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对一种未经批准用于莱姆病诊断的新型伯氏疏螺旋体培养方法的担忧。

Concerns regarding a new culture method for Borrelia burgdorferi not approved for the diagnosis of Lyme disease.

出版信息

MMWR Morb Mortal Wkly Rep. 2014 Apr 18;63(15):333.

Abstract

In 2005, CDC and the Food and Drug Administration (FDA) issued a warning regarding the use of Lyme disease tests whose accuracy and clinical usefulness have not been adequately established. Often these are laboratory-developed tests (also known as "home brew" tests) that are manufactured and used within a single laboratory and have not been cleared or approved by FDA. Recently, CDC has received inquiries regarding a laboratory-developed test that uses a novel culture method to identify Borrelia burgdorferi, the spirochete that causes Lyme disease. Patient specimens reportedly are incubated using a two-step pre-enrichment process, followed by immunostaining with or without polymerase chain reaction (PCR) analysis. Specimens that test positive by immunostaining or PCR are deemed "culture positive". Published methods and results for this laboratory-developed test have been reviewed by CDC. The review raised serious concerns about false-positive results caused by laboratory contamination and the potential for misdiagnosis.

摘要

2005 年,疾病预防控制中心和食品药品监督管理局(FDA)发布了一项关于使用尚未充分证实准确性和临床实用性的莱姆病检测的警告。这些检测通常是实验室开发的检测(也称为“自制”检测),由单一实验室制造和使用,未经 FDA 批准或认可。最近,疾病预防控制中心收到了有关一种实验室开发的检测的询问,该检测使用一种新颖的培养方法来识别伯氏疏螺旋体,这种螺旋体引起莱姆病。据报道,患者标本使用两步预富集过程进行孵育,然后进行免疫染色,或进行聚合酶链反应(PCR)分析。免疫染色或 PCR 检测呈阳性的标本被认为是“培养阳性”。疾病预防控制中心审查了该实验室开发检测的已发表方法和结果。该审查对实验室污染导致的假阳性结果以及误诊的可能性提出了严重关切。

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