Truffot-Pernot C, Veziris N
ER5, EA 1541, Laboratoire de Bactériologie-Hygiène, UPMC Université Paris-06, 75005 Paris, France.
Rev Mal Respir. 2011 Oct;28(8):1034-47. doi: 10.1016/j.rmr.2011.07.002. Epub 2011 Oct 10.
This review describes current developments for the bacteriological diagnosis of active tuberculosis. It deals mainly with molecular methods, describing their performance and how they can be integrated into more traditional diagnostic approaches. At present, microscopic examination and culture are still essential for the diagnosis of TB and to guide therapeutic decisions. Nucleic acid amplification and line probe assays speed up the identification and susceptibility testing of mycobacteria in AFB smear positive specimens or in culture. They are also efficient for comparison of M. tuberculosis strains with each other (genotyping). On the other hand, at present, molecular tests are not applicable for diagnosis in smear negative specimens and even less so for diagnosis of culture-negative tuberculosis. The use of serology for antibody/antigen detection is not useful and it is not appropriate to assays based on the release of interferon-γ release as they are currently available. Notable progress has been made but more sensitive diagnostic tests for TB are still urgently needed.
本综述描述了活动性结核病细菌学诊断的当前进展。主要涉及分子方法，阐述了其性能以及如何将其整合到更传统的诊断方法中。目前，显微镜检查和培养对于结核病的诊断及指导治疗决策仍然至关重要。核酸扩增和线性探针检测可加快对抗酸杆菌涂片阳性标本或培养物中分枝杆菌的鉴定和药敏试验。它们在比较结核分枝杆菌菌株彼此之间（基因分型）也很有效。另一方面，目前分子检测不适用于涂片阴性标本的诊断，对于培养阴性结核病的诊断更是如此。用于抗体/抗原检测的血清学方法并无用处，基于γ-干扰素释放的检测方法目前也不适用。虽已取得显著进展，但仍迫切需要更敏感的结核病诊断检测方法。
