Rakotosamimanana Niaina, Rabodoarivelo Marie Sylvianne, Palomino Juan Carlos, Martin Anandi, Razanamparany Voahangy Rasolofo
Unité des Mycobactéries, Institut Pasteur de Madagascar, Antananarivo, Madagascar.
Unité des Mycobactéries, Institut Pasteur de Madagascar, Antananarivo, Madagascar.
Int J Infect Dis. 2017 Mar;56:248-252. doi: 10.1016/j.ijid.2016.12.005. Epub 2016 Dec 12.
Tuberculosis (TB) is an infectious disease of global public health importance caused by Mycobacterium tuberculosis complex. The disease has worsened with the emergence of multidrug-resistant (MDR)-TB strains. The timely diagnosis and treatment of TB remains a key public health priority, and laboratories have a critical role in the rapid and accurate detection of TB and drug resistance. Molecular assays based on nucleic acid amplification techniques have been developed for the rapid, sensitive, and specific diagnosis of TB, with the ability to determine the drug sensitivity status. These molecular techniques are now available or are being implemented in developing countries. However, traditional microscopy and culture methods cannot yet be replaced; the molecular assays can be applied in parallel with these tests for the diagnosis of TB or for drug susceptibility testing. Performing such molecular tests is often restricted by constraints with regard to sputum sample storage and safe transportation from remote health centres to central laboratories. Since smear slides are performed routinely for the diagnosis of TB in most TB diagnostic laboratories, they are readily available and could be the ideal tool to transport sputum for further molecular tests. The aim of this review was to provide a comprehensive survey on the use of smear slides for both TB diagnosis and the molecular test approach. Based on the literature, stained smear microscopy slides can be a safe system for the transportation of sputum specimens from remote health centres to reference TB laboratories for further molecular TB or MDR-TB detection, and could help in the rapid diagnosis and therefore timely management of TB patients.
结核病（TB）是一种由结核分枝杆菌复合群引起的具有全球公共卫生重要性的传染病。随着耐多药（MDR）-TB菌株的出现，该疾病的情况恶化。结核病的及时诊断和治疗仍然是关键的公共卫生优先事项，实验室在结核病和耐药性的快速准确检测中起着至关重要的作用。基于核酸扩增技术的分子检测方法已被开发用于结核病的快速、灵敏和特异性诊断，并能够确定药物敏感性状况。这些分子技术现已在发展中国家可用或正在实施。然而，传统的显微镜检查和培养方法尚未被取代；分子检测可与这些检测并行应用于结核病诊断或药物敏感性测试。进行此类分子检测通常受到痰标本储存以及从偏远卫生中心安全运输至中心实验室的限制。由于在大多数结核病诊断实验室中，涂片检查是常规用于结核病诊断的，它们很容易获得，并且可能是运输痰液进行进一步分子检测的理想工具。本综述的目的是对涂片在结核病诊断和分子检测方法中的应用进行全面调查。根据文献，染色涂片显微镜载玻片可以是一种将痰标本从偏远卫生中心运输到结核病参考实验室进行进一步分子结核病或耐多药结核病检测的安全系统，并有助于快速诊断，从而及时管理结核病患者。
