xpert mtbrif系统快速检测结核分枝杆菌及利福平耐药性探讨.docVIP

精品论文 参考文献 Xpert MTBRIF系统快速检测结核分枝杆菌及利福平耐药性探讨 徐州市云龙区东甸子徐州传染病医院结核科 江苏徐州 221004 【摘 要】目的：探究Xpert MTB/RIF系统快速检测结核分枝杆菌及利福平耐药性。方法：收集100例疑似肺结核患者痰液标本，给予涂片抗酸杆菌检查与结核杆菌培养，并采用Xpert MTB/RIF系统快速检测结核分枝杆菌及利福平耐药性。结果：在100例疑似肺结核患者中，40例培养与涂片显示阳性，占40%；9例涂片显示阴性但培养显示阳性，占9%；6例培养与涂片显示阴性，且符合肺结核诊断标准，占6%；45例无结核病临床证据。经Xpert MTB/RIF检测，培养阳性者敏感度为94.2%，培养阳性、涂片阳性者敏感度为93.7%，培养阳性、涂片阴性敏感度为93.1%，涂片阴性、符合临床标准敏感度为47.6%，非结核者灵敏度为99.3%。49例培养显示阳性标本中，采用比例法测得4株利福平耐药菌，耐药率为8.2%，在经Xpert检测灵敏度为93.9%，特异度为98%。结论：Xpert MTB/RIF系统快速检测结核分枝杆菌及利福平耐药性，具有较高临床应用价值。 【关键词】Xpert MTB/RIF系统；检测；结核分枝杆菌；利福平；耐药性 【Abstract】Objective：To explore the rapid detection of mycobacterium tuberculosis with MTB/RIF system and drug resistance of rifampicin. Methods：100 sputum specimens of patients with suspected tuberculosis were collected，acid-fast bacillus examination and mycobacterium tuberculosis cultivation were given，and the mycobacterium tuberculosis and drug resistance of rifampicin were rapidly detected with MTB/RIF system. Results：In 100 patients with suspected pulmonary tuberculosis，40 cases of cultivation and smear both showed positive，accounts for 40%. 9 cases of smear showed negative but the cultivate showed positive，accounts for 9%.6 cases of cultivation and smear showed negative，and conform to the tuberculosis diagnosis standard，accounts for 6%. 45 cases of patients had no tuberculosis clinical evidence. After the MTB/RIF detection，the cultivate positive sensitivity was 94.2%，the cultivate and smear of positive sensitivity was 93.7%，the cultivate of positive and smear of negative sensitivity was 93.1%，smear of negative，accord with standard of clinical sensitivity was 47.6%，and the sensitivity of people without tuberculosis is 99.3%. Among 49 cases of the cultivate of positive specimens，4 strains of rifampicin resistant bacteria were measured using the ratio method，the resistant rate of 8.2%，and the detection sensitivity was 91.7%，the specificity was 99.4%. Conclusion：It has high clinical value to rapidly de