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[分枝杆菌诊断方法的进展]

[Advances in diagnostic methods for mycobacteria].

作者信息

Abe C

机构信息

Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo.

出版信息

Kekkaku. 1993 Nov;68(11):701-8.

PMID:8264126
Abstract

Two systems, biphasic MB-Check and radiometric BACTEC, based on liquid media proved to be significantly better than the egg-based solid media for the isolation of mycobacteria from clinical specimens. The difference in the rates of isolation of mycobacteria between two groups of media was more remarkable with smear-negative specimens. The time to the detection of the Mycobacterium tuberculosis complex with MB-Check was shorter than that with the 3% Ogawa egg method but longer than that with BACTEC. A total of 135 sputum specimens were examined by the polymerase chain reaction (PCR) using oligonucleotides based on the repetitive sequence (IS986) of M. tuberculosis as a primer. The PCR gave an overall positivity rate of 84.2%, as compared with 71.9% by smear and 96.9% by culture in the liquid medium, MB-Check. Although the sensitivity of the PCR appeared to be similar to that of culture with the MB-Check system, the PCR should be very useful for rapid detection of M. tuberculosis infections. DNA probe technology facilitates a rapid and specific identification of microorganisms. The diagnostic specificity and sensitivity of the nonradioactive Accuprobe M. tuberculosis complex and Accuprobe M. avium complex culture confirmation tests were nearly 100%. The results of the colorimetric microdilution plate hybridization test (DDH-Mycobacteria) for identification of mycobacteria were consistent with those of biochemical identification. About 90% of clinical isolates could be identified by the DDH kit. Both of these methods may contribute to the rapid diagnosis of mycobacterial infections. Epidemiological studies with techniques which allow differentiation of strains within M. tuberculosis groups are important for limiting the dissemination of the disease.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

基于液体培养基的双相MB-Check和放射性BACTEC这两种系统,在从临床标本中分离分枝杆菌方面,被证明明显优于基于鸡蛋的固体培养基。两组培养基在分枝杆菌分离率上的差异,在涂片阴性标本中更为显著。用MB-Check检测结核分枝杆菌复合群的时间,比用3%小川鸡蛋法短,但比用BACTEC长。总共135份痰标本通过聚合酶链反应(PCR)进行检测,该反应使用基于结核分枝杆菌重复序列(IS986)的寡核苷酸作为引物。PCR的总体阳性率为84.2%,相比之下,涂片法为71.9%,在液体培养基MB-Check中培养法为96.9%。虽然PCR的灵敏度似乎与MB-Check系统的培养法相似,但PCR对于快速检测结核分枝杆菌感染应该非常有用。DNA探针技术有助于快速、特异性地鉴定微生物。非放射性的结核分枝杆菌复合群Accuprobe和鸟分枝杆菌复合群Accuprobe培养确认试验的诊断特异性和灵敏度接近100%。用于鉴定分枝杆菌的比色微量稀释板杂交试验(DDH-分枝杆菌)结果与生化鉴定结果一致。约90%的临床分离株可用DDH试剂盒鉴定。这两种方法都可能有助于分枝杆菌感染的快速诊断。采用能够区分结核分枝杆菌组内菌株的技术进行流行病学研究,对于限制疾病传播很重要。(摘要截选至250词)

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