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敏感的诊断 paucibacillary结核病与目标下一代测序:一个分子诊断研究

Yu Chen^1,2, Lichao Fan¹, Zhong Ren³

¹Department of Tuberculosis, Shenyang Tenth People's Hospital/Shenyang Chest Hospital, Shenyang, 110044, China.

|March 27, 2025

概括

针对性下一代测序 (tNGS) 显示出对儿童结核病 (TB) 和肺外病例的诊断有前途. 然而,它在预测耐药性的准确性需要在广泛临床使用之前进一步验证.

科学领域:

传染性疾病传染性疾病
基因组学就是基因组学.
分子诊断学分子诊断

背景情况:

目标下一代测序 (tNGS) 是结核病 (TB) 诊断和药物耐药性预测的强大工具.
它在包括儿科和肺外结核 (EPTB) 在内的乳结核病中的实用性仍然不太清楚.
这项研究评估了tNGS在这些具有挑战性的结核病患者群体中的表现.

研究的目的:

评估tNGS在儿科和EPTB人群中的结核病检测的诊断准确性.
评估tNGS在预测这些特定患者群体中耐药性的能力.
确定tNGS对于具有挑战性的结核病表现的临床适用性.

主要方法:

儿童 (<18岁) 和成年人被怀疑患有结核病或EPTB的未来招生.
对所有参与者进行全面的临床评估,实验室测试和tNGS分析.
对复合参考标准的性能评估和与GeneXpert和表型药物敏感性测试进行比较,以预测耐药性.

主要成果:

tNGS在儿童 (分别为74%和97%) 和EPTB成年人 (分别为77%和98%) 结核病诊断方面表现出高灵敏度和特异性.
药物耐药性预测的灵敏度有所不同,里芬辛在88%,但杆菌素在38%.
药物耐药性预测的特异性始终很高,从89%到100%不等.

结论:

tNGS是一个有前途的诊断工具,用于在儿科和EPTB患者中快速和灵敏地检测结核病.
在这些人群中,tNGS用于药物耐药性预测的可变精度需要进一步验证.
解决耐药性预测的局限性对于在具有挑战性的结核病例中临床实施tNGS至关重要.

关键词:

孩子孩子孩子孩子药物耐药性药物耐药性药物耐药性肺外结核是肺外结核的一种疾病.有针对性的下一代测序.结核病是一种疾病.

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