[1]杨元利,张永峰,杨 翰.Xpert MTB/RIF Ultra对结核性脑膜炎的早期诊断价值[J].陕西医学杂志,2024,(4):544-547,568.[doi:DOI:10.3969/j.issn.1000-7377.2024.04.024]
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Xpert MTB/RIF Ultra对结核性脑膜炎的早期诊断价值
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2024年4期
页码:
544-547,568
栏目:
临床检验
出版日期:
2024-04-05

文章信息/Info

作者:
杨元利张永峰杨 翰
(西安市胸科医院,陕西 西安 710100)
关键词:
脑脊液 诊断 结核性脑膜炎 Xpert MTB/RIF Xpert MTB/RIF Ultra 宏基因测序
分类号:
R 529.3
DOI:
DOI:10.3969/j.issn.1000-7377.2024.04.024
文献标志码:
A
摘要:
目的:评价Xpert MTB/RIF Ultra(Ultra)对结核性脑膜炎(TBM)的早期诊断价值。方法:对79例患者的临床资料进行分析,用Ultra、Xpert MTB/RIF(Xpert)、宏基因测序(mNGS)和分枝杆菌培养(MGIT)检测脑脊液(CSF)中的结核分枝杆菌。在临床诊断的基础上,分析各方法的检测性能和利福平药物敏感性。结果:Ultra的敏感度(56.4%)、曲线下面积(AUC值)和Kappa值(0.521)均高于MGIT(20%、0.600、0.236)、Xpert(40%、0.700、0.236)和mNGS(32.7%、0.664、0.352)。在31例Ultra阳性病例中,24例对利福平敏感,7例耐药性不确定。结论:与其他方法相比,Ultra检测脑脊液中结核分枝杆菌具有较高的敏感性。因此,Ultra可用于TBM的早期诊断。

参考文献/References:

