Role of line probe assay in diagnosis and detection of drug resistance in Mycobacterium tuberculosis

Phalguni Malhotra, D. Chhina, Veenu Gupta, Akashdeep Singh, D. Sandhu
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引用次数: 1

Abstract

http://dx.doi.org/10.21276/IJRDPL.22780238.2019.8(2).46-49 ABSTRACT: Tuberculosis caused by Mycobacterium tuberculosis has remained a major global health problem worldwide. TB requires prolonged period of time for isolation by conventional culture methods. The emergence and spread of multi drug resistant (MDR-TB) poses great threats and challenges in controlling the infection. MDR-TB is resistant to both first line drugs rifampicin and isoniazid. PCR tests are based on targeting the mutation in rpoB, katG and inhA genes which can detect resistance to these drugs. To compare microscopy, conventional culture and Line probe assay for the detection of M. tuberculosis & detect rifampicin and isoniazid resistance using Lineprobe assay in various clinical samples. A total of 347 suspected patients of tuberculosis were included in the study. Demographic details & clinical presentation was noted. Various samples were received & processed for ZN staining, culture on LJ media and Line probe assay. Out of 347 cases, majority of cases were in the age group of 51-60 years (18.4%). Majority of the population was males (65.1%). Among suspected tuberculosis patients, cough with expectoration (55.9%) was the commonest complaint. Microscopy was positive in 17.3%, conventional culture was positive in 16.1% and line probe assay was positive in 26.2%. Out of 347, 91 were diagnosed with MTB, out of which 85.7% were sensitive to both rifampicin and isoniazid whereas 14.3% showed resistance to either rifampicin / isoniazid or both. LPA & direct microscopy are a good screening method for early diagnosis and detection of drug resistance but are not a complete replacement of conventional culture which is still a gold standard.
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线探针法在结核分枝杆菌耐药诊断和检测中的作用
摘要:结核分枝杆菌引起的结核病一直是全球主要的健康问题。结核病需要较长的时间用传统的培养方法进行分离。耐多药结核病(MDR-TB)的出现和传播给控制感染带来了巨大的威胁和挑战。耐多药结核病对一线药物利福平和异烟肼都有耐药性。PCR检测基于rpoB、katG和inhA基因的突变,可以检测对这些药物的耐药性。比较显微镜法、常规培养法和Lineprobe法检测结核分枝杆菌的效果,并用Lineprobe法检测不同临床样本对利福平和异烟肼的耐药性。研究共纳入347例疑似结核病患者。记录了人口统计学细节和临床表现。接收各种样品并进行ZN染色,LJ培养基培养和Line探针检测。347例病例中,51 ~ 60岁年龄组占绝大多数(18.4%)。以男性居多(65.1%)。在疑似肺结核患者中,咳嗽伴咳痰(55.9%)是最常见的主诉。镜检阳性率为17.3%,常规培养阳性率为16.1%,线探针法阳性率为26.2%。在347名患者中,91人被诊断为结核分枝杆菌,其中85.7%对利福平和异烟肼均敏感,14.3%对利福平/异烟肼或两者均耐药。LPA和直接镜检是一种早期诊断和发现耐药的良好筛选方法,但不能完全取代传统培养,传统培养仍然是一种金标准。
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