Jobarteh Tijan, Otu Jacob, Gitteh Ensa, Mendy Francis, Faal-Jawara Tutty I, Ofori-Anyinam Boatema, Ayorinde Abigail, Secka Ousman, Antonio Martin, Gehre Florian
Medical Research Council Unit, Gambia.
Medical Research Council Unit, Gambia.
Int J Mycobacteriol. 2016 Dec;5 Suppl 1:S166. doi: 10.1016/j.ijmyco.2016.09.049. Epub 2016 Nov 11.
OBJECTIVE/BACKGROUND: To evaluate the Kudoh swab method for improving laboratory diagnosis of tuberculosis (TB) in Gambia.
A total of 75 sputa (50 smear positive and 25 smear negative) were examined. Sputum samples were collected from leftover routine samples from the Medical Research Council Unit, Gambia TB Diagnostic Laboratory. The samples were processed using the standard N-acetyl-l-cysteine-NaOH (NALC-NaOH) methods currently used and Kudoh swab method. These were cultured on standard Lowenstein Jensen (LJ) and Modified Ogawa media, respectively, and incubated aerobically at 36±1°C for mycobacterial growth. To determine if the decontamination and culture methods compared could equally detect the Mycobacterium tuberculosis complex (MTBC) highly commonly isolated in Gambia, spoligotyping was done.
In total, 72% (54/75) of MTBC were recovered by both LJ and Modified Ogawa methods. The LJ method recovered 52% (39/75) and Modified Ogawa recovered 56% (42/75) of the MTBC, respectively. Spoligotyping showed Euro-American 35% (19/54), Indo-Oceanic 35% (19/54), Mycobacterium africanum (West African type 2) 26% (14/54), Beijing 2% (1/54), and M. africanum (West African type 1) 2% (1/54).
The Kudoh method is simpler and cheaper than the NALC-NaOH method. There was no significant difference in recovery between the methods. The Kudoh method is ideal in overburdened TB laboratories with poor resources in developing countries. The predominant lineages were Euro-American and Indo-Oceanic, followed by M. africanum (West African type 2).
目的/背景：评估久道拭子法对改善冈比亚结核病实验室诊断的效果。
共检测了75份痰液样本（50份涂片阳性和25份涂片阴性）。痰液样本取自冈比亚结核病诊断实验室医学研究理事会部门剩余的常规样本。样本分别采用目前使用的标准N-乙酰-L-半胱氨酸-氢氧化钠（NALC-NaOH）方法和久道拭子法进行处理。这些样本分别接种于标准罗-琴（LJ）培养基和改良小川培养基上，在36±1°C有氧条件下培养以促进分枝杆菌生长。为确定所比较的去污和培养方法能否同样检测出冈比亚常见的结核分枝杆菌复合群（MTBC），进行了间隔寡核苷酸分型。
LJ培养基法和改良小川培养基法总共培养出72%（54/75）的MTBC。LJ培养基法培养出52%（39/75）的MTBC，改良小川培养基法培养出56%（42/75）的MTBC。间隔寡核苷酸分型显示欧美型占35%（19/54），印度洋型占35%（19/54），非洲分枝杆菌（西非2型）占26%（14/54），北京型占2%（1/54），非洲分枝杆菌（西非1型）占2%（1/54）。
久道拭子法比NALC-NaOH法更简便、成本更低。两种方法在培养成功率上无显著差异。久道拭子法对于发展中国家资源匮乏、负担过重的结核病实验室而言是理想的方法。主要菌系为欧美型和印度洋型，其次是非洲分枝杆菌（西非2型）。
