在有或没有结核病的幼儿中对Mycobacterium tuberculosis的免疫敏感化
Jesús Gutierrez1, LaShaunda L Malone1,2, Mitchka Mohammadi3
1Department of Population and Quantitative Science, Case Western Reserve School of Medicine, Cleveland, OH 44106, USA.
Pathogens (Basel, Switzerland)
|September 27, 2025
概括
结核素皮肤测试 (TST) 在5毫米的门是比QuantiFERON Gold Plus (QFT-Plus) 在识别结核病 (TB) 暴露的幼儿的结核菌 (Mtb) 敏感性和结核病的更有效. 这一发现有助于诊断儿科结核病,并指导在流行性环境中进行预防治疗.
科学领域:
- 儿童传染病 儿童传染病
- 菌根菌感染 菌根菌感染
- 诊断免疫学 诊断免疫学
背景情况:
- 在儿童中早期发现Mycobacterium结核病 (Mtb) 感染对于降低儿科发病率和死亡率至关重要.
- 在幼儿中对Mtb感染的最佳诊断测试仍然是争论的主题.
- 5岁以下的结核病 (TB) 家庭接触者 (HHC) 具有感染Mtb的高风险.
研究的目的:
- 通过结核素皮肤测试 (TST) 和QuantiFERON Gold Plus (QFT-Plus) 来确定乌干达年轻儿童重度结核病暴露的mtb免疫敏感化患病率.
- 评估TST和QFT-Plus之间的一致性,以检测Mtb敏感性.
- 为了评估TST和QFT-Plus在儿童群体中确诊和未确诊的结核病的诊断准确性.
主要方法:
- 一个结核病家庭接触 (HHC) 研究设计被用于130名乌干达5岁以下的儿童.
- 结核素皮肤测试 (TST) 用5毫米和10毫米的阳性值进行.
- 使用制造商的值进行了QuantiFERON Gold Plus (QFT-Plus) 干扰素马释放试验.
- 协同分析 (科恩的卡帕) 和后勤回归被用来分析测试协议和结核病的几率.
主要成果:
- 5毫米的TST值确定了Mtb敏感性 (49.2%) 的最高流行率,与QFT-Plus (Kappa=0.59) 的中等一致性.
- 阳性TST (5毫米) 与结核病的几率增加了一倍.
- 阳性TST (5毫米) 显示出对结核病的最高敏感性 (60%),而QFT-Plus显示出最高的特异性 (72%).
- 10毫米TST和QFT-Plus之间的一致性很大 (Kappa=0.65),随着年龄的增长而增加.
结论:
- 在年轻的BCG接种疫苗的儿童中,家庭有显著的结核病暴露,TST (5毫米) 在识别Mtb敏感性和结核病方面比QFT-Plus更有效.
- 在结核病流行环境中,TST测试对高风险儿科群体的Mtb敏感性评估仍然很有价值.
- 研究结果支持使用TST来优先考虑预防性治疗,并帮助儿童结核病诊断.
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