Evaluation of indirect susceptibility testing of Mycobacterium tuberculosis to the first- and second-line, and alternative drugs by the newer MB/BacT system
Evaluation of indirect susceptibility testing of Mycobacterium tuberculosis to the first- and second-line, and alternative drugs by the newer MB/BacT system
复制标题
DOI：
10.1590/s0074-02762003000600020
复制
发表时间：
2003-09-01
期刊：
影响因子：
--
通讯作者：
Caldas, Paulo César de Souza
中科院分区：
文献类型：
--
作者：
Barreto, Angela Maria Werneck;Araújo, Joselba Borges Melo;Caldas, Paulo César de Souza
为了评价Organon Teknika MB/BacT系统对替代药物氧氟沙星（OFLO）、阿米卡星（AMI）和利福丁（RIF）的间接敏感性，以及对标准治疗方案中常用药物如利福平（RMP）、异烟肼（INH）、吡嗪酰胺（PZA）、链霉素（SM）、乙胺丁醇（EMB）和乙硫酰胺（ETH）的间接敏感性，对117例肺结核患者的临床标本进行了多药耐药调查。于二零零一年至二零零二年按次序录取参加考试。将50个结核分枝杆菌培养物接种到金标准BACTEC 460 TB （Becton Dickinson）培养基中，用于研究对AMI、RIF和OFLO的耐药性，其余67个接种到Lowenstein Jensen （LJ）培养基（巴西目前使用的金标准）中，用于研究对RMP、INH、PZA、SM、EMB和ETH的耐药性。我们观察到AMI（80.8-100）、RIF（80.8-100）和OFLO（78.1-100）的灵敏度为100%；与BACTEC系统相比，AMI（85.4-100）、RIF（85.4-100）和OFLO（86.7-100）的特异性为100%。比较LJ的结果，我们发现RMP（80-100）的敏感性为100%，其次是INH - 95% (81.8-99.1), EMB - 94.7%(71.9-99.7)，在95%置信区间内，除PZA - 98.3（89.5-99.9）外，所有药物的特异性为100%。结果显示高水平的准确性，并表明全自动、非放射性MB/BacT系统适合在公共卫生实验室的药敏试验中常规使用。
In order to evaluate the Organon Teknika MB/BacT system used for testing indirect susceptibility to the alternative drugs ofloxacin (OFLO), amikacin (AMI), and rifabutin (RIF), and to the usual drugs of standard treatment regimes such as rifampin (RMP), isoniazid (INH), pyrazinamide (PZA), streptomycin (SM), ethambutol (EMB), and ethionamide (ETH), cultures of clinical specimens from 117 patients with pulmonary tuberculosis tinder multidrug-resistant investigation, admitted sequentially for examination from 2001 to 2002, were studied. Fifty of the Mycobacterium tuberculosis cultures were inoculated into the gold-standard BACTEC 460 TB (Becton Dickinson) for studying resistance to AMI, RIF and OFLO, and the remaining 67 were inoculated into Lowenstein Jensen (LJ) medium (the gold standard currently used in Brazil) for studying resistance to RMP, INH, PZA, SM, EMB, and ETH. We observed 100% sensitivity for AMI (80.8-100), RIF (80.8-100), and OFLO (78.1-100); and 100% specificity for AMI (85.4-100), RIF (85.4-100), and OFLO (86.7-100) compared to the BACTEC system. Comparing the results obtained in LJ we observed 100% sensitivity for RMP (80-100), followed by INH - 95% (81.8-99.1), EMB - 94.7% (71.9-99.7), and 100% specificity for all drugs tested except for PZA - 98.3 (89.5-99.9) at 95% confidence interval. The results showed a high level of accuracy and demonstrated that the fully automated, non-radiometric MB/BacT system is indicated for routine use in susceptibility testing in public health laboratories.