RESUMO
Objective To investigate the application value of Xpert mycobacterium tuberculosis/rifampicin (GeneXpertMTB/RIF) and Hain techniques for the diagnosis of sputum smear negative tuberculosis and for the assessment of rifampin resistance. Methods A total of 254 patients with suspected pulmonary tuberculosis treated in our hospital from March 2018 to June 2019 were enrolled. GeneXpertMTB/RIF, Hain techniques, Roche culture and drug susceptibility testing were performed. Taking Roche culture results as a gold standard, the efficacy of GeneXpertMTB/RIF and Hain techniques in detecting sputum smear-negative pulmonary tuberculosis was analyzed by ROC curve. Based on the results of drug susceptibility testing, the efficacy of GeneXpertMTB/RIF and Hain techniques in detecting rifampicin resistance was analyzed. Results The sensitivity, specificity and accuracy of GeneXpertMTB/RIF in the diagnosis of sputum smear negative pulmonary tuberculosis were 82.18%, 86.93% and 83.52%, respectively. The sensitivity, specificity and accuracy of Hain technique in the diagnosis of sputum smear negative pulmonary tuberculosis were 67.33%, 77.12% and 73.23%, respectively. The sensitivity, specificity and accuracy of GeneXpertMTB/RIF in evaluating rifampicin resistance were 73.33%, 98.84% and 95.05%, respectively. The sensitivity, specificity and accuracy of Hain technique in evaluating rifampicin resistance were 86.67%, 82.56% and 83.17%, respectively. Conclusion Compared with Hain technology, GeneXpertMTB/RIF had better clinical value for diagnosis of sputum smear negative tuberculosis and for the assessment of rifampin resistance. This study demonstrates that GeneXpertMTB/RIF technique has a good application value in the rapid diagnosis and treatment of sputum smear negative pulmonary tuberculosis.
RESUMO
Objective To analyze the results of sputum culture from smear-positive pulmonary tuberculosis cases after treatment for 2 months.Methods Sputum specimens from newly diagnosed 147 smear-positive pulmonary tuberculosis cases after treatment for 2 months were fast cultured by BacT/ALERT 3D.Poeitive cultures were further detected by HAIN test in Zhejiang Provincial Center for Disease Control and prevention and compared with L-J meditun.Results Mycobacteria were found in 45 specimens by Bact/ALERT 3D in contrast to 22 by Lonswtein-Jenson method.The median time was 19.3 days for the whole Bact/ALERT 3D test while the whole procedure would cost 3 months for traditional L-J test.Conclusion Results from sputum smear could not reflect tuberculosis progress properly while BacT/ALERT 3D fast culture would help to find drug resistant patients promptly and accurately.
RESUMO
Objective To identify non-tuberculous Mycobacterium(NTM) rapidly with HAIN molecular assay genotype Mycobacterium kit,and investigate the advantages and disadvantages of this method.Methods Seventy-four clinical NTM isolates were collected from hospitals in Zhejiang and Anhui province.Clinical strains were identified with HAIN molecular assay genotype Mycobacterium kit.16S rRNA gene sequencing was used to estimate and compare with this method.Results The results of kit showed that there were thirty-one M.intracellulare strains,twelve M.chelonae strains,eight M.fortuitum strains,six M.kansasii strains,five M.avium strains,three M.smegmatis strains,two M.phlei strains,two M.scrofulaceum strains and one M.gordon strain.Four strains were identified as Mycobacterium without further identification.Eight M.tuberculosis strains were identified correctly too.Compared with 16S rRNA gene sequencing,except for four strains identified as Mycobacterium,others 70 strains got the same results as 16S rRNA gene sequencing,the coincidence was 94.59％,and it could further identify thirteen Mycobacterium chelonae complex and eight Mycobacterium kansasii complex to subspecies M.abscessus and M.kansasii,respectively.If only to identify strains under the identification range of this kit,the coincidence reach to 100％,Conclusion The method of HAIN molecular assay genotype Mycobacterium kit is simple and accurate,the time is shorter and should widely be applied clinically.