对脊柱结核感染的不同诊断方法的评估
Zhaoxin Li1, Jin Wang1, Xin Xiu1
1Shandong University of Traditional Chinese Medicine, Shandong, China.
BMC infectious diseases
|October 18, 2023
概括
在诊断脊柱结核病 (STB) 方面,T-SPOT.TB 显示出高效率,而 Xpert MTB/RIF 则提供可靠性和对 rifampin 耐药性的检测. 将Xpert MTB/RIF与甲基因组下一代测序 (mNGS) 结合起来,可以改善性病患者的早期诊断和治疗.
科学领域:
- 传染性疾病 传染性疾病
- 微生物学 微生物学
- 诊断医学 诊断医学 诊断医学
背景情况:
- 结核病 (TB) 是全球主要的传染性死亡原因.
- 外肺结核占病例的24.6%,其中脊柱结核病 (STB) 主要.
- 准确及时诊断性传染病仍然是一个重大的临床挑战.
研究的目的:
- 评估和比较四种STB检测方法的诊断性能.
- 评估的方法包括Mycobacteria Growth Indicator Tube (MGIT) -960培养,T-SPOT.TB,Xpert Mycobacterium结核病综合体 (MTB) /耐利抗药 (RIF) 和元基因组下一代测序 (mNGS).
- 评估这些诊断工具组合的实用性.
主要方法:
- 分析了126名疑似性传播疾病患者的队列.
- 对每种方法和组合计算出诊断性能指标 (灵敏度,特异性,PPV,NPV).
- 临床诊断作为比较的参考标准.
主要成果:
- T-SPOT.TB表现出高灵敏度 (92.7%) 和净净值 (95.9%).
- 埃克斯珀特MTB/RIF显示高特异性 (100%) 和PPV (100%),并检测出里法抗性.
- 结合Xpert MTB/RIF和mNGS,获得了73.2%的灵敏度和100%的特异性;mNGS+T-SPOT.TB获得了97.6%的灵敏度和100%的特异性.
结论:
- T-SPOT.TB在性病诊断方面非常有效,而Xpert MTB/RIF是可靠的,可以检测耐药性.
- 基因组下一代测序 (mNGS) 有助于识别病原体,特别是在非STB的情况下.
- 将Xpert MTB/RIF与mNGS结合起来,可以提高早期诊断,药物耐药性检测,并减少STB的诊断时间.
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