利用盒式技术在地区实验室痰显微镜检查结果阴性的患者中检测结核杆菌

Q4 Medicine

Tuberculosis and Lung Diseases Pub Date : 2024-05-01 DOI:10.58838/2075-1230-2024-102-2-36-42

P. I. Eliseev, E. Nikishova, A. Y. Krupskaya, V. I. Shtraukh, E. Khimova, A. Maryandyshev

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引用次数: 0

摘要

目的：对痰涂片显微镜检查结果为阴性的肺结核患者进行结核杆菌检测和利福平药敏试验的结果进行评估。研究对象为2016年至2020年在阿尔汉格尔斯克州登记的肺结核患者；这些患者在治疗前被告知为痰涂片镜检结果为阴性的新发病例和复发病例，并且有分子基因检测（MGT）（Xpert MTB/RIF MTB/RIF）和BACTEC MGIT 960的结果。479人（40%）登记为痰涂片镜检结果为阴性的肺结核病例。对 327 名（68%）患者进行了 MGT 检查。120名（37%）患者的痰涂片镜检结果呈阳性，165名（50%）患者的 BACTEC MGIT 960 检测结果呈阳性。70%的病例结果一致。136人（41%）两次检测均未发现结核分枝杆菌，95人（29%）两次检测结果均为阳性。在 30% 的病例中，两次检测的结果存在差异。在 71 个病例（22%）中，BACTEC MGIT 960 检测到培养物生长，而 MGT 检测结果为阴性。在 8%的病例中，检测到了结核分枝杆菌的 DNA，但营养培养基上没有培养物生长。43/120（36%）例患者对利福平产生耐药性。从采集痰液到根据痰液 MGT 结果开始 MDR-TB 治疗的中位时间为 18 天（IQR 10-29 天）。分子基因检测可以及时发现大多数痰涂片结果为阴性的肺结核患者，并缩短药物敏感性检测的时间，从而使该检测成为肺结核检查的第一项检测。

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Detection of M. tuberculosis Using Cartridge-Based Technology in Patients with Negative Sputum Microscopy Results in a Regional Laboratory

The objective: to evaluate results of M. tuberculosis detection and testing drug susceptibility to rifampicin using molecular genetic methods in tuberculosis patients with a negative sputum smear microscopy result.Subjects and Methods. Pulmonary tuberculosis patients registered in Arkhangelsk Region from 2016 to 2020 were enrolled in the study; those patients were notified as new cases and relapses with a negative sputum smear microscopy result before treatment and had results of molecular genetic testing (MGT) (Xpert MTB/RIF MTB/RIF) and BACTEC MGIT 960 available.Results. 479 people (40%) were registered as pulmonary tuberculosis cases with a negative sputum smear microscopy result. MGT was performed in 327 (68%) patients. A positive result of MGT was received in 120 (37%) patients, a positive result of BACTEC MGIT 960 was received in 165 (50%) people. Concordance of results was observed in 70% of cases. In 136 (41%) people, both tests did not detect Mycobacterium tuberculosis, in 95 (29%) both tests showed a positive result. Discrepancies between the results of two tests were observed in 30% of cases. In 71 (22%) cases, culture growth was observed in BACTEC MGIT 960 with negative results of MGT. In 8% of cases, DNA of Mycobacterium tuberculosis was detected, but there was no culture growth on the nutrient medium. 43/120 (36%) cases of resistance to rifampicin were detected. The median time from sputum collection to initiation of MDR-TB treatment based on sputum MGT results made 18 (IQR 10–29) days. Molecular genetic testing makes it possible to promptly detect the majority of TB patients with a negative sputum smear result, and reduce the time for drug susceptibility testing, which allows this testing to be used as the first test when examining for pulmonary TB.

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来源期刊

Tuberculosis and Lung Diseases Medicine-Pulmonary and Respiratory Medicine

CiteScore

1.20

自引率

0.00%

发文量

审稿时长

8 weeks

期刊介绍： The Journal is aimed for professional development of researchers, doctors, teachers of medical universities and training institutions. The Journal focuses on the presentation of results of research, case studies, issues of differential diagnostics and treatment in the phthisiologist’s practice, national programs on tuberculosis control in the Russian Federation, WHO strategies, discussion of prevention issues to stop transmission of TB/HIVco-infection, and extrapulmonary tuberculosis.