基于便的分子试验和处理方法的执行,用于儿童结核病诊断:系统性审查和元分析
Lucía Carratalà-Castro1, Shilzia Munguambe2, Belén Saavedra-Cervera3
1Centro de Investigação em Saúde de Manhiça, Manhiça, Mozambique; ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.
The Lancet. Microbe
|November 15, 2024
概括
基于便的Xpert Ultra分子测试改善了儿童结核病的诊断,增加了细菌学确认率. 简化,无离心机的方法进一步提高了这些关键的诊断工具的灵敏度.
科学领域:
- 儿童传染病 儿童传染病
- 分子诊断学 分子诊断学
- 结核病的研究研究.
背景情况:
- 全球努力的重点是改善儿童结核病 (TB) 诊断,使用可访问的生物样本,如便.
- 准确和及时的儿童诊断仍然是一个挑战,需要新的方法.
研究的目的:
- 系统地审查用于诊断儿童结核病的基于便的分子测试的准确性.
- 评估预处理方法和研究设计对诊断性能的影响.
主要方法:
- 2000年至2024年间发表的研究的系统审查和元分析.
- 包括16岁以下可能患有结核病的儿童,比较便分子测试 (Xpert MTB/RIF,Xpert Ultra) 与微生物或临床诊断.
- 通过便处理方法进行分层分析,并量化了Xpert Ultra.便的额外诊断产量.
主要成果:
- 在使用细菌学确认作为参考时,Stool Xpert Ultra表现出较高的灵敏度 (0.73) 与Xpert MTB/RIF (0.60) 相比.
- 便Xpert Ultra增加了整体结核病细菌学确认的38.6%.
- 与没有离心机的方法 (0.61) 相比,无离心机的方法改善了Xpert Ultra便的灵敏度 (0.77).
结论:
- 基于便的Xpert Ultra是儿童结核病诊断的宝贵工具.
- 它增强了细菌学确认,即使在测试其他标本时也是如此.
- 简化处理方法在提高诊断准确性方面表现有前途.
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