摘要目的 探讨高强度荧光分枝杆菌噬菌体φ2 GFP10检测MTB对抗结核药物耐药性的价值.方法 选取北京胸科医院2014年4-6月疑诊耐药结核病患者的MTB临床分离株128株,用φ2GFP10噬菌体法测定其对异烟肼、利福平和链霉素的敏感度,并以罗氏药敏试验结果为对照评价其诊断价值.采用SPSS 17.0软件绘制荧光酶标仪法的受试者工作曲线,并确定临界值.结果 φ2 GFP10荧光噬菌体法检测异烟肼、利福平和链霉素的敏感度分别为100.0％(62/62)、98.1％ (53/54)和92.6％ (50/54),特异度分别为84.8％ (56/66)、91.9％(68/74)和91.9％(68/74).噬菌体法和传统检测方法对异烟肼、利福平和链霉素耐药性检测的一致性分别为0.92、0.95和0.92.噬菌体法检测利福平和链霉素的耐药性2d即可获得结果,而异烟肼为3d.结论 φ2 GFP10噬菌体法检测利福平、异烟肼和链霉素耐药的敏感度和特异度较高,且耗时短、成本低,有望成为一种快速、简便、经济的耐药结核病筛选方法.

abstractsObjective To evaluate the high-intensity green fluorescent protein fluorophage φ2GFP10 method for drug susceptibility testing of tuberculosis for isoniazid (INH),rifampin (RIF),and streptomycin (SM).Methods A total of 128 clinical M.tuberculosis strains were isolated from patients with suspected drug-resistant tuberculosis visiting Beijing Chest Hospital (Beijing,China) from April to June 2014.All of the isolates were tested by the phage assay,while conventional drug susceptibility tests were performing on Lwenstein-Jensen culture medium as reference.Results The sensitivities of φ2GFP10 assay for INH,RIF,and SM resistance detection were 100.0％,98.1％ (53/54),and 92.6％ (50/54),respectively,while their specificities were 84.8％ (56/66),91.9％ (68/74),and 91.9％ (68/74),respectively.The agreement between the phage assay and the conventional assay for detecting INH,RIF,and SM resistance was 0.92,0.95 and 0.92,respectively.The φ2 GFP10-phage assay could be done within 2 days for RIF and SM,and 3 days for INH.Conclusions The φ2GFP10-phage method for drug susceptibility test is very sensitive and specific.The method has the potential to be a valuable,rapid and economical screening method for detecting drug-resistant tuberculosis.