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中国防痨杂志 ›› 2021, Vol. 43 ›› Issue (7): 664-669.doi: 10.3969/j.issn.1000-6621.2021.07.005

• 论著 • 上一篇    下一篇

荧光PCR熔解曲线法在非结核分枝杆菌菌种鉴定中的应用价值

李爱芳, 谈小文, 崔晓利, 康磊, 党丽云, 张耀辉, 杨翰()   

  1. 710100 西安市胸科医院
  • 收稿日期:2021-02-23 出版日期:2021-07-10 发布日期:2021-07-09
  • 通信作者: 杨翰 E-mail:xajhyanghan@163.com
  • 基金资助:
    西安市科技计划项目(20YXYJ0001(3))

Application value of fluorescence PCR melting curve method in the identification of non-tuberculous mycobacteria

LI Ai-fang, TAN Xiao-wen, CUI Xiao-li, KANG Lei, DANG Li-yun, ZHANG Yao-hui, YANG Han()   

  1. Xi'an Chest Hospital, Xi'an 710100, China
  • Received:2021-02-23 Online:2021-07-10 Published:2021-07-09
  • Contact: YANG Han E-mail:xajhyanghan@163.com

摘要: 目的 探讨荧光PCR熔解曲线法对非结核分枝杆菌(non-tuberculous mycobacteria,NTM)菌种鉴定的价值,为临床NTM肺病的快速准确诊断提供科学依据。方法 收集西安市胸科医院2020年4—10月经BACTEC MGIT 960液体培养阳性、MPB64快速抗原检测阴性的71例疑似NTM临床分离株。每例患者临床分离株采用同一标本进行荧光PCR熔解曲线法、基因芯片法及16S rRNA基因测序法菌种鉴定。以16S rRNA基因测序结果为参考标准,评价荧光PCR熔解曲线法菌种鉴定的检测效能。结果 荧光PCR熔解曲线法检出67株NTM菌株,其中以龟/脓肿分枝杆菌(37.3%,25/67)和胞内分枝杆菌(25.3%,17/67)为主。荧光PCR熔解曲线法检测龟/脓肿分枝杆菌的敏感度、特异度和符合率分别为100.0%(24/24)、97.7%(42/43)和98.5%(66/67);检测胞内分枝杆菌的敏感度、特异度和符合率分别为94.4%(17/18)、100.0%(49/49)和98.5%(66/67)。荧光PCR熔解曲线法与16S rRNA基因测序法一致率达97.0%(65/67);基因芯片法与16S rRNA基因测序法一致率为83.6%(56/67)。结论 荧光PCR熔解曲线法与16S rRNA基因测序法菌种鉴定具有较高的一致性,能够用于分枝杆菌菌种的快速鉴定,具有较好的临床应用价值。

关键词: 分枝杆菌, 聚合酶链反应, 微阵列分析, 基因测序

Abstract: Objective To explore the application value of fluorescent PCR melting curve method in the identification of non-tuberculous mycobacteria (NTM), and to provide scientific basis for rapid and accurate diagnosis. Methods A total of 71 suspected NTM clinical isolates with positive BACTEC MGIT 960 liquid culture and negative MPB64 rapid antigen test were collected from Xi'an Chest Hospital from April to October 2020. Each clinical isolate was identified using the same specimen by fluorescent PCR melting curve method, gene chip method and 16S rRNA gene sequencing. The 16S rRNA gene sequencing results were used as reference standards to evaluate the detection efficiency of the fluorescent PCR melting curve method for strain identification. Results Detected by the melting curve method, the 67 NTM strains were mainly Mycobacterium tortoise/abscess (37.3%, 25/67) and Mycobacterium intracellular (25.3%, 17/67). The sensitivity, specificity and coincidence rate of Mycobacterium tortoise/abscess by fluorescence PCR melting curve method were 100.0% (24/24), 97.7% (42/43) and 98.5% (66/67), respectively; and those of Mycobacterium intracellular were 94.4% (17/18), 100.0% (49/49) and 98.5% (66/67), respectively. The consistency was 97.0% (65/67) rate between the fluorescence PCR melting curve method and the 16S rRNA gene sequencing method, and was 83.6% (56/67) between the gene chip method and the 16S rRNA gene sequencing method. Conclusion The fluorescence PCR melting curve method has high consistency with the gene sequencing method, it could be used for the rapid detection of mycobacterial species identification with good clinical application value.

Key words: Mycobacteria, Polymerase chain reaction, Microarray analysis, Gene sequencing