在中国对Mycobacterium结核病的表型药物敏感性测试的熟练程度,2008-2021年
Yuanyuan Song1, Bing Zhao1, Shengfen Wang1
1National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, the People's Republic of China.
PloS one
|May 29, 2024
概括
中国的熟练测试显示,抗结核药物敏感性测试 (DST) 的整体质量有所改善. 然而,对某些药物的敏感性和对其他药物的可复制性需要进一步增强.
科学领域:
- 微生物学 微生物学
- 临床诊断 临床诊断 临床诊断
- 公共卫生 公共卫生
背景情况:
- 结核病 (TB) 药物敏感性测试 (DST) 对于有效治疗至关重要.
- 能力测试 (PT) 程序评估实验室在DST中的表现.
- 自2008年以来,中国已经对抗肺结核的DST进行了广泛的PT.
研究的目的:
- 分析2008年至2021年中国抗结核DST能力测试的趋势和结果.
- 评估参与实验室的性能指标,包括敏感性,特异性和可重复性.
- 确定DST方法和实验室实践需要改进的领域.
主要方法:
- 对13轮Mycobacterium tuberculosis DST.能力测试数据的分析.
- 包括研究期间从30个到546个参与实验室的数据.
- 计算各种抗结核药物的灵敏度,特异性,可重复性和一致率,主要使用洛文斯坦-詹森 (L-J) 方法.
主要成果:
- 对于所有测试药物,特异性总体上有所改善,而对于阿米卡和卡普雷奥米,敏感性没有改善.
- 皮拉津胺和卡纳米的一致率,以及卡普雷米和皮拉津胺的可重复性,并没有显著改善.
- 大多数实验室都提高了DST质量,除了二线注射药物和pyrazinamide.
结论:
- 能力测试推动了中国实验室的整体质量改善,这些实验室进行了抗结核DST.
- 对于某些药物,特别是二线药物和pyrazinamide,仍然存在特定的挑战.
- 开发新的或改进的表型DST方法对于解决当前的局限性至关重要.
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