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目的评价Xpert结核分枝杆菌/利福平试验(Xpert MTB/RIF试验)检测儿童结核病及利福平耐药性的临床应用价值。方法收集72例疑似结核病患儿痰标本,进行涂片镜检、固体培养、比例法药敏试验和Xpert MTB/RIF检测,分析Xpert MTB/RIF法检测痰中MTB及其耐药性的敏感度和特异度,与金标准进行一致性检验。结果以固体培养结果作为金标准,Xpert MTB/RIF法检测痰标本MTB的敏感度和特异度分别为96.9%和87.5%,Xpert MTB/RIF和MTB固体培养具有较好的一致性(K=0.808);以比例法药敏试验结果作为金标准,Xpert MTB/RIF方法检测利福平耐药的敏感度和特异度分别为95.9%和93.9%,Xpert MTB/RIF和比例法药敏试验具有较好的一致性(K=0.831)。结论 Xpert MTB/RIF法检测痰液标本的敏感度和特异性高,可为儿童结核病早期诊断及其利福平耐药情况提供及时的数据。
Objective To evaluate the clinical value of Xpert Mycobacterium tuberculosis / rifampicin test (Xpert MTB / RIF test) in detecting tuberculosis and rifampicin resistance in children. Methods Totally 72 sputum samples from children with suspected tuberculosis were collected and examined by smear microscopy, solid culture, drug susceptibility test by ratio method and Xpert MTB / RIF assay. The sensitivity of Xpert MTB / RIF method in detecting sputum MTB and drug resistance was analyzed And specificity, consistent with the gold standard test. Results The sensitivity and specificity of Xpert MTB / RIF method for detecting MTB in sputum specimens were 96.9% and 87.5%, respectively. The results of Xpert MTB / RIF assay showed good agreement with solid culture results (K = 0.808 ). The sensitivity and specificity of Xpert MTB / RIF assay for detecting rifampicin resistance were 95.9% and 93.9%, respectively. The susceptibility test of Xpert MTB / RIF and proportion method were more sensitive Good consistency (K = 0.831). Conclusion The sensitivity and specificity of Xpert MTB / RIF assay for detecting sputum specimens are high and provide timely data for the early diagnosis of tuberculosis and the rifampicin resistance in children.