[1] HARDING E.WHO global progress report on tuberculosis elimination[J].Lancet Respir Med,2020(8):19.
[2] ROCK R B,OLIN M,BAKER C A,et al.Central nervous system tuberculosis:Pathogenesis and clinical aspects[J].Clinical Microbiology Reviews,2008,21(2):243-261.
[3] HO J F,MARAIS B J,GILBERT G L,et al.Diagnosing tuberculous meningitis-have we made any progress? [J].Tropical Medicine & International Health:TM & IH,2013,18(6):783-793.
[4] DE-ALMEIDA S M,FURLAN S M P,CRETELLA A M M,et al.Comparison of cerebrospinal fluid biomarkers for differential diagnosis of acute bacterial and viral meningitis with atypical cerebrospinal fluid characteristics[J].Medical Principles and Practice:International Journal of the Kuwait University,Health Science Centre,2020,29(3):244-254.
[5] CRESSWELL F V,TUGUME L,BAHR N C,et al.Xpert MTB/RIF Ultra for the diagnosis of HIV-associated tuberculous meningitis:A prospective validation study[J].Lancet Infectious Diseases 2020,20(3):308-317.
[6] THWAITES G E,CHAU T T,FARRAR J J.Improving the bacteriological diagnosis of tuberculous meningitis[J].J Clin Microbiol,2004,42(1):378-379.
[7] MAI N T,THWAITES G E.Recent advances in the diagnosis and management of tuberculous meningitis[J].Current Opinion in Infectious Diseases,2017,30(1):123-128.
[8] 杨翰,李爱芳,张永峰,等.结核性脑膜炎分子诊断研究进展[J].陕西医学杂志,2021,50(11):1457-1461.
[9] DRAIN P K,HYLE E P,NOUBARY F,et al.Diagnostic point-of-care tests in resource-limited settings[J].The Lancet Infectious Diseases,2014,14(3):239-249.
[10] PIERSIMONI C,GHERARDI G,GRACCICOTTI N,et al.Comparative evaluation of Xpert MTB/RIF and the new Xpert MTB/RIF ultra with respiratory and extra-pulmonary specimens for tuberculosis case detection in a low incidence setting[J].J Clin Tuberc Other Mycobact Dis,2019,15:100094.
[11] DONOVAN J,THU D D A,PHU N H,et al.Xpert MTB/RIF Ultra versus Xpert MTB/RIF for the diagnosis of tuberculous meningitis:A prospective,randomised,diagnostic accuracy study[J].The Lancet Infectious Diseases,2020,20(3):299-307.
[12] BEUTLER M,PLESNIK S,MIHALIC M,et al.A pre-clinical validation plan to evaluate analytical sensitivities of molecular diagnostics such as BD MAX MDR-TB,Xpert MTB/Rif Ultra and FluoroType MTB[J].PLoS One,2020,15:e0227215.
[13] MISHRA H,REEVE B W P,PALMER Z,et al.Xpert MTB/RIF Ultra and Xpert MTB/RIF for diagnosis of tuberculosis in an HIV-endemic setting with a high burden of previous tuberculosis:A two-cohort diagnostic accuracy study[J].The Lancet:Respir Med,2020,8:368-382.
[14] WU X,TAN G,GAO R,et al.Assessment of the Xpert MTB/RIF Ultra assay on rapid diagnosis of extrapulmonary tuberculosis[J].International Journal of Infectious Diseases:IJID:Official Publication of the International Society for Infectious Diseases,2019,81(4):91-96.
[15] SLATKO B E,GARDNER A F,AUSUBEL F M.Overview of next-generation sequencing technologies[J].Current protocols in Molecular Biology,2018,122:e59.
[16] CHEN P,SUN W,HE Y.Comparison of metagenomic next-generation sequencing technology,culture and GeneXpert MTB/RIF assay in the diagnosis of tuberculosis[J].Thorac Dis,2020,12(8):4014-4024.[17 ] MARAIS S,THWAITES G,SCHOEMAN J F,et al.Tuberculous meningitis:A uniform case definition for use in clinical research[J].Lancet Infect Dis,2010,10(11):803-812.
[18] GARCIA G M,GUTIERREZ M F A,NAVARRO A S,et al.Clinical,imaging,and laboratory characteristics of adult mexican patients with tuberculous meningitis:A retrospective cohort study[J].Journal of Epidemiology and Global Health,2020,10(1):59-64.
[19] 王淑琦,黄海荣,王桂荣.Xpert MTB/RIF Ultra与Xpert MTB/RIF检测技术的临床应用及研究进展[J].中国防痨杂志,2018,40(7):776-780.
[20] BAHR N C,NUWAGIRA E,EVANS E E,et al.Diagnostic accuracy of Xpert MTB/RIF Ultra for tuberculous meningitis in HIV-infected adults:A prospective cohort study[J].The Lancet Infect Dis,2017,18:68-75.
[21] 陈祺裕,许予馨,周厚清.宏基因组二代测序用于临床感染性疾病诊断价值的Meta分析[J].中国卫生检验杂志,2021,31(18):246-250.
[22] YU G C,WANG X D,ZHU P F,et al.Comparison of the efficacy of metagenomic next-generation sequencing and Xpert MTB/RIF in the diagnosis of tuberculous meningitis[J].J Microbiol Methods,2020(18):106124.
[23] 陈文,姚利,陈康,等.宏基因组二代测序技术检测脑脊液在结核性脑膜炎诊断中的应用价值的Meta分析[J].中国防痨杂志,2021,43(10):1066-1072.
[24] 代小伟,王嫩寒,陈双双,等.二代测序技术检测临床痰标本中结核分枝杆菌的初步评价[J].中国防痨杂志,2022,44(7):669-679.
[25] 王雅娟,曹新益,刘升明.宏基因组二代测序和GeneXpert MTB/RIF对结核病诊断价值的Meta分析[J].中国防痨杂志,2022,44(12):1327-1337.

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备注/Memo

备注/Memo:
基金项目:陕西省重点研发计划项目(2020SF-109)
更新日期/Last Update: 2024-04-07