参照基因Xpert周期阈值研究肺结核的分枝杆菌负担和表型耐药模式

B. Kashyap, Krishna Sarkar, Kapil Singh, Puneeta Hyanki
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引用次数: 0

摘要

导言和目的。结核病(TB)仍然是全球健康面临的重大挑战。早期准确诊断对于防止进一步传播至关重要。本研究旨在将周期阈值与涂片镜检和培养阳性相关联,并确定涂片分级和培养阳性水平的临界周期阈值。材料与方法纳入 40 例肺结核推定病例,对其进行 Ziehl Neelsen 染色、Lowenstein Jensen 培养基培养、CBNAAT 和一线抗结核药物药敏试验。结果。我们的研究预测痰涂片分级为 3+、2+ 和 1+,Ct 值的临界值分别为≤16.74、≤19.68 和≤22.32。培养阳性时间与 Ct 值之间呈强正相关。以 Ct 值≤22.32 为临界值预测培养阳性的敏感性为 92%,特异性为 67%。通过 1%比例法检测,没有一个分离株显示出利福平耐药性。结论了解如何正确使用 CBNAAT Ct 值及其与涂片显微镜检查等级、培养和药敏试验的相关性,有助于临床医生早期识别并及时启动适当的治疗。这些知识有助于预防耐药性、减少传播和减轻与结核病相关的疾病负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A study on the mycobacterial burden and phenotypic drug resistance pattern with reference to the GeneXpert Cycle Threshold values in pulmonary tuberculosis
Introduction and aim. Tuberculosis (TB) remains a significant global health challenge. Early and accurate diagnosis is crucial to prevent further transmission. The present study aimed to correlate cycle threshold values with smear microscopy and culture positivity, and determine cut-off cycle threshold values for levels of smear grade and culture positivity. Material and methods. Forty presumptive cases of pulmonary TB were included and subjected to Ziehl- Neelsen stain, culture on Lowenstein Jensen media, CBNAAT and drug susceptibility testing for first line anti-tubercular drugs. Results. Our study predicts 3+, 2+, and 1+ sputum smear grade at a cut-off of Ct value ≤ 16.74, ≤19.68, and ≤ 22.32 respectively. A strong positive correlation was found between time to culture positivity and Ct value. A cut-off of Ct value ≤22.32 predicts culture positivity with a sensitivity of 92%, and a specificity of 67%. None of the isolates showed rifampicin resistance by 1% proportion method. Conclusion. Understanding the appropriate utilization of CBNAAT Ct values and their correlation with smear microscopy grade, culture, and drug susceptibility testing can assist clinicians in early identification and prompt initiation of appropriate treatment. This knowledge can contribute to the prevention of drug resistance, reduced transmission, and a decreased disease burden associated with TB.
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