在乌干达开始MDR-TB治疗的患者中,混合的Mycobacterium结核病感染对快速分子诊断的影响
Kevin Komakech1, Lydia Nakiyingi2, Ashab Fred3
1Department of Medical Microbiology, Mycobacteriology (BSL-3) Laboratory, Makerere University, Kampala, Uganda.
BMC infectious diseases
|January 10, 2024
概括
在9.4%的患者中发现的混合Mycobacterium结核病 (MTB) 感染可能导致GeneXpert MTB/RIF (Xpert) 测试结果不准确. 线式探针测试 (LPA) 的性能没有受到影响,这使其成为对利芬辛耐药性测试的可靠替代品.
科学领域:
- 微生物学 微生物学
- 传染性疾病 传染性疾病
- 分子诊断学 分子诊断
背景情况:
- 混合型Mycobacterium结核病 (MTB) 感染涉及多种不同的MTB菌株.
- 这些感染可以导致耐药性,治疗失败,并影响诊断测试的表现.
研究的目的:
- 评估混合MTB菌株感染对GeneXpert MTB/RIF (Xpert) 和Line Probe Assay (LPA) 的性能的影响.
主要方法:
- 一项横截面研究分析了62名MTB涂抹阳性,抗利芬素患者的唾液样本.
- 菌株间隔重复单元变量数并列重复 (MIRU-VNTR) 基因定型确定了混合MTB感染.
- 将Xpert和LPA的表现与混合MTB感染状态进行了比较.
主要成果:
- 混合MTB感染的流行率为9.4% (5/53个样本).
- 混合MTB感染增加了虚假敏感Xpert结果的几率 (OR 7.556).
- 混合MTB感染没有显著影响LPA的表现;HIV阳性预测混合感染.
结论:
- 混合MTB感染可能会影响GeneXpert测试的准确性.
- 线式探针测试 (LPA) 仍然是对利芬辛耐药性的可靠快速诊断方法,特别是在混合感染场景中.
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