Atashi S, Izadi B, Jalilian S, Madani S H, Farahani A, Mohajeri P
West Tuberculosis Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Molecular Pathology Research Center, Emam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
New Microbes New Infect. 2017 Jul 13;19:117-120. doi: 10.1016/j.nmni.2017.07.002. eCollection 2017 Sep.
Despite a control programme and anti-tuberculosis drugs, drug-resistant tuberculosis (DR-TB) is one of the most serious public health issues worldwide. Rapid laboratory diagnosis of is needed for the diagnosis of multidrug-resistant (MDR) TB and to find the optimal treatment protocol. The purpose of this study was to detect resistance to rifampicin in new cases of TB using the GeneXpert MTB/RIF (/rifampicin) assay and the standard proportional method in west and northwest Iran. In this descriptive cross-sectional study, sputum samples were enrolled and screened for using Ziehl-Neelsen stain and mycobacterial culture. Samples from individuals with smear-positive TB were cultured on Lowenstein-Jensen medium; afterwards, the presence of resistance to rifampicin was examined by the GeneXpert MTB/RIF and standard proportional methods. A total of 400 new cases of suspected TB were collected, 162 (40.5%) of which were smear- and culture-positive for . The frequencies of rifampicin resistance in new smear-positive TB cases were 3.1% and 4.3% for GeneXpert and standard proportional method, respectively. Sensitivity and specificity of GeneXpert were 71% and 100%, respectively, compared with the proportional method. GeneXpert can be a quick and helpful method for the diagnosis of rifampicin-resistant TB in regions with high rates of DR-TB or MDR-TB. GeneXpert MTB-RIF assay must be used as an early diagnostic method whose results must be confirmed by the standard proportional method. The GeneXpert and proportional methods complement but do not replace each other.
尽管实施了控制计划并使用了抗结核药物，但耐多药结核病（DR-TB）仍是全球最严重的公共卫生问题之一。对于耐多药结核病（MDR-TB）的诊断以及寻找最佳治疗方案而言，快速的实验室诊断至关重要。本研究的目的是在伊朗西部和西北部地区，使用GeneXpert MTB/RIF（/利福平）检测法和标准比例法，检测新发结核病病例对利福平的耐药性。在这项描述性横断面研究中，收集痰液样本并使用萋-尼氏染色法和分枝杆菌培养法进行筛查。涂片阳性结核病患者的样本在罗-琴培养基上培养；随后，通过GeneXpert MTB/RIF检测法和标准比例法检测对利福平的耐药情况。共收集了400例疑似结核病新病例，其中162例（40.5%）涂片和培养均为阳性。在新发涂片阳性结核病病例中，GeneXpert检测法和标准比例法检测出的利福平耐药率分别为3.1%和4.3%。与标准比例法相比，GeneXpert检测法的灵敏度和特异度分别为71%和100%。在耐多药结核病或耐多药结核病发病率较高的地区，GeneXpert检测法可能是诊断利福平耐药结核病的一种快速且有用的方法。必须将GeneXpert MTB-RIF检测法用作早期诊断方法，其结果必须通过标准比例法进行确认。GeneXpert检测法和标准比例法相互补充，但不能相互替代。
