Improving the diagnosis of tuberculosis: old and new laboratory tools.

IF 3.9 3区 医学 Q1 PATHOLOGY
Priya Solanki, Linzy Elton, Isobella Honeyborne, Mirae Park, Giovanni Satta, Timothy D McHugh
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Abstract

Introduction: Despite recent advances in diagnostic technologies and new drugs becoming available, tuberculosis (TB) remains a major global health burden. If detected early, screened for drug resistance, and fully treated, TB could be easily controlled.

Areas covered: Here the authors discuss M. tuberculosis culture methods which are considered the definitive confirmation of M. tuberculosis infection, and limited advances made to build on these core elements of TB laboratory diagnosis. Literature searches showed that molecular techniques provide enhanced speed of turnaround, sensitivity, and richness of data. Sequencing of the whole genome, is becoming well established for identification and inference of drug resistance. PubMed® literature searches were conducted (November 2022-March 2024).

Expert opinion: This section highlights future advances in diagnosis and infection control. Prevention of prolonged hospital admissions and rapid TAT are of the most benefit to the overall patient experience. Host transcriptional blood markers have been used in treatment monitoring studies and, with appropriate evaluation, could be rolled out in a diagnostic setting. Additionally, the MBLA is being incorporated into latest clinical trial designs. Whole genome sequencing has enhanced epidemiological evidence. Artificial intelligence, along with machine learning, have the ability to revolutionize TB diagnosis and susceptibility testing within the next decade.

改进结核病诊断:新旧实验室工具。
导言:尽管近年来诊断技术不断进步,新药也已问世,但结核病(TB)仍然是全球健康的一大负担。如果能及早发现、筛查耐药性并进行全面治疗,结核病将很容易得到控制:作者在此讨论了结核杆菌的培养方法(固体和液体),这些方法通常被认为是结核杆菌感染的最终确认方法,以及在这些结核病实验室诊断核心要素的基础上取得的有限进展。对分子技术的文献检索表明,这些技术可提高周转速度、灵敏度和数据的丰富性。事实证明,对分离株进行全基因组测序已在全球范围内得到广泛认可,可用于鉴定和推断耐药性。随着各种技术的推广,在每种临床环境中都应考虑最具影响力(和成本效益)的诊断途径。测试的难易程度、周转时间、普遍的耐药模式和测试的准确性等因素都应加以考虑和探讨。进行了 PubMed® 文献检索(2022 年 11 月至 2024 年 3 月):本节重点介绍了结核病诊断和感染控制方面的未来进展。Xpert MTB Ultra 的检测限低得多,是一种灵敏度更高、特异性更强的诊断工具,可用于感染控制措施。虽然成本会产生影响,但防止长期住院和快速 TAT 对患者的整体体验最为有利。宿主转录血液标记物可用于治疗监测研究,经过适当的临床评估和验证后,有可能在诊断环境中推广使用。此外,MBLA 正在被纳入最新的临床试验设计中。全基因组测序增强了流行病学证据。人工智能和机器学习有能力在未来十年内彻底改变结核病诊断和药敏试验。
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来源期刊
CiteScore
6.60
自引率
0.00%
发文量
71
审稿时长
1 months
期刊介绍: Expert Review of Molecular Diagnostics (ISSN 1473-7159) publishes expert reviews of the latest advancements in the field of molecular diagnostics including the detection and monitoring of the molecular causes of disease that are being translated into groundbreaking diagnostic and prognostic technologies to be used in the clinical diagnostic setting. Each issue of Expert Review of Molecular Diagnostics contains leading reviews on current and emerging topics relating to molecular diagnostics, subject to a rigorous peer review process; editorials discussing contentious issues in the field; diagnostic profiles featuring independent, expert evaluations of diagnostic tests; meeting reports of recent molecular diagnostics conferences and key paper evaluations featuring assessments of significant, recently published articles from specialists in molecular diagnostic therapy. Expert Review of Molecular Diagnostics provides the forum for reporting the critical advances being made in this ever-expanding field, as well as the major challenges ahead in their clinical implementation. The journal delivers this information in concise, at-a-glance article formats: invaluable to a time-constrained community.
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