针对性下一代测序用于肺结核和肺外结核的综合诊断和药物耐药性检测:单中心回顾性研究
Jingyi Dai1,2, Qiujing Li1, Juan Wan1
1Department of Public Laboratory, The Third People's Hospital of Kunming City/Infectious Disease Clinical Medical Center of Yunnan Province, Kunming, Yunnan, People's Republic of China.
Microbiology spectrum
|February 27, 2026
概括
针对性下一代测序 (tNGS) 提供了一种高度敏感的方法来检测各种样本中的结核病 (TB) 和耐药性. 这种先进的技术改善了结核病的诊断和患者管理,特别是对于耐药菌株.
科学领域:
- 传染性疾病 传染性疾病
- 基因组学就是基因组学.
- 医学诊断 医学诊断 医学诊断
背景情况:
- 结核病 (TB) 仍然是一个重大的全球卫生挑战,传统诊断往往缺乏灵敏度和速度.
- 耐药结核病菌株使诊断和治疗变得复杂,需要先进的检测方法.
- 目前的核酸放大试验 (NAAT) 提供更快的结果,但可能不会提供全面的耐药性信息或检测并发感染.
研究的目的:
- 评估针对性下一代测序 (tNGS) 的诊断有效性,以检测肺结核和肺外结核样本中的* Mycobacterium 结核病*和耐药性突变.
- 为了比较tNGS与传统微生物学测试和NAAT (Xpert MTB/RIF) 的性能.
- 评估tNGS在结核病例中识别共感染病原体的能力.
主要方法:
- 对159名疑似结核病患者的回顾性分析.
- 在tNGS对126个肺和33个肺外样本的应用.
- 用传统微生物学测试和Xpert MTB/RIF对tNGS结果进行比较分析.
主要成果:
- tNGS表现出对结核病的高诊断灵敏度:83.9%在支气管支气管洗液中,89.5%在唾液中,100%在肺外样本中.
- 与Xpert MTB/RIF对于检测里法辛耐药性的协议为83.3%.
- tNGS确定了22种药物耐药性突变,并检测出共感染呼吸道病原体,提供了全面的患者感染概况.
结论:
- tNGS是一种高度敏感和全面的工具,用于诊断结核病和检测耐药性,其性能优于传统方法.
- tNGS识别共同感染的能力提高了对复杂结核病例的理解和管理,特别是涉及多药耐药菌株的结核病例.
- tNGS具有显著的潜力,可以通过提供更快,更精确的检测来改善结核病诊断,特别是在资源有限的环境中.
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