分子生物学联合液体MGIT培养法在结核分枝杆菌临床检验中的价值研究
Study on the value of molecular biology combined with liquid MGIT culture method in clinical examination of mycobacterium tuberculosis.
作者信息
Qi Jinyou, Fan Wei
机构信息
Department of Laboratory Medicine, Huai'an Tumor Hospital Jiangsu, China.
出版信息
Am J Transl Res. 2021 Aug 15;13(8):9757-9763. eCollection 2021.
OBJECTIVE
To investigate the clinical value of molecular biology (xpert MTB/RIF) combined with a liquid mycobacterium culture tube (MGIT) in the clinical examination of Mycobacterium tuberculosis (MTB).
METHODS
A total of 782 patients with suspected pulmonary tuberculosis who came to our hospital from February 2018 to February 2020 were selected as the research subjects. Sputum samples of all patients were taken in the morning, and BACTEC MGIT culture and xpert MTB/RIF, Lowenstein-Jenden (L-J) culture and acid fast staining microscopy were used respectively to detect the sputum samples. The positive samples were cultured, and the bacteria identification and liquid drug sensitivity test were carried out. We also analyzed the value of xpert MTB/RIF combined with MGIT culture method in the clinical testing of MTB.
RESULTS
(1) Among the 782 suspected patients, 405 cases were diagnosed with pulmonary tuberculosis and 377 cases were non tuberculosis patients. The sensitivity of smear microscopy was 17.28% (70/405), the specificity was 98.94% (373/377), and the average time was 3.05 h. The sensitivity of L-J culture test was 20.49% (83/405), the specificity was 97.61% (368/377), and the average time was 28.58 h. The sensitivity of MGIT culture test was 38.02% (154/405), the specificity was 96.82% (365/377), and the average time was 11.23 h. The sensitivity of xpert MTB/RIF test was 36.54% (148/405), the specificity was 99.46% (375/377), and the average time was 2.03 h. The sensitivity of MTB/RIF + MGIT test was 42.47% (172/405), the specificity was 96.02% (362/377), and the average time was 11.29 h. The sensitivity of MTB/RIF combined with MGIT culture was significantly higher than that of smear microscopy and L-J culture (χ=61.31, 45.33, P<0.001). (2) The average culture time of 13 smear negative xpert MTB/RIF negative specimens was 17.02 days. The average culture time of 82 smear negative xpert MTB/RIF positive samples was 14.12 days. The average culture time of 77 smear positive xpert MTB/RIF positive samples was 7.45 days. (3) The sensitivity of Xpert MTB/RIF test for rifampicin resistance is 100% (11/11), and the specificity is 91.14% (144/158).
CONCLUSION
The method of molecular biology combined with MGIT has a high sensitivity and specificity for clinical diagnosis of MTB.
目的
探讨分子生物学方法（Xpert MTB/RIF）联合液体分枝杆菌培养管（MGIT）在结核分枝杆菌（MTB）临床检测中的应用价值。
方法
选取2018年2月至2020年2月我院收治的782例疑似肺结核患者作为研究对象。所有患者均于清晨采集痰液标本，分别采用BACTEC MGIT培养法、Xpert MTB/RIF法、罗氏（L-J）培养法及抗酸染色镜检法检测痰液标本。对阳性标本进行培养，并进行细菌鉴定及液体药敏试验。分析Xpert MTB/RIF联合MGIT培养法在MTB临床检测中的应用价值。
结果
（1）782例疑似患者中，确诊肺结核405例，非肺结核患者377例。涂片镜检敏感性为17.28%（70/405），特异性为98.94%（373/377），平均用时3.05 h。L-J培养法敏感性为20.49%（83/405），特异性为97.61%（368/377），平均用时28.58 h。MGIT培养法敏感性为38.02%（154/405），特异性为96.82%（365/377），平均用时11.23 h。Xpert MTB/RIF法敏感性为36.54%（148/405），特异性为99.46%（375/377），平均用时2.03 h。MTB/RIF+MGIT法敏感性为42.47%（172/405），特异性为96.02%（362/377），平均用时11.29 h。MTB/RIF联合MGIT培养法的敏感性显著高于涂片镜检法及L-J培养法（χ=61.31，45.33，P<0.001）。（2）13例涂片阴性且Xpert MTB/RIF阴性标本的平均培养时间为17.02天。82例涂片阴性且Xpert MTB/RIF阳性标本的平均培养时间为14.12天。77例涂片阳性且Xpert MTB/RIF阳性标本的平均培养时间为7.45天。（3）Xpert MTB/RIF法检测利福平耐药的敏感性为100%（11/11），特异性为91.14%（144/158）。
结论
分子生物学方法联合MGIT对MTB临床诊断具有较高的敏感性和特异性。
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