在3012个唾液样本中评估和比较用于诊断Mycobacterium结核病和非结核菌的实验室方法
Qian Wu1, Yelei Zhu2, Yu Zhang1
1Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
准确的结核病诊断对于控制其传播至关重要. 在Xpert-MTB/RIF测试显示高灵敏度的Mycobacterium结核病 (MTB),而结合测试提高了MTB检测. 非结核菌 (NTM) 诊断需要进一步改进.
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:
- 结核病 (TB) 仍然是一个重大的全球卫生挑战,需要快速准确的诊断方法.
- 及时诊断Mycobacterium结核病 (MTB) 和非结核菌 (NTM) 对于有效的传播控制至关重要.
- 目前对MTB和NTM的实验室测试需要评估它们在唾液样本中的临床效用.
研究的目的:
- 在临床唾液样本中评估五种MTB检测方法的诊断性能.
- 为了比较单一和组合诊断方法的灵敏度和特异性.
- 评估不同测试对MTB和NTM诊断的临床价值.
主要方法:
- 使用五种诊断方法对3012个唾液样本进行分析:常规的唾液涂抹显微镜,三明治杯唾液涂抹显微镜,唾液培养,Xpert-MTB/RIF和CapitalBio TB/NTM套件.
- 对单个测试和各种组合的诊断准确性的比较评估.
- 统计分析以确定灵敏度和显著性 (p < 0.05).
主要成果:
- 在单一方法中,Xpert-MTB/RIF对MTB检测表现出最高的灵敏度 (79.6%).
- 将CapitalBio TB/NTM套件与培养组合起来,显著提高了MTB诊断灵敏度,达到88.4%.
- 与CapitalBio TB/NTM套件 (45.7%) 相比,培养对NTM的敏感度更高 (85.7%).
- CapitalBio TB/NTM套件对一般菌根菌具有77.1%的敏感性,当与涂抹和培养物相结合时,敏感性增加到84.2%.
结论:
- Xpert-MTB/RIF是一种快速,灵敏和可靠的工具,用于吐中检测MTB.
- 结合诊断方法,特别是培养方法,可以提高MTB诊断的敏感性.
- 目前,CapitalBio TB/NTM套件对NTM诊断的灵敏度不足以用于临床实践,这表明需要改进NTM检测策略.
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