针对性下一代测序用于诊断耐药结核病:系统性审查和元分析
Tiana Carina Schwab1, Lisa Perrig1, Pauline Carlotta Göller1
1Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
The Lancet. Infectious diseases
|May 25, 2024
概括
目标下一代测序 (NGS) 在直接从患者样本中检测耐药结核病方面提供了高准确度. 解决高负担国家的实施障碍对于更广泛的采用至关重要.
科学领域:
- 分子诊断学 分子诊断学
- 传染病研究传染病研究.
- 基因组医学是一种基因组医学.
背景情况:
- 耐药结核病是一个重大的全球卫生挑战.
- 目标下一代测序 (NGS) 能够快速,多基因检测耐药性突变.
- 之前针对针对性NGS诊断耐药结核病的综合性审查是有限的.
研究的目的:
- 确定针对性的NGS测试,用于诊断耐药结核病.
- 确定在该领域目标NGS利用的程度.
- 评估这些测试的诊断准确性.
主要方法:
- 发表和未发表报告的系统审查和元分析 (2005-2024年).
- 搜索了多个数据库,包括MEDLINE,Embase和临床试验.gov.gov.
- 包括使用表型或基因型药物敏感性测试作为参考标准的测试准确性研究.
主要成果:
- 124份报告有资格进行系统审查;包括在元分析中的24项研究评估了23种药物.
- 目标NGS的整体综合灵敏度为94.1%,特异性为98.1%.
- 观察到关键药物如利法素 (99.1%的灵敏度) 和阿米卡辛 (99.4%的特异性) 的高精度,临床样本和分离物也是如此.
结论:
- 向的NGS显示出高灵敏度和特异性,可以直接从临床样本中检测结核病耐药性.
- 一些当前药物的性能数据仍然很少.
- 在高负担国家实施有针对性的NGS的障碍需要紧急关注.
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