Jin Yang-Hui, Shi Shi-Yuan, Zheng Qi, Shen Jian, Ying Xiao-Zhang, Wang Yi-Fan
Department of Orthopaedics, Integrated Chinese and Western Medicine Hospital of Zhejiang Chinese Medical University, Hangzhou 310003, Zhejiang, China.
Department of Orthopaedics, Integrated Chinese and Western Medicine Hospital of Zhejiang Chinese Medical University, Hangzhou 310003, Zhejiang, China;
Zhongguo Gu Shang. 2017 Sep 25;30(9):787-791. doi: 10.3969/j.issn.1003-0034.2017.09.002.
To investigate the application value of Xpert MTB/RIF in diagnosis of spinal tuberculosis and detection of rifampin resistance.
The 109 pus specimens were obtained from patients who were primaryly diagnosed as spinal tuberculosis. All of the pus specimens were detected by acid-fast stain, liquid fast culturing by BACTEC MGIT 960 and Xpert MTB/RIF assay to definite the differences in sensitivity and specificity of mycobacterium tuberculosis among detecting methods. Pus specimens obtained by different methods were deteceded by MTB/RIF test to analyze the self-influence on Xpert MTB/RIF test. The result of liquid fast culturing by BACTEC MGIT 960 was used as the gold standard; and the value of Xpert MTB/RIF assay in detecting rifampin resistance was analyzed.
The sensitivity of acid-fast stain, liquid fast culturing by BACTEC MGIT 960 and Xpert MTB/RIF assay were 25.92%, 48.15%, 77.78%, respectively. The sensitivity of pus specimens obtained from open surgery, ultrasound positioning puncture and biopsy the sensitivity were 83.78%, 76.47%, 44.68% respectively deteceded by MTB/RIF test. According to the gold standard of the results of liquid fast culturing by BACTEC MGIT 960 assay, the sensitivity and specificity of Xpert MTB/RIF assay in detecting rifampin resistance were 80%(4/5) and 90.70%(39/43), respectively.
Xpert MTB/RIF assay has higher value in diagnosis of spinal tuberculosi, and also can detect rifampin resistance. The number of mycobacterium tuberculosis in pus specimens has a great influence in the sensitivity of Xpert MTB/RIF assay.
探讨Xpert MTB/RIF在脊柱结核诊断及利福平耐药检测中的应用价值。
收集109例初诊为脊柱结核患者的脓液标本，分别采用抗酸染色、BACTEC MGIT 960液体快速培养及Xpert MTB/RIF检测，比较各检测方法对结核分枝杆菌检测的敏感度和特异度。采用不同方法获取的脓液标本进行MTB/RIF检测，分析其对Xpert MTB/RIF检测的自身影响。以BACTEC MGIT 960液体快速培养结果为金标准，分析Xpert MTB/RIF检测利福平耐药的价值。
抗酸染色、BACTEC MGIT 960液体快速培养及Xpert MTB/RIF检测的敏感度分别为25.92%、48.15%、77.78%。MTB/RIF检测显示，开放手术、超声定位穿刺及活检获取的脓液标本敏感度分别为83.78%、76.47%、44.68%。以BACTEC MGIT 960液体快速培养结果为金标准，Xpert MTB/RIF检测利福平耐药的敏感度和特异度分别为80%（4/5）和90.70%（39/43）。
Xpert MTB/RIF在脊柱结核诊断中具有较高价值，且能检测利福平耐药情况。脓液标本中结核分枝杆菌数量对Xpert MTB/RIF检测敏感度影响较大。
