Salfinger M, Morris A J
Wadsworth Center for Laboratories and Research, New York State Department of Health, Albany 12201-0509.
Am J Clin Pathol. 1994 Apr;101(4 Suppl 1):S6-13.
Recent surveys show that many mycobacteriology laboratories continue to use less-than-optimal culture and susceptibility methods. This review summarizes available methods to diagnose. Mycobacterium tuberculosis. Although the local epidemiologic characteristics of M tuberculosis will partially determine what diagnostic measures are used, all laboratories should use a broth culture method in addition to a solid medium when culturing for M tuberculosis. Laboratories serving communities where drug resistance is common should use the BACTEC system for susceptibility testing or send isolates to a laboratory that uses it. Conventional testing in this setting must be aggressively discouraged. Rapid genetic amplification methods to detect mycobacteria in clinical specimens can greatly reduce the time needed to diagnose tuberculosis, especially if these methods can reliably detect M tuberculosis in smear-negative specimens. Many other diagnostic methods are being developed and clinicians and laboratories must regularly reassess whether a new method would be beneficial to their patients and the public.
近期调查显示，许多分枝杆菌学实验室仍在使用不太理想的培养和药敏试验方法。本综述总结了诊断结核分枝杆菌的现有方法。尽管结核分枝杆菌的当地流行病学特征将部分决定采用何种诊断措施，但所有实验室在培养结核分枝杆菌时除使用固体培养基外，还应采用肉汤培养法。在耐药情况普遍的社区服务的实验室应使用BACTEC系统进行药敏试验，或将分离株送至使用该系统的实验室。在这种情况下，必须大力劝阻采用传统检测方法。用于检测临床标本中分枝杆菌的快速基因扩增方法可大大缩短诊断结核病所需的时间，特别是如果这些方法能够可靠地检测涂片阴性标本中的结核分枝杆菌。许多其他诊断方法正在研发中，临床医生和实验室必须定期重新评估一种新方法是否对其患者和公众有益。
