快速分子检测的实用性用于检测多药耐药的Mycobacterium结核病在肺外样本
Katarzyna Kania1,2, Katarzyna Wójcik3, Kamil Drożdż4
1Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Jagiellonian University Medical College, ul. Medyczna 9, 30-688 Krakow, Poland.
Diagnostics (Basel, Switzerland)
|May 14, 2025
概括
快速分子测试对于诊断肺外结核 (TB) 和检测多抗药性结核 (MDR-TB) 有效. 这些由世卫组织推的测试提供了高准确性和速度,有助于针对性治疗的关键早期检测.
科学领域:
- 临床微生物学 临床微生物学
- 传染病 传染病 传染病
- 分子诊断学 分子诊断学
背景情况:
- 外肺结核 (TB) 的诊断是具有挑战性的,特别是多药耐药 (MDR) 菌株.
- 经过肺结核验证的快速分子测定,需要评估肺外结核实用性.
- 早期发现结核病的耐药性对于有效治疗至关重要.
研究的目的:
- 评估世卫组织推的快速分子测试的性能,用于诊断肺外结核病.
- 评估这些试验检测多抗药性Mycobacterium结核病复合体 (MTBC) 的能力.
- 为了比较分子测定结果与表型药物敏感性测试 (DST).
主要方法:
- 从2019-2022年对6274个临床样本 (4891个肺部,1383个肺外) 的分析.
- 使用了BD MAXTM MDR-TB,Xpert® MTB/RIF,Xpert® MTB/XDR,以及FluoroType MTB测定方法.
- 使用Löwenstein-Jensen和BACTECTM MGITTM液体培养物与表型DST进行分子结果比较.
主要成果:
- 在BD MAX检测的426个样本中检测到MTBC;50个来自肺外部.
- 对于肺外结核,BD MAX显示出高灵敏度 (93.1%) 和特异性 (98.4%).
- 11%的MTBC阳性病例表现出对异化/利番素的耐药性;3.69%是MDR-TB.
- 分子测定准确检测出与DST高度一致的抗性突变 (κ = 0.69-0.89).
结论:
- 对肺结核进行验证的分子试验对肺外结核诊断和药物耐药性分析具有可靠性.
- 快速的周转和准确性支持在常规诊断中更广泛地实施.
- 这些测试对于挑战肺外样本特别有价值,使得及时,有针对性的治疗成为可能.
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