التفاصيل البيبلوغرافية
| العنوان: |
使用過濾法與分子生物技術偵測結核菌及實驗室成本效益分析 ; Use of Filtration and Cost-Effective Molecular Laboratory Detection of the Mycobacteria tuberculosis Complex |
| المؤلفون: |
竇慧琴, Hui-Zin Tu |
| المساهمون: |
林裕森, Yu-Sen Lin |
| سنة النشر: |
2007 |
| المجموعة: |
National Kaohsiung Normal University Institutional Repository (NKNUIR) / 國立高雄師範大學機構典藏 |
| مصطلحات موضوعية: |
抗酸性染色, 結核病, 非結核分枝桿菌, 拋棄式過濾器, 核酸增幅技術, acid-fast stain, tuberculosis (TB), non-tuberculous mycobacteria (NTM), point-of-use water filter, strand displacement amplification (SDA) technology |
| الوصف: |
目前台灣的結核病(tuberculosis)死亡率占台灣死亡原因的第12名。所以，如何正確且快速的診斷出結核病，顯得相當重要。結核菌痰液抹片的抗酸性染色檢查中，常因環境中的非結核分枝桿菌(non-tuberculous mycobacterium, NTM)，造成偽陽性的染色結果，導致醫生錯誤的臨床診斷及處置。非結核分枝桿菌在自來水中是正常的菌群，實驗室一旦使用被 NTM 污染的自來水處理病人檢體、進行抗酸性染色、清洗儀器及配製試劑，就會造成染色時的偽陽性。抗酸性染色陽性的檢體，以核酸增幅技術直接偵測結核分枝桿菌，可以及早針對結核病病人做隔離治療。本研究評估使用0.2 μm 拋棄式過濾器可將細菌阻擋在膜外的特性，去除水中的 NTM，以減少抗酸性染色偽陽性的結果。並且對於染色結果呈陽性的檢體，立即使用去氧核醣核酸 (DNA) 增幅技術來偵測檢體中微量之結核菌。結果顯示以拋棄式過濾器所過濾的水、自來水與去離子水的染色結果，與培養的結果比較，其專一性分別為98.6%、87.6%及89.9%，陽性預測值分別為83.3%、40.6%及46.2%，顯示過濾器能大幅提高檢驗的專一性與陽性預測值。以核酸增幅技術偵測的結果與培養結果做比較，測得的敏感性、專一性、陽性預測值及陰性預測值分別為87.2%、97.6%、97.7%及86.6%。若有臨床診斷輔助，其敏感性及陰性預測值可達91.8%及91.0%。本研究證實，使用拋棄式過濾器，可以大量減低抗酸性染色結果的偽陽性;再針對抗酸性染色陽性的檢體執行快速檢驗，可以幫助醫師早期診斷結核病，減少不必要的醫療浪費。 ; Pseudo-outbreaks of tuberculosis (TB) occurred in Taiwan caused management problems because many patients may undergo preliminary anti-tuberculosis therapy and isolation. Thus, it is important to develop accurate and rapid procedures to detect TB. The false positive results may be due to acid-fast stain of non-tuberculosis mycobacterium (NTM) with the laboratory tap water that is used to process the specimens. NTM is often found in tap water and can be lead to a false positive acid-fast stain result. Thus, the effectiveness of point-of-use 0.2 μm water filter to reduce false positive acid-fast stain was evaluated. Detection of deoxyribonucleic acid (DNA) in 361 acid-fast positive respiratory specimens for M. tuberculosis complex was also evaluated with the homogenous strand displacement amplification (SDA) technology and fluorescent energy (ET). Using mycobacteria cultures as gold standard, the false positive rate of samples treated by filtered water (1.2%, 7/562) is significant lower than samples treated by tap water (10.7%, 60/562) and deionized water (8.7%, 49/562). The specificity and positive predictive value for samples treated with filtered water (98.6% and 88.3%, respectively) is significantly higher than that for samples with tap water (87.6% and 40.6%, respectively) and deionized water (89.9% and 46.2%, respectively). When the PCR ... |
| نوع الوثيقة: |
other/unknown material |
| وصف الملف: |
110 bytes; text/html |
| اللغة: |
English |
| العلاقة: |
http://ir.nknu.edu.tw/ir//handle/987654321/5071Test; http://ir.nknu.edu.tw/ir/bitstream/987654321/5071/1/index.htmlTest |
| الإتاحة: |
http://ir.nknu.edu.tw/ir//handle/987654321/5071Test
http://ir.nknu.edu.tw/ir/bitstream/987654321/5071/1/index.htmlTest |
| رقم الانضمام: |
edsbas.7FEC10A6 |
| قاعدة البيانات: |
BASE |
