Research of effectiveness of fluorescence PCR melting curve assay in detecting drug resistance of levofloxacin and moxifloxacin in patients with multidrug-resistant pulmonary tuberculosis

doi:10.19982/j.issn.1000-6621.20210488

Abstract

Abstract:

Objective: To explore the clinical value of fluorescence PCR melting curve assay for rapid detection of levofloxacin (Lfx) and moxifloxacin (Mfx) resistance of multidrug-resistant pulmonary tuberculosis (MDR-TB) patients. Methods: From November 2018 to December 2019, 195 MDR-PTB patients from Infectious Disease Hospital of Heilongjiang Province were selected as subjects. All the patients were screened by fluorescence PCR melting curve assay and confirmed by the automatic BACTEC MGIT 960 Mycobacteria Culture System and proportion method of drug sensitivity test (DST). The accuracy of fluorescence PCR melting curve assay for detecting drug resistance to Lfx and Mfx of Mycobacterium tuberculosis (MTB) was analyzed. Results: Using the proportion method, among the 195 MDR-MTB strains, the drug resistance rates of Lfx and Mfx were 46.15% (90/195) and 48.72% (95/195), respectively. Using the above results as standard, the sensitivity, specificity, consistency and Kappa value of Lfx resistance of MTB were 95.56% (86/90), 73.33% (77/105), 83.59% (163/195) and 0.83; and the sensitivity, specificity, consistency and Kappa value of Mfx resistance of MTB were 95.79% (91/95), 77.00% (77/100), 86.15% (168/195) and 0.85 by fluorescence PCR melting curve analysis. Conclusion: The results of fluorescence PCR melting curve assay in detecting the resistance of MDR-TB to Lfx and Mfx were highly consistent with the results of proportion method of DST. Fluorescence PCR melting curve analysis assay is suitable for screening the drug resistance of MDR-TB to Lfx and Mfx.

Key words: Tuberculosis,pulmonary, Tuberculosis,multidrug-resistant, Quinolones, Molecular diagnostic techniques, Diagnostic self evaluation

CLC Number:

R521
R446.5

JIN Long, TIAN Qi, ZHANG Bao-qing, XING Hai-dong, GAO Ming-xia, ZHANG Xiu-ying, WANG Li-hua, ZHANG Xiao-lei. Research of effectiveness of fluorescence PCR melting curve assay in detecting drug resistance of levofloxacin and moxifloxacin in patients with multidrug-resistant pulmonary tuberculosis[J]. Chinese Journal of Antituberculosis, 2022, 44(2): 159-163. doi: 10.19982/j.issn.1000-6621.20210488

Figures/Tables 1

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荧光PCR熔解曲线法	比例法药敏试验		合计 (株)	敏感度 [%(95%CI)]	特异度 [%(95%CI)]	一致率 [%(95%CI)]	Kappa值
荧光PCR熔解曲线法	耐药 (株)	敏感 (株)	合计 (株)	敏感度 [%(95%CI)]	特异度 [%(95%CI)]	一致率 [%(95%CI)]	Kappa值
左氧氟沙星				95.56(89.12~98.26)	73.33(64.16~80.86)	83.59(77.75~88.13)	0.83
突变	86	28	114
未突变	4	77	81
莫西沙星				95.79(89.67~98.35)	77.00(67.85~84.16)	86.15(80.60~90.31)	0.85
突变	91	23	114
未突变	4	77	81