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优化核酸MALDI-TOF-MS试验的诊断有效性,用于抗结核病药物耐药性检测

Xichao Ou¹, Zexuan Song¹, Bing Zhao¹

¹National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, No. 155 Chang Bai Road, Changping District, Beijing, 102206, People's Republic of China.

European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology

|November 18, 2023

概括

一种新型核酸基质辅助激光吸附离子化飞行时间质谱法 (MALDI-TOF-MS) 试验在检测Mycobacterium结核病耐药性方面显示出高准确性. 这种方法是快速诊断的一个有前途的工具,特别是对利法,异亚,乙胺醇和莫西素的耐药性.

科学领域:

微生物学微生物学
分子诊断学分子诊断
质谱测量质量谱测量

背景情况:

结核病 (TB) 仍然是一个重大的全球卫生挑战.
快速准确地检测耐药性对于有效的结核病治疗和控制至关重要.
现有的诊断方法可能耗时,延迟了适当的患者管理.

研究的目的:

为了评估核酸矩阵辅助激光吸附离子化飞行时间质谱法 (MALDI-TOF-MS) 试验的诊断性能.
评估测试在检测Mycobacterium结核病分离物中耐药性的有效性.
为了确定MALDI-TOF-MS对特定抗结核病药物的准确性:里法 (RIF),伊索尼亚 (INH),乙胺醇 (EMB),莫西素 (MXF),思胺 (SM) 和皮拉津胺 (PZA).

主要方法:

总共分析了263个Mycobacterium结核病临床分离物.
核酸MALDI-TOF-MS试验被用来检测对RIF,INH,EMB,MXF,SM和PZA的耐药性.
结果与表型微型乳头稀释药物敏感性测试 (DST) 和全基因组测序 (WGS) 作为参考标准进行了比较.

主要成果:

与DST相比,MALDI-TOF-MS试验对RIF,INH,EMB和MXF抗性检测具有很高的灵敏度和特异性.
与WGS相比,该试验在RIF,EMB,MXF和SM电阻方面表现出色.
虽然总体上准确,但该试验在检测PZA耐药性方面表现较差 (50.0%的灵敏度).

结论:

核酸MALDI-TOF-MS测定与DST和WGS等既定方法相比,提供了高度一致的结果.
这种测试是快速准确检测关键抗结核病药物的药物敏感性的有希望的工具.
为了可靠地检测对所有测试药物的耐药性,特别是对pyrazinamide,可能需要进一步优化.

关键词:

药物耐药性药物耐药性药物耐药性药物敏感性测试是对药物敏感性的测试.结核病菌菌菌的结核病菌的结核病菌.核酸MALDI-TOFMSMS是一种核酸.

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