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在中国使用MeltPro TB检测法快速诊断耐多药和广泛耐药结核病。

Rapid diagnosis of MDR and XDR tuberculosis with the MeltPro TB assay in China.

作者信息

Pang Yu, Dong Haiyan, Tan Yaoju, Deng Yunfeng, Cai Xingshan, Jing Hui, Xia Hui, Li Qiang, Ou Xichao, Su Biyi, Li Xuezheng, Zhang Zhiying, Li Junchen, Zhang Jiankang, Huan Shitong, Zhao Yanlin

机构信息

National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.

PATH, Beijing, China.

出版信息

Sci Rep. 2016 May 6;6:25330. doi: 10.1038/srep25330.

Abstract

New diagnostic methods have provided a promising solution for rapid and reliable detection of drug-resistant TB strains. The aim of this study was to evaluate the performance of the MeltPro TB assay in identifying multidrug-resistant (MDR-) and extensively drug-resistant tuberculosis (XDR-TB) patients from sputum samples. The MeltPro TB assay was evaluated using sputum samples from 2057 smear-positive TB patients. Phenotypic Mycobacterial Growth Indicator Tube (MGIT) 960 drug susceptibility testing served as a reference standard. The sensitivity of the MeltPro TB assay was 94.2% for detecting resistance to rifampicin and 84.9% for detecting resistance to isoniazid. For second-line drugs, the assay showed a sensitivity of 83.3% for ofloxacin resistance, 75.0% for amikacin resistance, and 63.5% for kanamycin resistance. However, there was a significant difference for detecting kanamycin resistance between the two pilot sites in sensitivity, which was 53.2% in Guangdong and 81.5% in Shandong (P = 0.015). Overall, the MeltPro TB assay demonstrated good performance for the detection of MDR- and XDR-TB, with a sensitivity of 86.7% and 71.4%, respectively. The MeltPro TB assay is an excellent alternative for the detection of MDR- and XDR-TB cases in China, with high accuracy, short testing turn-around time, and low unit price compared with other tests.

摘要

新的诊断方法为快速、可靠地检测耐多药结核菌株提供了一个有前景的解决方案。本研究的目的是评估MeltPro TB检测法在从痰样本中识别耐多药(MDR-)和广泛耐药结核病(XDR-TB)患者方面的性能。使用来自2057例涂片阳性结核病患者的痰样本对MeltPro TB检测法进行评估。表型分枝杆菌生长指示管(MGIT)960药敏试验作为参考标准。MeltPro TB检测法检测利福平耐药性的灵敏度为94.2%,检测异烟肼耐药性的灵敏度为84.9%。对于二线药物,该检测法检测氧氟沙星耐药性的灵敏度为83.3%,检测阿米卡星耐药性的灵敏度为75.0%,检测卡那霉素耐药性的灵敏度为63.5%。然而,两个试点地区在检测卡那霉素耐药性的灵敏度上存在显著差异,广东为53.2%,山东为81.5%(P = 0.015)。总体而言,MeltPro TB检测法在检测MDR-TB和XDR-TB方面表现良好,灵敏度分别为86.7%和71.4%。与其他检测方法相比,MeltPro TB检测法在中国检测MDR-TB和XDR-TB病例方面是一种优秀的替代方法,具有高准确性、短检测周转时间和低单价的特点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62b0/4858717/699939844543/srep25330-f1.jpg

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