中国感染控制杂志2024，Vol.23Issue(7)：840-846,7.DOI:10.12138/j.issn.1671-9638.20244901
肉汤微量稀释法对耐多药结核分枝杆菌敏感性检测的评价
Susceptibility detection of multidrug-resistant Mycobacterium tuberculosis by broth microdilution method
摘要
Abstract
Objective To evaluate the application effect of broth microdilution(BMD)method in susceptibility testing of multidrug-resistant Mycobacterium tuberculosis(MDR-MTB).Methods The Roche's proportion method and BMD method were adopted in drug susceptibility testing on 108 MDR-MTB strains and 11 non-MDR-MTB strains in Hainan Province.Whole genome sequencing(WGS)was performed on strains with inconsistent results by the above two methods.Results The average time to acquire drug susceptibility testing results by Roche's propor-tional method and BMD method were 28.0 and 8.5 days,respectively.Roche's proportional method showed higher resistance rates to isoniazid(INH),rifampicin(RFP),ethambutol(EMB),kanamycin(KM),and capreomycin(CPM)than BMD method(all P＜0.001).BMD method showed higher resistance rates to protionamide(PTO)and para-aminosalicylic acid(PAS)than Roche's proportional method(both P＜0.001).Taking Roche's proportional method as the gold standard,the sensitivity and specificity of BMD method for testing drug resistance were 50.00％-100％and 95.69％-100％,respectively.Except EMB(87.39％)and INH(94.96％),the consistency rates of the BMD method in testing drug resistance of other drugs were all ≥95.00％.The overall consistency rate between Roche's proportional method and WGS was 76.19％(32/42),while the consistency rate between BMD method and WGS was 23.81％(10/42),difference was statistically significant(x2=23.048,P＜0.001).34 MTB strains showed inconsistent results by two drug susceptibility testing methods.Among the 26 MTB strains that were resis-tant in Roche's proportion method but sensitive in BMD method,22 strains(84.62％)had mutations in relevant re-sistance genes.Among the 11 MTB strains that were sensitive in Roche's proportion method but resistant in BMD method,5 strains(45.45％)had mutations in relevant resistance genes.Conclusion BMD method is an accurate and rapid MDR-MTB susceptibility testing method,but further improvement and optimization are still needed.Drug resistance is closely related to mutations in relevant resistance genes.关键词
耐多药结核分枝杆菌/罗氏比例法/肉汤微量稀释法/最低抑菌浓度/药物敏感试验Key words
multidrug-resistant Mycobacterium tuberculosis/Roche's proportional method/broth microdilution method/minimum inhibitory concentration/antimicrobial susceptibility testing分类
医药卫生引用本文复制引用
钟业腾,王洁莹,陈灼霖,许玉妮,邱文华,裴华..肉汤微量稀释法对耐多药结核分枝杆菌敏感性检测的评价[J].中国感染控制杂志,2024,23(7):840-846,7.基金项目
海南省重点研发项目(ZDYF2022SHFZ100) （ZDYF2022SHFZ100）
海南省自然科学基金项目(822RC844、820MS144) （822RC844、820MS144）
海南省卫生健康行业科研项目(22A200272、22A200271) （22A200272、22A200271）
