Majumdar T, Bhattacharya S, Barman D, Bhoumik P, Bir R
Department of Microbiology, Agartala Government Medical College, Agartala, India.
Department of Medicine, Agartala Government Medical College, Agartala, India.
Int J Tuberc Lung Dis. 2016 Feb;20(2):166-9. doi: 10.5588/ijtld.14.0986.
Multidrug-resistant tuberculosis (MDR-TB) poses a global threat that is further compounded by the human immunodeficiency virus (HIV) epidemic.
To detect MDR-TB among pulmonary TB (PTB) patients with or without HIV coinfection by isolating and identifying Mycobacterium tuberculosis from clinical samples and performing drug susceptibility testing (DST).
Sputum was collected from presumed PTB cases. Microscopic examination was performed following Ziehl-Neelsen (ZN) staining and cultured in Löwenstein-Jensen (LJ) medium. First-line anti-tuberculosis DST of the isolates was performed using MGIT™ (Mycobacterial Growth Indicator Tube) and multiplex allele-specific polymerase chain reaction (MAS-PCR).
Of 172 study subjects, 59.3% (102/172) were smear-positive and 40.7% (70/172) were smear-negative. In the smear-positive and -negative groups, respectively 62.7% (64/102) and 8.6% (6/70) were culture-positive. DST on MGIT showed a cumulative resistance of 7.1% (5/70) to isoniazid (INH) and rifampicin. More ethambutol (EMB) and combined INH+EMB resistance was detected using MAS-PCR.
MDR-TB is a problem in Tripura, and culture and phenotypic DST are required for diagnosis. MAS-PCR may provide an alternative rapid screening tool.
耐多药结核病（MDR-TB）构成全球威胁，而人类免疫缺陷病毒（HIV）流行使其威胁进一步加剧。
通过从临床样本中分离和鉴定结核分枝杆菌并进行药敏试验（DST），检测合并或未合并HIV感染的肺结核（PTB）患者中的耐多药结核病。
从疑似肺结核病例中采集痰液。采用萋-尼（ZN）染色进行显微镜检查，并在罗-琴（LJ）培养基中培养。使用分枝杆菌生长指示管（MGIT™）和多重等位基因特异性聚合酶链反应（MAS-PCR）对分离株进行一线抗结核药敏试验。
172名研究对象中，59.3%（102/172）涂片阳性，40.7%（70/172）涂片阴性。在涂片阳性和阴性组中，培养阳性率分别为62.7%（64/102）和8.6%（6/70）。MGIT药敏试验显示对异烟肼（INH）和利福平的累积耐药率为7.1%（5/70）。使用MAS-PCR检测到更多乙胺丁醇（EMB）以及INH+EMB联合耐药情况。
耐多药结核病在特里普拉邦是一个问题，诊断需要进行培养和表型药敏试验。MAS-PCR可能提供一种替代的快速筛查工具。
