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唾液细菌负荷和年龄对GeneXpert和肺结核的传统方法的影响:一项为期4年的回顾性比较研究
Kui Li1,2, Qianqian Hu3, Jun Liu3
1Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West YantaRoad, Xi'an, Shaanxi Province, 710061, China.
BMC infectious diseases
|November 27, 2023
概括
GeneXpert MTB/RIF (Xpert) 测试准确检测肺结核,结果不受液细菌负荷的影响,但受患者年龄的影响. 新的Ct值细分为诊断抗利芬素耐药性提供了一种实用的方法.
科学领域:
- 微生物学 微生物学
- 诊断医学 诊断医学 诊断医学
- 分子生物学分子生物学
背景情况:
- 肺结核的诊断依赖于准确的检测方法.
- 评估GeneXpert MTB/RIF (Xpert),Auramine O染色和洛文斯坦-詹森介质的诊断性能至关重要.
- 了解影响检测的因素,如液细菌负荷 (SBL) 和qRT-PCR值周期 (Ct) 值,对于优化结核病诊断至关重要.
研究的目的:
- 评估Xpert,Auramine O染色和Lowenstein-Jensen介质对肺结核的诊断准确性. 为了评估Xpert,Auramine O染色和Lowenstein-Jensen介质对肺结核的诊断准确性.
- 调查SBL和Ct值对这些检测方法的性能的影响.
- 为了确定与虚假阴性Xpert结果相关的因素,并探索最佳的Ct值截止值来检测利芬素耐药性.
主要方法:
- 在49个月内对980个唾液样本进行了回顾性分析.
- 使用基平方测试进行比较性绩效评估.
- 接收器操作特征 (ROC) 曲线分析,以确定最佳的切断界限.
- 后勤回归分析,以确定假负Xpert结果的风险因素.
主要成果:
- Xpert的阳性检测率没有受到SBL的显著影响,与其他方法相比,SBL低 (≤1+) 时显示出差异.
- 在Ct值和SBL之间观察到强烈的负相关性 (P < 0.0001).
- 年龄被确定为假阴性Xpert结果的独立风险因素 (P = 0.029).
- 实现了100%的灵敏度和特异性,Ct < 16.
- 利芬辛耐药性分类的最佳Ct截止值为<18.6,18.6-34.1和>34.1周期.
结论:
- 艾克斯伯特的表现受到年龄的影响,而不是SBL,以较低的SBL (≤1+) 显示优势.
- 来自Xpert的瑞芬辛耐药性检测结果是可靠的.
- 新的CT值细分提供了一种实用和临床上有意义的方法来诊断抗利芬素的耐药性,帮助医生准确诊断结核病.
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