Huang Hai, Zhang Yanlin, Li Sheng, Wang Jun, Chen Jun, Pan Zhiyun, Gan Hui
1 Department of Tuberculosis Specialty, Wuhan Pulmonary Hospital , Wuhan, China .
2 Department of Mycobacteriology Laboratory, Wuhan Pulmonary Hospital , Wuhan, China .
Microb Drug Resist. 2018 Jun;24(5):675-679. doi: 10.1089/mdr.2017.0114. Epub 2017 Oct 20.
The Xpert MTB/RIF test (Cepheid, Sunnyvale, CA) can simultaneously detect the Mycobacterium tuberculosis (MTB) complex DNA and rifampicin (RFP) resistance and can rapidly determine RFP resistance and predict multidrug-resistant tuberculosis (MDR-TB). In this study, we analyzed clinical examination results of a hospital specializing in TB treatment in Wuhan, Hubei, China, and examined the use of traditional culture and drug-sensitive test (DST) results as a gold standard to assess the diagnosis value of the Xpert MTB/RIF test in RFP resistance and MDR-TB.
A total of 2,910 specimens were received in the Mycobacteriology Laboratory, Wuhan Pulmonary Hospital, for Xpert MTB/RIF testing between December 2013 and December 2014. After the results were reviewed by exclusion criteria, 1,066 Xpert test results were eligible for our study. We then compared the Xpert test results with sputum acid-fast bacilli staining, cultures, and DST results.
In total, Xpert correctly identified 96.71% (147/152) RFP-resistant TB and 98.25% (898/914) RFP-sensitive TB specimens. Of the 147 RFP-resistant TB specimens detected by Xpert, 122 MDR-TB (82.99%) were identified by traditional culture and DST techniques.
Xpert can simultaneously detect MTB and RFP resistance with high sensitivity and specificity. Thus, Xpert testing aids in saving a considerable amount of time in the diagnosis and treatment of MDR-TB.
Xpert MTB/RIF检测（赛沛公司，加利福尼亚州森尼韦尔市）可同时检测结核分枝杆菌（MTB）复合群DNA及利福平（RFP）耐药性，能快速判定RFP耐药性并预测耐多药结核病（MDR-TB）。在本研究中，我们分析了中国湖北武汉一家结核病专科医院的临床检测结果，并以传统培养和药敏试验（DST）结果作为金标准，评估Xpert MTB/RIF检测在RFP耐药性及MDR-TB诊断中的价值。
2013年12月至2014年12月期间，武汉肺科医院结核实验室共接收2910份标本进行Xpert MTB/RIF检测。经排除标准审核结果后，1066份Xpert检测结果符合我们的研究要求。然后，我们将Xpert检测结果与痰涂片抗酸杆菌染色、培养及DST结果进行比较。
总体而言，Xpert正确鉴定出96.71%（147/152）的RFP耐药结核病标本以及98.25%（898/914）的RFP敏感结核病标本。在Xpert检测出的147份RFP耐药结核病标本中，传统培养和DST技术鉴定出122例MDR-TB（82.99%）。
Xpert能同时高灵敏度和特异性地检测MTB及RFP耐药性。因此，Xpert检测有助于在MDR-TB的诊断和治疗中节省大量时间。
