飞行时间质谱核酸检测技术在耐药肺结核诊断中的临床应用。

IF 2.1 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease Pub Date : 2025-01-12 DOI:10.1016/j.diagmicrobio.2025.116686

Hong-mei Shi , Zi-kang Wang , Han Wu , Jian-kang Li , Yan-yan Mo , Xin Liu , Chang Zhao , Jiang Du , Rui-xia Liang

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引用次数: 0

摘要

目的：探讨基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）对结核病和耐药结核病的临床诊断价值。患者与方法：回顾性分析201例肺结核患者。所有患者均接受了涂片镜检、分枝杆菌生长指示管（MGIT） 960培养、环介导等温扩增（LAMP）分子检测、Xpert MTB/RIF （Xpert）和基于MALDI-TOF质谱法的MassARRAY检测。结果：入组患者中，涂片、培养、LAMP、Xpert、MALDI-TOF MS检测阳性率分别为28.36%、43.78%、47.26%、64.68%、85.57%。MALDI-TOF MS检出率显著高于其他方法（均P < 0.05）。88例培养阳性患者中，涂片、LAMP、Xpert和MALDI-TOF MS的阳性检出率分别为43.2%、68.2%、85.2%和94.3%；113例培养阴性病例中，上述检查阳性率分别为16.8%、31.0%、48.7%和78.8%。130例专家阳性病例中，涂片阳性率40.77%，培养阳性率57.7%，LAMP阳性率70.77%，MALDI-TOF MS阳性率98.46%；在71例专家阴性病例中，上述检查的阳性率分别为5.6%、18.3%、4.2%和62.0%。在61例利福平耐药病例中，MALDI-TOF MS检出率（96.72%）显著高于Xpert (81.97%) （P < 0.05）。MALDI-TOF MS与pDST在11种抗结核药物耐药性检测中的一致性为83.0% ~ 98.9%。结论：飞行时间质谱核酸检测技术为结核病和耐药结核病的快速诊断提供了强有力的工具，具有灵敏度高、可靠性高等优点，值得进一步推广应用。

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Clinical application of time-of-flight mass spectrometry nucleic acid detection technology in diagnosis of drug-resistant pulmonary tuberculosis

Purpose

This study aims to evaluate the clinical diagnostic value of matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) for tuberculosis and drug-resistant tuberculosis.

Patients and methods

Totally 201 pulmonary tuberculosis patients were recruited retrospectively. All patients underwent smear microscopy, Mycobacterium growth indicator tube (MGIT) 960 culture, loop-mediated isothermal amplification (LAMP) molecular testing, Xpert MTB/RIF (Xpert), and MassARRAY assay which is a MALDI-TOF MS based method.

Results

Among the enrolled patients, 28.36 %, 43.78 %, 47.26 %, 64.68 %, and 85.57 % tested positive by smear, culture, LAMP, Xpert, and MALDI-TOF MS, respectively. MALDI-TOF MS had significantly higher detection rates than the other methods (All P < 0.05). In the 88 culture-positive patients, the positive detection rates for smear, LAMP, Xpert, and MALDI-TOF MS were 43.2 %, 68.2 %, 85.2 %, and 94.3 %, respectively; In 113 culture-negative cases, the positive rates for the above tests were 16.8 %, 31.0 %, 48.7 %, and 78.8 %, respectively. Among the 130 Xpert-positive cases, the positive rates for smear, culture, LAMP, and MALDI-TOF MS were 40.77 %, 57.7 %, 70.77 %, and 98.46 %, respectively; In the 71 Xpert-negative cases, the positive rates for above tests were 5.6 %, 18.3 %, 4.2 %, and 62.0 %, respectively. In the 61 rifampicin-resistant cases, the successful detection rate of MALDI-TOF MS (96.72 %) was significantly higher than that of Xpert (81.97 %) (P < 0.05). The concordance between MALDI-TOF MS and pDST for detecting resistance to 11 anti-tuberculosis drugs ranged from 83.0 % to 98.9 %.

Conclusion

Nucleic acid detection technology using time-of-flight mass spectrometry provides a powerful tool for the rapid diagnosis of tuberculosis and drug-resistant tuberculosis, with advantages of high sensitivity and reliability, warranting further promotion and application.

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来源期刊

Diagnostic microbiology and infectious disease 医学-传染病学

CiteScore

5.30

自引率

3.40%

发文量

149

审稿时长

56 days

期刊介绍： Diagnostic Microbiology and Infectious Disease keeps you informed of the latest developments in clinical microbiology and the diagnosis and treatment of infectious diseases. Packed with rigorously peer-reviewed articles and studies in bacteriology, immunology, immunoserology, infectious diseases, mycology, parasitology, and virology, the journal examines new procedures, unusual cases, controversial issues, and important new literature. Diagnostic Microbiology and Infectious Disease distinguished independent editorial board, consisting of experts from many medical specialties, ensures you extensive and authoritative coverage.