Kim Seoung-Cheol, Jeon Bo-Young, Kim Jin-Sook, Choi In Hwan, Kim Jiro, Woo Jeongim, Kim Soojin, Lee Hyeong Woo, Sezim Monoldorova, Cho Sang-Nae
Department of Microbiology, Institute for Immunology and Immunological Disease, Yonsei University College of Medicine, Seoul, Korea.
Department of Biomedical Laboratory Science, College of Health Science, Yonsei University, Wonju, Korea.
Tuberc Respir Dis (Seoul). 2016 Oct;79(4):282-288. doi: 10.4046/trd.2016.79.4.282. Epub 2016 Oct 5.
Tuberculosis (TB) is a major health problem, and accurate and rapid diagnosis of multidrug-resistant (MDR) and extended drug-resistant (XDR) TB is important for appropriate treatment. In this study, performances of solid and liquid culture methods were compared with respect to MDR- and XDR-TB isolate recovery and drug susceptibility testing.
Sputum specimens from 304 patients were stained with Ziehl-Neelsen method. (Mtb) isolates were tested for recovery on Löwenstein-Jensen (LJ) medium and the BacT Alert 3D system. For drug susceptibility testing of Mtb, isolates were evaluated on M-KIT plates and the BacT Alert 3D system.
The recovery rates were 94.9% (206/217) and 98.2% (213/217) for LJ medium and the BacT Alert 3D system, respectively (kappa coefficient, 0.884). The rate of drug resistance was 13.4% for at least one or more drugs, 6.0% for MDR-TB and 2.3% for XDR-TB. M-KIT plate and BacT 3D Alert 3D system were comparable in drug susceptibility testing for isoniazid (97.7%; kappa coefficient, 0.905) and rifampin (98.6%; kappa coefficient, 0.907). Antibiotic resistance was observed using M-KIT plates for 24 of the total 29 Mtb isolates (82.8%).
The liquid culture system showed greater reduction in the culture period, as compared with LJ medium; however, drug susceptibility testing using M-KIT plates was advantageous for simultaneous testing against multiple drug targets.
结核病是一个主要的健康问题，准确快速诊断耐多药（MDR）和广泛耐药（XDR）结核病对于恰当治疗很重要。在本研究中，比较了固体和液体培养方法在MDR-和XDR-结核分枝杆菌分离株回收及药敏试验方面的性能。
对304例患者的痰液标本采用萋-尼氏法染色。结核分枝杆菌分离株在罗氏（LJ）培养基和BacT Alert 3D系统上进行回收检测。对于结核分枝杆菌的药敏试验，分离株在M-KIT平板和BacT Alert 3D系统上进行评估。
LJ培养基和BacT Alert 3D系统的回收率分别为94.9%（206/217）和98.2%（213/217）（kappa系数为0.884）。至少对一种或多种药物的耐药率为13.4%，MDR-TB为6.0%，XDR-TB为2.3%。M-KIT平板和BacT 3D Alert 3D系统在异烟肼（97.7%；kappa系数为0.905）和利福平（98.6%；kappa系数为0.907）的药敏试验中具有可比性。在总共29株结核分枝杆菌分离株中，有2个（82.8%）使用M-KIT平板观察到抗生素耐药。
与LJ培养基相比，液体培养系统显示培养周期明显缩短；然而，使用M-KIT平板进行药敏试验有利于同时针对多个药物靶点进行检测。
