Guillet-Caruba C, Martinez V, Doucet-Populaire F
Service de bactériologie-hygiène, hôpital Antoine-Béclère, AP-HP, HUPS, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France.
Service de médecine interne et immunologie clinique, hôpital Antoine-Béclère, AP-HP, HUPS, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France; Inserm U996, labex lhermit, université Paris-Sud, 32, rue des Carnets, 92140 Clamart, France.
Rev Med Interne. 2014 Dec;35(12):794-800. doi: 10.1016/j.revmed.2014.05.001. Epub 2014 Aug 8.
This review focuses on the role of new tools in the "modern" microbiological diagnosis of tuberculosis. Traditional techniques of microscopy and culture remain essential to diagnostic certainty, but some innovations replace daily the older techniques such as the identification of Mycobacterium tuberculosis complex by immunochromatography or mass spectrometry MALDI-TOF type from positive cultures, or susceptibility testing in liquid medium. New tools that use molecular techniques have become important. They all have in common to optimize the fight against tuberculosis by reducing diagnostic delay. They also allow rapid detection of drug resistance. However, the techniques of gene amplification directly from clinical samples are still less sensitive than culture. Bacteriological diagnosis of tuberculosis disease therefore still relies on the complementarities of different phenotypic and molecular techniques.
本综述聚焦于新工具在结核病“现代”微生物诊断中的作用。传统的显微镜检查和培养技术对于确诊仍然至关重要，但一些创新技术正日益取代旧技术，比如通过免疫色谱法或基质辅助激光解吸电离飞行时间质谱（MALDI-TOF）类型从阳性培养物中鉴定结核分枝杆菌复合群，或在液体培养基中进行药敏试验。使用分子技术的新工具已变得至关重要。它们的共同之处在于通过减少诊断延迟来优化结核病防治工作。它们还能快速检测耐药性。然而，直接从临床样本进行基因扩增的技术仍不如培养敏感。因此，结核病的细菌学诊断仍依赖于不同表型和分子技术的互补性。
