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在儿童结核病中,tNGS与Xpert MTB/RIF的诊断价值

Huiwen Zheng¹, Haiming Yang², Yonghong Wang¹

¹Laboratory of Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, 100045, China.

|December 27, 2023

概括

针对性下一代测序 (tNGS) 对于诊断儿童结核病 (TB) 的灵敏度高于Xpert MTB/RIF测定,特别是在胃吸血和样中. 虽然tNGS表现出更好的灵敏度,但其特异性与Xpert.com相比较低.

科学领域:

儿童传染病儿童传染病
分子诊断学分子诊断学
微生物学微生物学

背景情况:

儿童结核病 (TB) 诊断面临挑战,原因是结核病性质和样本限制.
准确和灵敏的诊断工具对于儿童结核病病例的及时开始治疗至关重要.

研究的目的:

评估针对儿童结核病的下一代定向测序 (tNGS) 的诊断性能.
为了将tNGS的准确性与已建立的Xpert MTB/RIF测试进行比较.

主要方法:

一项队列研究包括从2021年7月到2022年12月怀疑结核病的103名儿童 (≤18岁).
对tNGS和Xpert MTB/RIF的诊断性能指标 (灵敏度,特异性) 进行了评估,使用各种样本类型,包括胃吸附物,唾液,和流.
此外,还评估了对利法和普胺的耐药性检测.

主要成果:

在72例确诊病例中,tNGS在诊断结核病方面表现出较高的灵敏度 (34.7%),相比Xpert MTB/RIF (20.8%),尽管差异在统计学上并不显著 (P=0.063).
对tNGS的特异性为87.1%,对于Xpert MTB/RIF的特异性为96.8% (P=0.162).
tNGS在胃吸血和唾液/样品中显示出更高的灵敏度.

结论:

针对性下一代测序为儿童结核病提供了一个有希望的,更敏感的诊断方法,特别是在特定的样本类型.
虽然tNGS的灵敏度更高,但其特异性低于Xpert MTB/RIF,需要在临床实践中仔细解释.

关键词:

在Paucibacillary中使用.敏感度敏感度敏感度结核病是一种疾病.在Xpert MTB/RIF中使用.tNGS是什么意思 tNGS是什么意思

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