(94/94)。总之,BluePoint MycoID plus试剂盒在NTM菌种水平的回收和鉴定方面诊断价值优于培养法。此外,BluePoint MycoID plus试剂盒在MTB鉴定中的诊断准确性与传统培养法相似,对耐利福平结核分枝杆菌的鉴定准确率高。