SMaRT-PCR: sampling using masks and RT-PCR, a non-invasive diagnostic tool for paediatric pulmonary TB.

IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES
A Shaikh, K Sriraman, S Vaswani, I Shah, V Poojari, V Oswal, S Mane, S Rajagara, N Mistry
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Abstract

BACKGROUNDKey challenges in paediatric TB diagnosis are invasive sampling and poor sensitivity of standard methods. This study demonstrates the diagnostic potential of non-invasive sampling of bioaerosols from children using SMaRT-PCR, comprising mask sampling combined with reverse transcriptase-polymerase chain reaction (RT-PCR) for TB.METHODSExhaled bioaerosols were captured on modified N-95 masks in a 10-min talk-cough-breathe process from 51 children (30 with TB confirmed using standard sampling methods and 21 without TB) aged 2-15 years. All mask samples were tested using in-house RT-PCR for 16s and rpoB RNA transcripts. Additional mask samples from children with TB were tested using Xpert® MTB/RIF (n = 3) and Xpert® MTB/RIF Ultra (n = 27).RESULTSSMaRT-PCR sensitivity for detecting TB among treatment-naïve children was 96% if 16s or rpoB was present, and 75% if both genes were present, comparable to standard methods (71%) in the same cohort. Specificity was better for both genes, at 95%, than 85% for a single gene detection. Mask sampling with Xpert MTB/RIF or Ultra had a sensitivity of only 13%.CONCLUSIONThis is the first study to provide evidence for testing bioaerosols as a promising alternative for detecting paediatric TB. Sampling is non-invasive and simple, with the potential for point-of-care applications. This pilot study also suggests that RNA transcript-based detection may improve TB diagnostic sensitivity in children; however, further investigation is required to establish its adaptability in clinical settings..

SMaRT-PCR:使用口罩和 RT-PCR 进行采样,这是一种针对小儿肺结核的无创诊断工具。
背景:儿科结核病诊断面临的主要挑战是侵入性采样和标准方法灵敏度低。本研究证明了使用 SMaRT-PCR 对儿童生物气溶胶进行非侵入性采样的诊断潜力,SMaRT-PCR 包括口罩采样和结核病反转录聚合酶链反应 (RT-PCR)。方法在 51 名 2-15 岁儿童(30 名使用标准采样方法确诊为结核病,21 名未确诊为结核病)的 10 分钟谈话-咳嗽-呼吸过程中,用改良的 N-95 口罩采集吸入的生物气溶胶。所有口罩样本均通过内部 RT-PCR 检测 16s 和 rpoB RNA 转录本。结果如果 16s 或 rpoB 均存在,则 MaRT-PCR 检测治疗无效儿童结核病的灵敏度为 96%,如果两个基因均存在,则灵敏度为 75%,与同一队列中标准方法的灵敏度(71%)相当。检测两种基因的特异性为 95%,优于检测单一基因的 85%。使用 Xpert MTB/RIF 或 Ultra 进行掩蔽采样的灵敏度仅为 13%。采样是非侵入性的,操作简单,有可能应用于护理点。这项试点研究还表明,基于 RNA 转录物的检测可能会提高儿童结核病诊断的灵敏度;不过,要确定它在临床环境中的适应性,还需要进一步的调查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.90
自引率
20.00%
发文量
266
审稿时长
2 months
期刊介绍: The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.
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