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使用针对性下一代测序来直接检测耐药性Mycobacterium结核病

Shannon G Murphy¹, Carol Smith¹, Pascal Lapierre¹

¹Wadsworth Center, New York State Department of Health, Albany, NY, United States.

Frontiers in public health

|July 17, 2023

概括

这项研究引入了一种快速向下一代测序 (tNGS) 试验,直接从患者样本中检测结核菌复合体 (MTBC) 感染中的耐药性. tNGS检测能快速提供准确的结果,帮助及时做出耐药结核病的治疗决策.

科学领域:

微生物学微生物学
遗传学遗传学是一个
传染性疾病传染性疾病

背景情况:

结核病 (TB) 治疗依赖于抗生素组合,但对多药耐药 (MDR) 和广泛耐药 (XDR) 菌株的疗效有限.
对于Mycobacterium tuberculosis complex (MTBC) 的常规表型药物敏感性测试是耗时的,延迟了适当的患者管理.

研究的目的:

开发和验证一个多重,向的下一代测序 (tNGS) 试验,用于快速预测MTBC药物耐药性 (DR).
允许对临床呼吸器样本进行直接测试,减少与培养方法相比的周转时间.

主要方法:

设计了一种多重PCR试验,以放大与MTBC耐药性相关的13个全长基因和促进子区域.
利用牛津纳米孔技术进行长时间读取的安普利康测序和内部生物信息学管道进行实时突变识别.
在72个初级标本和55个MTBC阳性培养物上验证了tNGS试验的灵敏度,特异性,可重现性和准确性,并将结果与全基因组测序 (WGS) 进行比较.

主要成果:

从82%的涂抹阳性初级标本中获得完整或部分敏感性概况.
在tNGS识别的抗性突变和WGS结果之间显示出100%的一致性.
tNGS试验提供2-3天的周转时间,比培养衍生WGS快得多,可以处理混合菌根菌种.

结论:

tNGS测定可靠地直接从临床标本和培养物中预测MTBC耐药性.
这种快速诊断工具为耐药结核病患者的及时和适当治疗提供了关键信息.
该试验适合临床实施,通过加快治疗决策来改善患者的治疗结果.

关键词:

药物易感性药物易感性这种细菌是Mycobacterium.这是一个纳米孔.电阻的电阻是指电阻的电阻有针对性的测序.结核病是一种肺结核病.

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