The Fourth People's Hospital of Lianyungang City, Lianyungang, 222000, Jiangsu Province, China.
Haibin Rehabilitation Hospital, Lianyungang, Jiangsu Province, China.
Sci Rep. 2021 Sep 9;11(1):17951. doi: 10.1038/s41598-021-97559-y.
Most Mycobacterium tuberculosis (Mtb) resistant to rifampicin (RIF) has mutations in the rpoB gene, while most Mtb resistant to isoniazid (INH) has mutations in the katG gene or inhA promoter. We used gene chip technology to detect mutations in these genes to determine the resistance of Mtb to RIF and INH. A total of 4148 clinical specimens with sputum smear positivity for acid-fast bacilli (AFB) were detected. Then, taking the results of the drug sensitivity test (DST) as the reference standard, the detection efficiency of sputum samples from different grades of positive smears was compared in detail. We found that the sensitivity of the gene chip method for detecting sputum samples with a grade ≥ AFB 2 + was higher than that of sputum samples with a grade ≤ AFB 1 + (P < 0.05). When the grade of the sample was ≤ AFB 1 +, the sensitivity of the gene chip method was 72.6% for RIF, 67.3% for INH, and 60.0% for MDR-TB. When the grade of the sample was ≥ AFB 2 +, the sensitivity of the gene chip method was 84.5% for RIF, 78.2% for INH, and 73.9% for MDR-TB. The results show that gene chip technology can be directly used to diagnose drug-resistant tuberculosis in clinical specimens, and the diagnostic efficiency for the detection of sputum specimens with a grade ≥ AFB 2 + is better than that of other sputum specimens.
大多数对利福平（RIF）耐药的结核分枝杆菌（Mtb）在 rpoB 基因中具有突变，而大多数对异烟肼（INH）耐药的 Mtb 在 katG 基因或 inhA 启动子中具有突变。我们使用基因芯片技术检测这些基因中的突变，以确定 Mtb 对 RIF 和 INH 的耐药性。共检测到 4148 例痰涂片抗酸杆菌（AFB）阳性的临床标本。然后，以药敏试验（DST）结果为参考标准，详细比较不同阳性涂片等级的痰标本检测效率。我们发现，基因芯片法检测 AFB 2+及以上等级痰标本的灵敏度高于 AFB 1+及以下等级痰标本（P<0.05）。当样本等级为≤AFB 1+时，基因芯片法检测 RIF 的灵敏度为 72.6%，检测 INH 的灵敏度为 67.3%，检测耐多药结核分枝杆菌（MDR-TB）的灵敏度为 60.0%。当样本等级为≥AFB 2+时，基因芯片法检测 RIF 的灵敏度为 84.5%，检测 INH 的灵敏度为 78.2%，检测 MDR-TB 的灵敏度为 73.9%。结果表明，基因芯片技术可直接用于临床标本中耐药结核分枝杆菌的诊断，且对 AFB 2+及以上等级痰标本的检测诊断效率优于其他痰标本。
