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目的探讨耐利福平作为宁波地区耐多药结核病筛选指标的可行性。方法对结核分枝杆菌临床分离株采用美国BD公司BACTEC MGIT 960全自动快速分枝杆菌培养鉴定药敏实验,并对数据进行分析。应用诊断性试验评价指标评价耐利福平作为耐多药结核病筛选指标的科学性。结果在2603株结核分枝杆菌临床分离株中,312株对利福平耐药,其中267株至少同时对异烟肼耐药,结核分枝杆菌的耐多药率为10.3%。若以至少同时耐异烟肼和利福平作为诊断耐多药结核病的参考标准,以耐利福平作为耐多药结核病筛选指标的敏感性为100%、特异性为98.1%、准确度为98.3%、阳性预测值为85.6%、阴性预测值为100%、阳性似然比为5.9、阴性似然比为0。结论耐利福平可以作为宁波地区耐多药结核病的初步筛选指标。
Objective To investigate the feasibility of rifampicin as a screening index for multidrug-resistant tuberculosis in Ningbo. Methods The clinical isolates of Mycobacterium tuberculosis were identified by BACTEC MGIT 960 automatic rapid culture Mycobacterium tuberculosis in the United States to identify susceptibility test and the data were analyzed. Evaluation of Rifampicin as a Screening Indicator of Multidrug Resistant Tuberculosis Using Diagnostic Tests. Results Among the 2603 clinical isolates of Mycobacterium tuberculosis, 312 were resistant to rifampicin, of which 267 were resistant to isoniazid at least. The MDR-resistance rate of M. tuberculosis was 10.3%. If at least both isoniazid and rifampin were used as reference standards for the diagnosis of multidrug-resistant tuberculosis, the sensitivity and the specificity of rifampicin as a screening indicator for multidrug-resistant tuberculosis were 100% and 98.1% respectively, with an accuracy of 98.3%, the positive predictive value was 85.6%, the negative predictive value was 100%, the positive likelihood ratio was 5.9, and the negative likelihood ratio was 0. Conclusion Rifampicin can be used as a preliminary screening of MDR-TB in Ningbo.