在结核病和耐药结核病患者中进行全面诊断的增强向性NGS测试
Miaoran Wang1, Ying Wu2, Ying Xi2
1Department of Plastic Surgery, China Medical University, No.77, Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110044, China.
International journal of antimicrobial agents
|August 22, 2025
概括
一种基于多重PCR的新型定向下一代测序 (tNGS) 试验可以准确检测结核病 (TB),耐药性和其他呼吸道病原体,从而改善疑似结核病病例的差异诊断.
科学领域:
- 分子生物学
- 传染性疾病
- 基因组学
背景情况:
- 确切的结核病诊断至关重要,但目前的方法难以检测敏感性,耐药性和区分其他呼吸道病原体.
- 现有诊断工具的局限性需要先进的分子方法来全面管理呼吸系统疾病.
研究的目的:
- 开发和验证基于多重PCR的目标下一代测序 (tNGS) 试验,用于同时检测结核病,耐药突变和其他呼吸道病原体.
- 在疑似结核病患者中评估tNGS试验的分析和临床性能.
主要方法:
- 开发和分析验证基于多重PCR的tNGS测定,评估检测极限 (LoD),精度和抗干扰性.
- 在181名可疑结核病患者的tNGS试验中,使用支气管洗或唾液样本进行前性临床评估,并与微生物培养和Xpert MTB/ RIF进行比较.
主要成果:
- 对于结核病和其他病原体,tNGS试验显示了较低的LoD (10拷贝/毫升),具有高精度和抗干扰性.
- 临床验证显示94. 94%的确诊结核病敏感性和92. 86%的与Xpert MTB/ RIF的结核病耐药性一致,确定了额外的突变.
- 该试验准确检测出非结核菌 (NTM) 和其他呼吸道病原体,支持差异诊断.
结论:
- tNGS试验可提供可靠的结核病检测,耐药突变和广泛的呼吸道病原体,包括NTM.
- 这种测试提高了差异诊断能力,有助于选择可疑结核病患者的有效治疗策略.
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