几种液体分枝杆菌分离培养方法的多中心应用评估

摘要

目的 评估自动化及手动液体分枝杆菌分离培养系统的临床应用效果.方法 采集2008年11月～ 2009年4月就诊的肺结核可疑症状者痰标本1012例,其中涂阳472例,涂阴540例.对每份痰标本进行L-J培养及4种液体培养.结果 使用L-J培养、MGITTM 960、BacT/ ALERT 3D、MicroMGITTM手动判读仪、紫外灯的检出率分别为47.1％ (477/1012)、52.5％(531/1012)、51.9％ (310/597)、51.8％ (524/1012)、52.8％ (429/812).几种液体培养方法检出率均高于L-J培养,具有统计学差异(P＜0.05).自动化MGITTM 960和MicroMGITTM手动判读仪、紫外灯的检出率无统计学差异(P＞0.05).5种培养方法阳性结果报告时间分别为21.1±8.1天、11.0±5.9天、16.4 ±8.3天、11.8±6.6天、10.7±5.6天.4种液体培养方法阳性结果报告时间均短于L-J方法(P＜0.05).MGITTM 960阳性结果报告时间短于MicroMGITTM手动判读仪,且有统计学差异(P =0.048),但比紫外灯长,两者比较无统计学差异(P =0.520).结论 自动化及手动液体培养方法较L-J方法均能检出更多分枝杆菌,且能缩短阳性结果报告时间,且手动判读系统不需要昂贵仪器,更加适合基层实验室推广应用.%Objective To evaluate the effectiveness of automatic and manual liquid culture methods for detection of Mycobacterium. Methods Totally 1012 speimens from pulmnary tuberculosis suspects were collected from November 2008 to April 2009. Among them, 472 were smear microscopy positive and 540 negative. All specimens were isolated by L - J method, MGITTM 960, BacT/Alert 3D system, MicroMGITTM reader and UV lamp. Results The positive rate of L - J method, MGITTM 960, BacT/Alert 3D and MicroMGITTM reader and UV lamp were 47. 1% (77/1012) , 52.5% (531/1012) , 51.9% (310/597) ,51.8% (524/1012) , 52.8% (429/812) , respectively. The liquid culture positive rate was significantly higher than that of L - J method ( P < 0. 05 ) . There are no significantly difference between automatic MGIT TM 960 and mnual MicroMGITTM reader or UV lamp(P >0.05). The mean time of detection positive result with L-J method, MGITTM 960, BacT/Alert 3D system, MicroMGITTM and UV lamp were 21. 1 ±8. 1, 11.0 ±5.9, 16.4 ±8.3, 11.8 ±6.6, 10.7 ±5.6 days, respectively. The mean detection time of liquid culture was statistically shorter than solid medium culture(P <0. 05). The median time of detection of automatic MGITTM 960 was statistically shorter than manual MicroMGITTM reader( P = 0. 048) , but was longer than UV lamp(P =0. 520). Conclusion Automatic and manual liquid medium methods could detect more Mycobacteriumthan than solid medium method, shorten the detection time. Manual liquid medium method may be used in more laboratories with its low cost.