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A Tuberculosis Molecular Bacterial Load Assay TB-MBLA
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评估Mycobacterium结核病PCR在排除活性结核病中的作用
Inge Rogers1, Michelle A Barron2
1Infection Prevention and Control Department, UCHealth, Medical Center of the Rockies, Loveland, CO.
American journal of infection control
|July 4, 2024
概括
负的Mycobacterium结核病 (Mtb) 聚合酶链反应 (PCR) 测试并不排除Mtb诊断,即使是负的酸快细菌涂抹. 一些患有风险因素和阳性干扰素马释放试验的患者可能仍然患有Mtb.
科学领域:
- 微生物学 微生物学
- 传染性疾病 传染性疾病
- 临床诊断 临床诊断 临床诊断
背景情况:
- 酸快细菌 (AFB) 染色和Mycobacterium结核病 (Mtb) 聚合酶链反应 (PCR) 是标准的实验室测试.
- 这些测试经常用于指导疑似肺结核患者的隔离预防措施的取消.
研究的目的:
- 评估AFB染色和Mtb PCR在培养确认肺Mtb的患者的诊断效用.
- 为了确定这些测试的负结果是否可以可靠地排除Mtb感染.
主要方法:
- 对52名患有培养确认的肺Mtb.的患者进行了回顾性病例审查.
- 对这些患者的唾液AFB涂抹结果和Mtb PCR测试结果的分析.
- 测试结果与临床风险因素的相关性以及干扰素-释放试验 (IGRA) 的发现.
主要成果:
- 在52名肺部培养确认的Mtb患者中,有4名患者 (约7.7%) 具有阴性唾液AFB涂抹和阴性MtbPCR结果.
- 这四名受试者具有重要的Mtb感染风险因素.
- 所有四个阴性AFB涂抹和PCR测试的受试者都有阳性干扰素马释放试验.
结论:
- 负的Mtb PCR结果不应仅仅依赖于排除Mtb的诊断.
- 当初始实验室检测结果为阴性时,临床怀疑和其他诊断测试,如IGRA,仍然至关重要.
- 用于Mtb诊断的实验室算法需要在患者风险因素和其他测试结果的背景下仔细解释.
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