GeneXpert MTB/RIF试验与4种结核分枝杆菌检测方法的比较

陈军; 陈丽峰; 饶有益; 余坚; 任易

doi:10.13201/j.issn.1004-2806-b.2018.12.019

GeneXpert MTB/RIF试验与4种结核分枝杆菌检测方法的比较

- 武汉市肺科医院(市结核病防治所)检验科(武汉, 430030)
基金项目:
2013年度武汉市卫计委临床医学科研项目(No:WX13B22)

2014年度武汉市临床医学科研项目(No:WX14C56)

详细信息

通讯作者: 任易,E-mail:menease@sina.com

中图分类号: R378.91

收稿日期: 2018-06-23

Comparison of GeneXpert MTB/RIF assay with four mycobacterium tuberculosis （MTB） detection methods

- Department of Clinical Laboratory, Wuhan Municipal Pulmonary Hospital, Wuhan, 430030, China

More Information

Corresponding author: REN Yi, E-mail: menease@sina.com

Received Date: 23 June 2018

摘要

摘要: 目的:比较GeneXpert MTB/RIF试验(Xpert试验)与4种结核分枝杆菌检测方法,探讨Xpert试验在肺结核快速诊断中的应用价值。方法:收集2015-08-2016-02武汉市肺科医院各病区送检的同一患者的3份痰标本共计536例,同时进行荧光抗酸染色涂片、结核分枝杆菌核酸扩增荧光检测(TB-DNA PCR)、Xpert试验、罗氏固体培养及MGIT960液体培养检测,比较5种方法在诊断结核病中的敏感度与特异度。结果:荧光抗酸染色涂片、TB-DNA PCR、Xpert试验、罗氏固体培养及MGIT960液体培养检测结核分枝杆菌的敏感度分别为42.97%、57.57%、62.43%、54.59%和62.43%;特异度分别为95.27%、99.21%、98.42%、88.97%及88.19%。在涂片阳性肺结核中,Xpert检出率为99.37%(158/159),MGIT960培养检出率为98.11%(156/159);在涂片阴性肺结核中,Xpert检出率为34.60%(73/211),MGIT960培养检出率为35.55%(75/211)。在220例Xpert检测与培养均阳性的标本中,两者均耐药为32例,均敏感为179例,Xpert利福平耐药而比例法敏感为8例,Xpert利福平敏感而比例法耐药为1例。2种方法检测利福平耐药具有高的一致性(Kappa值0.85)。结论:Xpert试验在肺结核诊断中具有与金标准液体培养一致的敏感性,同时快速筛查利福平耐药结核,对控制耐药结核的传播具有重要的临床价值,值得在临床推广应用。
- GeneXpert MTB/RIF试验 /
- 结核分枝杆菌 /
- 检测 /
- MGIT960
Abstract: Objective:To explore rapid diagnosis of GeneXpert MTB/RIF assay(Xpert assay)on tuberculosis by comparing Xpert with four mycobacterium tuberculosis(MTB)detection methods.Method:From August 2015 to February 2016,536 patients were included in the study,3 sputum specimens from every patient were collected for smear fluorescent staining,TB-DNA PCR,Xpert assay,L-J solid culture and MGIT960 liquid culture.Sensitivity and specificity of 5 detection methods were compared.Result:Sensitivities of smear fluorescent staining,TB-DNA PCR,Xpert assay,L-J solid culture and MGIT960 liquid culture were 42.97%,57.57%,62.43%,54.59% and 62.43%,respectively.Specificities of five methods were 95.27%,99.21%,98.42%,88.97% and 88.19%.Among the smear-positive patients,the detection rates of Xpert and MGIT960 liquid culture were 99.37%(158/159),98.11%(156/159)respectively;among the smear-negative patients,the detection rates of Xpert and MGIT960 liquid culture was 34.60%(73/211),35.55%(75/211)respectively.MTB was detected by Xpert and MGIT960 liquid culture from 220 patients,in which 32 strains were resistant to rifampicin by two methods,179 strains were sensitive to rifampicin by two methods,8 strains were resistant by Xpert,but sensitive by the proportion method,1 strain was sensitive by Xpert,but resistant by the proportion method.The two methods had excellent consistency(Kappa value 0.85)Conclusion:Xpert assay has similar sensitivity with the gold standard MGIT960 liquid culture in diagnosis of tuberculosis and can rapidly screen resistance of rifampicin.The method is worth expanding and applying in clinical practice.
- GeneXpert MTB/RIF test /
- Mycobacterium tuberculosis /
- detection /
- MGIT960

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