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SMaRT-PCR:使用口罩采样和RT-PCR,这是儿童肺结核的非侵入性诊断工具

A Shaikh¹, K Sriraman¹, S Vaswani¹

¹The Foundation for Medical Research, Mumbai.

The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease

|April 2, 2024

概括

这项研究表明,非侵入性口罩采样和SMaRT-PCR (口罩采样与逆转录酶-聚合酶连锁反应相结合) 可以有效地诊断儿童结核病 (TB).

科学领域:

医学诊断医学诊断医学诊断
微生物学微生物学
儿科肺病学儿科肺病学

背景情况:

儿童结核病 (TB) 诊断面临的挑战是侵入性采样和当前方法的低灵敏性.
开发非侵入性诊断工具对于改善儿童结核病检测至关重要.
生物气溶采样为结核病诊断提供了一个潜在的非侵入性替代方案.

研究的目的:

评估使用SMaRT-PCR用于儿科结核病的非侵入性生物气溶采样的诊断潜力.
将SMaRT-PCR的灵敏度和特异性与儿童结核病标准诊断方法进行比较.
评估使用口罩采样在儿科队列中检测结核病的可行性.

主要方法:

从51名儿童 (年龄在2-15岁) 采集了呼出的生物气溶,这些儿童在谈话-咳-呼吸过程中使用修改后的N-95口罩.
面具样本使用内部逆转录酶-聚合酶链反应 (RT-PCR) 分析了16s和rpoBRNA转录.
额外的样本使用Xpert MTB/RIF和Xpert MTB/RIF Ultra测定进行了测试.

主要成果:

在未接受过治疗的儿童中,SMaRT-PCR显示出高灵敏度 (96%的基因,75%的基因),可与标准方法 (71%) 相比.
在检测两个基因时,SMaRT-PCR的特异性高达95%,超过单基因检测 (85%).
用Xpert测试进行的口罩采样显示低灵敏度 (13%).

结论:

通过SMaRT-PCR进行生物气溶测试,为诊断儿科结核病提供了一个有希望的,非侵入性的方法.
面具采样的简单性表明,面具在护理场所的应用有潜力.
基于RNA转录的检测可能会提高儿童的结核病诊断灵敏度,需要进一步的临床验证.

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