培养便标本在诊断肺结核方面没有任何附加价值
Dorte Bek Folkvardsen1, Victor Naestholt Dahl1,2, Christian Wejse2
1International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Artillerivej 5, Copenhagen, Denmark.
Journal of clinical tuberculosis and other mycobacterial diseases
|December 16, 2024
概括
在发病率低的环境中不建议对肺结核 (PTB) 进行便检测. 在便中很少检测到Mycobacterium结核病 (Mtb),这有可能错过PTB的诊断.
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:
- 肺结核 (PTB) 诊断可能是具有挑战性的,因为在唾液收集方面存在困难.
- 结核菌 (Mycobacterium tuberculosis,Mtb) 可能存在于被吞的便中,这表明便是潜在的替代标本.
- 关于便样本在PTB诊断中的有用性的证据是有限的,特别是在资源丰富的环境中.
研究的目的:
- 评估便样本在怀疑肺结核 (PTB) 的患者中检测Mycobacterium结核病 (Mtb) 的诊断效用.
- 评估便培养的可行性和准确性与呼吸道标本相比,以在资源丰富的环境中诊断PTB.
主要方法:
- 在两年内收集的562个便标本的回顾性分析.
- 在便样本中检测到Mtb的结果与提交给参考实验室的呼吸器样本的结果进行比较.
- 在诊断为PTB的患者的便样本中评估Mtb培养的阳性.
主要成果:
- 在19名PTB患者中,只有5名便样本呈MTB培养阳性.
- 所有便培养阳性病例也有阳性呼吸器样本.
- 仅仅依赖便样本来诊断PTB可能会导致遗漏病例.
结论:
- 对MTB的便培养对诊断PTB的敏感性较低,特别是在发病率低,资源丰富的环境中,如丹麦.
- 在这种情况下,不建议使用便检测作为PTB的一般诊断工具.
- 需要进一步的前性研究来探索便分析在特定亚种群或难以收集唾液的环境中的作用.
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