MMWR Morb Mortal Wkly Rep. 2009 Jan 16;58(1):7-10.
Guidelines for the use of nucleic acid amplification (NAA) tests for the diagnosis of tuberculosis (TB) were published in 1996 and updated in 2000. Since then, NAA testing has become a routine procedure in many settings because NAA tests can reliably detect Mycobacterium tuberculosis bacteria in specimens 1 or more weeks earlier than culture. Earlier laboratory confirmation of TB can lead to earlier treatment initiation, improved patient outcomes, increased opportunities to interrupt transmission, and more effective public health interventions. Because of the increasing use of NAA tests and the potential impact on patient care and public health, in June 2008, CDC and the Association of Public Health Laboratories (APHL) convened a panel of clinicians, laboratorians, and TB control officials to assess existing guidelines and make recommendations for using NAA tests for laboratory confirmation of TB. On the basis of the panel's report and consultations with the Advisory Council for the Elimination of TB (ACET),* CDC recommends that NAA testing be performed on at least one respiratory specimen from each patient with signs and symptoms of pulmonary TB for whom a diagnosis of TB is being considered but has not yet been established, and for whom the test result would alter case management or TB control activities, such as contact investigations. These guidelines update the previously published guidelines.
1996年发布了用于诊断结核病（TB）的核酸扩增（NAA）检测使用指南，并于2000年进行了更新。自那时以来，NAA检测已在许多机构成为常规程序，因为NAA检测能够比培养法提前1周或更长时间可靠地检测出标本中的结核分枝杆菌。结核病的实验室确诊时间提前可使治疗更早开始，改善患者预后，增加阻断传播的机会，并采取更有效的公共卫生干预措施。由于NAA检测的使用日益增多及其对患者治疗和公共卫生的潜在影响，2008年6月，美国疾病控制与预防中心（CDC）和公共卫生实验室协会（APHL）召集了一个由临床医生、检验人员和结核病防治官员组成的小组，以评估现有指南，并就使用NAA检测进行结核病实验室确诊提出建议。根据该小组的报告以及与消除结核病咨询委员会（ACET）*的磋商，CDC建议对每例有肺结核体征和症状、正在考虑结核病诊断但尚未确诊、且检测结果将改变病例管理或结核病防治活动（如接触者调查）的患者，至少采集一份呼吸道标本进行NAA检测。本指南更新了先前发布的指南。
