摘要
目的探讨基因芯片检测技术对分枝杆菌菌种鉴定和结核分枝杆菌耐药性检测的临床应用价值。方法收集云南省传染病专科医院2012年9月至2017年12月收治的患者阳性培养标本及抗酸染色阳性标本378例,用基因芯片检测系统分别进行分枝杆菌菌种鉴定、结核分枝杆菌的利福平和异烟肼耐药性检测。结果 378例标本鉴定为结核分枝杆菌复合群282株,检出率为74.6%(282/378);非结核分枝杆菌58株,检出率为15.3%(58/378),其中鸟分枝杆菌居多,占72.4%(42/58)。检测标本数最多的是痰液(61.7%),阳性培养物次之(25.4%)。结核分枝杆菌耐药检测结果显示,18株单耐利福平、12株单耐异烟肼、35株耐多药。利福平以rpoB531位点突变频率较高,为49.1%;526位点次之,为20.7%。异烟肼以KatG315(G→C)位点突变频率较高,达89.4%。结论基因芯片检测技术能够快速、准确地对结核分枝杆菌、非结核分枝杆菌进行鉴定;能够对结核分枝杆菌进行利福平和异烟肼的耐药检测,并能用于多种类型标本检测,是结核病、非结核分枝杆菌感染诊治值得推广的检测方法。
Objective To discuss the clinical value of gene chip technology in the identification of Mycobacterium and drug resistance of Mycobacterium tuberculosis(MTB). Methods A total of 378 samples of positive culture and acid-fast staining were collected from Yunnan Provincial Infectious Disease Hospital from September 2012 to December2017. The identification of Mycobacteria and detection of rifampicin and isoniazid resistance in Mycobacterium tuberculosis were performed by gene chip detection system. Results Among the 378 samples, 282 strains(74.6%) were identified as Mycobacterium tuberculosis complex group, 58 strains(15.3%) were nontuberculous mycobacteria(NTM), and72.4%(42/58) were Mycobacterium avium. Sputum was the most detected sample(61.7%), followed by positive culture(25.4%). The results showed that 18 strains were resistant to rifampicin, 12 strains were resistant to isoniazid, and 35 strains were multidrug resistant. The frequency of rifampicin mutation at rpoB531 locus was 49.1%, followed by 20.7%at rpoB526 locus. The mutation frequency of isoniazid at katG315(G) was 89.4%. Conclusion Gene chip technology can identify MTB and NTM rapidly and accurately. It can be detected rifampin and isoniazid resistance in MTB, and also can be used for various of specimens. It is a diagnostic method worthy of promotion for the diagnosis and treatment of tuberculosis and nontuberculous mycobacteria infection.
作者
张桂仙
高丽
谢祺
张米
李正伦
姚之莹
ZHANG Gui-xian;GAO Li;XIE Qi;ZHANG Mi;LI Zheng-lun;YAO Zhi-ying(Yunnan Provincial Infectious Disease Hospital,Kunming 650301,Yunnan,CHINA)
出处
《海南医学》
CAS
2019年第2期193-196,共4页
Hainan Medical Journal
基金
云南省科技计划项目(编号:2016BC005)
云南省卫生科技计划项目(编号:2016NS299)
关键词
基因芯片技术
结核分枝杆菌
耐药性检测
利福平
临床应用价值
Gene chip technology
Mycobacterium tuberculosis (MTB)
Drug resistance detection
Rifampicin
Clinical application value
