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快速诊断耐药结核病 - - 机遇和挑战
Kogieleum Naidoo1,2, Rubeshan Perumal1,2, Senamile L Ngema1,2
1Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban 4001, South Africa.
Pathogens (Basel, Switzerland)
|January 22, 2024
概括
全球结核病根除正面临药物耐药性的挑战. 早期检测和快速诊断对于管理耐药结核病 (DR-TB) 和改善患者的治疗结果至关重要.
科学领域:
- 微生物学 微生物学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 菌根结核病 (MTB) 抗药性增加威胁到全球结核病 (TB) 根除工作.
- 及时检测耐药性对于有效治疗和预防耐药结核病 (DR-TB) 传播至关重要.
- 传统的基于培养的药物敏感性测试 (DST) 在资源有限的环境中因延迟和技术要求而面临限制.
研究的目的:
- 审查现有的耐药结核病 (DR-TB) 快速诊断工具.
- 讨论与这些快速诊断方法相关的机遇和挑战.
- 在各种医疗保健环境中为 DR-TB 管理策略提供信息.
主要方法:
- 对DR-TB快速诊断试验的当前文献的综述.
- 基于核酸和表型的DST方法的分析.
- 讨论与新型结核病药物相关的诊断挑战.
主要成果:
- 基于核酸的快速测定表明,有望以足够的灵敏度和特异性检测抗性突变.
- 目前还没有批准的基因型DST测定用于新型药物,如贝达奎林,普雷托曼尼德和德拉曼尼德.
- 新型药物治疗方案的兴起需要回归基于培养的表型DST,以进行全面的耐药性分析.
结论:
- 快速诊断对于对抗DR-TB至关重要,但缺口仍然存在,特别是在新药方面.
- 快速分子测试与表型DST的整合对于最佳的患者管理至关重要.
- 解决诊断挑战是改善全球DR-TB患者治疗结果的关键.
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