在结核病 (TB) 诊断方法的更新
Mario José Matteo1, María Cecilia Latini2, Davor Nicolás Martinovic3
1Laboratorio de TB Dr Abel Cetrangolo, Hospital F. J. Muñiz, Ciudad Autónoma de Buenos Aires (CABA), Argentina.
Revista Argentina de microbiologia
|January 19, 2025
概括
准确且具有成本效益的快速诊断测试对于结核病 (TB) 治疗至关重要. 实时PCR等分子方法为结核病提供了高度敏感和特定的早期诊断.
科学领域:
- 传染性疾病 传染性疾病
- 微生物学 微生物学
- 公共卫生 公共卫生
背景情况:
- 世界卫生组织 (WHO) 的目标是到2035年,将结核病死亡人数减少95%,结核病发病率减少90%.
- 快速诊断测试对于及时启动结核病治疗和改善患者治疗结果至关重要.
- 目前用于潜伏和活跃结核病的诊断方法在灵敏度,特异性和适用性方面各不相同.
研究的目的:
- 审查和强调各种诊断测试在实现全球结核病控制目标中的作用.
- 为了比较不同结核病诊断方法的优点和局限性.
- 强调分子诊断工具对于有效的结核病检测和药物敏感性测试的重要性.
主要方法:
- 对潜在结核病的诊断方法的审查,包括结核素皮肤测试 (TST) 和干扰素释测试 (IGRA).
- 评估活跃结核病诊断技术:涂抹显微镜,培养,TB-Lipoarabinomannan (LAM) 抗原测定和分子测定.
- 专注于基于实时PCR的分子测试的特性,性能和推使用.
主要成果:
- 干扰素-释放试验 (IGRA) 对潜伏结核病检测具有更高的特异性,相比于不受到BCG疫苗接种影响的TST.
- 尽管敏感性有限,但TB-LAM显示了在HIV感染的个体中诊断低CD4计数的活跃结核病的潜力.
- 基于PCR的实时分子测试为肺结核和肺外结核提供了快速,高度敏感和特定的诊断,包括药物敏感性测试.
结论:
- 准确和快速的诊断对于实现世卫组织雄心勃勃的结核病减少目标至关重要.
- 建议分子诊断测试,特别是实时PCR,作为结核病的初始诊断选择.
- 持续开发和实施先进的诊断工具对于有效的全球结核病管理至关重要.
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