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BacT ALERT 3D结核分支杆菌快速培养系统在脊柱结核诊断中的应用

【摘要】 目的 分析BacT/ ALERT 3D法培养脊柱结核病灶标本的结果,探讨其在脊柱结核诊断中的价值。方法 对符合本实验要求的53例脊柱结核患者的43例进行手术治疗,术中收集结核肉芽肿、脓液及硬化骨作为标本,标本预处理后分别接种于三个BacT/ ALERT 3D液体培养基和三个罗氏培养基进行培养;另10例患者行CT引导下脓肿或病椎穿刺,标本用BacT/ ALERT 3D法培养,抗痨2周后术中取同样标本再用BacT/ALERT 3D法培养。阳性者萋—尼抗酸染色镜检后,接种PNB和TCH培养基进行菌种鉴定。结果 43例患者BacT/ ALERT 3D法培养阳性19例(人型结核杆菌为16例,牛型结核杆菌为3例),罗氏培养法阳性11例,阳性率分别为44%、25%,差异有统计学意义(P<0.005);阳性结果平均报告时间分别为16d和30d。其余10例患者入院即行CT引导下脓肿或病椎穿刺后BacT/ALERT 3D法培养,结果9例阳性,均为人型结核杆菌,阳性率90%,化疗2周后术中取同样标本经BacT/ ALERT 3D法培养仅2例阳性,阳性率20%,化疗前后结核分枝杆菌BacT/ ALERT 3D法培养阳性率差异有统计学意义(P<0.05)。BacT/ ALERT 3D法培养标本阳性率在结核肉芽肿(44%)、脓液(23%)和硬化骨(9%)差异有统计学意义(P<0.05)。结论 BacT/ ALERT 3D法是临床脊柱结核病原菌分离培养的较好方法,培养阳性率与培养物的取材时间、标本种类有直接关系。

  【关键词】 BacT/ ALERT 3D法;脊柱结核;结核分支杆菌

  Rapid Culture System of Mycobacterium Tuberculosis in the Diagnlsis of Spinal Tuberculosis (Orthopaedics Dept.of the Affiliated Hospital of Ningxia Med.Univ.,Yinchuan 750004)

  Abstract: Objective To analyze the results of BacT/ALERT 3D method in different obtain example time、in the culture of mycobacterium tuberculosis with various focuses and to study its applicability in the diagnlsis of spinal tuberculosis.Methods In 53 cases with spinal tuberculosis, 43 patients proper for this experiment were given surgery treatment and spinal tuberculosis granuloma,pus,and sclerosis bones were collected as the specimens during the surgery.The specimens were processed and inoculated into three BacT/ALERT 3D liquid vials and three L-J vials for culturing.Remainder 10 patients be hospitaltailed instantly CT lead pus,or the bad major part of a vertebra centesis processed BacT/ALERT 3D liquid and chemotherapy two week obtained alike example processed BacT/ALERT 3D liquid.The positives were observed with microscope after using conventional anti-acid colouration,and inoculated into PNB or TCH vials to appraise the kind of the bacteria.Results With BacT/ALERT 3D method,19 of the total 43 specimens showed cultured positive 16 specimens were identified as M.tu

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