目的 评价BACTEC MGIT 960进行4种二线抗结核药物药敏试验的效果.方法 用MGIT 960对结核分枝杆菌临床分离菌株进行二线抗结核药物卷曲霉素、卡那霉素、氧氟沙星和乙硫异烟胺的药敏检测,并将结果与L-J比例法结果进行比较分析.结果 111 株结核分枝杆菌临床分离株用MGIT960法与L-J比例法卷曲霉索、卡那霉素、氧氟沙星、乙硫异烟胺药敏符合率分别为95.5%(106/111)、93.7%(104/111)、97.3%(108/111)、85.6%(95/111).与比例法药敏结果比较,MGIT 960药敏检测的敏感度、特异度和准确性,卷曲霉素分别为80.0%、97.0%、95.5%,卡那霉素分别为92.3%,93.9%、93.7%,氧氟沙星分别为95.3%、98.5%、97.3%,乙硫异烟胺分别为100%、81.2%、85.6%.MGIT 960完成药敏试验的时间平均为8.3 d,L-J法平均为26.2 d,差异有统计学意义(P<0.01).结论 MGIT 960所得的药敏结果与传统比例法有较高的一致性,但检测时间较短,有利于耐药结核病患者的早期诊断和治疗.%Objective To evaluate the effects of the BACTEC MGIT 960 in detecting the resistance of climcal Mycobacterium tuberculosis isolates to the second-line anti-tuberculosis drags. Methods The drug susceptibility test of the clinical isolates to four anti-tuberculosis drugs, capreomycin ( CPM), kanamycin ( KAN), ofioxacin (OFLX) and Ethionamide (ETH) was conducted by MGIT 960, and the results were compared with those obtained by L-J proportion method. Results A total of 111 clinical Mycobacterium tuberculosis isolates were detected. The consistency of the drug susceptibility tests by MGIT 960 and L-J proportion method was 95.5％ for CPM (106/111), 93.7％ for KAN ( 104/111 ), 97. 3 ％ for OFLX ( 108/111 ) and 85.6％ for ETH (95/111 ). Compared with L-J proportion method, the sensitivity, specificity and accuracy of MGIT 960 were 80. 0％, 97.0％, 95.5％ for CPM, 92. 3％, 93.9％, 93.7％ for KAN, 95.3％, 98.5％, 97. 3％ for OFLX and 100％, 81.2％, 85.6％ for ETH. The completion of the drug susceptibility test by MGIT 960 needed 8. 3 days averagely, and that by L-J proportion method needed 26. 2 days, the difference was statistical significant (P ＜ 0. 01 ). Conclusion The result of drug susceptibility test by MGIT 960 was highly consistent with that by L-J proportion method, but the former needs much shorter time than the latter. The application of MGIT 960 could facilitate the early diagnosis and treatment of drug-resistant tuberculosis.
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