评价 Xpert MTB/RIF assay 在儿童结核病诊断中的应用。
Evaluation of Xpert MTB/RIF Assay for Diagnosis of Tuberculosis in Children.
机构信息
Department of Microbiology, Institute of Medical Sciences Banaras Hindu University, Varanasi, India.
Department of Pediatrics, Institute of Medical Sciences Banaras Hindu University, Varanasi, India.
出版信息
J Trop Pediatr. 2019 Feb 1;65(1):14-20. doi: 10.1093/tropej/fmy005.
INTRODUCTION
Childhood tuberculosis (TB) is now a global priority. With the advent of Xpert MTB/RIF, more TB cases in children are being reported. This study was undertaken to evaluate the performance of Xpert in diagnosis of pulmonary and extra-pulmonary TB in children.
METHODS
Specimens from 171 suspected TB cases in children aged <15 years were tested with Xpert, culture and smear microscopy in the Department of Microbiology, Institute of Medical Sciences, India.
RESULTS
The specimens included 106 gastric aspirates, 51 cerebrospinal fluids, 8 induced sputum and 6 lymph node aspirates. Xpert detected Mycobacterium tuberculosis in 19 cases (14 pulmonary and 5 extra-pulmonary), 7 of which were rifampicin-resistant. Sensitivity, specificity, positive predictive value and negative predictive value of Xpert compared with culture were 88.89, 98.04, 84.21 and 98.68%, respectively. The sensitivity was 100% in children aged 1-5 years and 6-10 years and in gastric aspirates.
CONCLUSION
Xpert is an efficient diagnostic tool in childhood tuberculosis.
简介
儿童结核病（TB）现在是全球重点关注的问题。随着 Xpert MTB/RIF 的出现，越来越多的儿童结核病病例得到报告。本研究旨在评估 Xpert 在诊断儿童肺内和肺外结核病方面的性能。
方法
在印度医学科学院微生物学系，对 171 例年龄<15 岁的疑似结核病儿童的标本进行了 Xpert、培养和涂片显微镜检查。
结果
标本包括 106 份胃液抽吸物、51 份脑脊液、8 份诱导痰和 6 份淋巴结抽吸物。Xpert 在 19 例（14 例肺内和 5 例肺外）中检测到结核分枝杆菌，其中 7 例对利福平耐药。与培养相比，Xpert 的敏感性、特异性、阳性预测值和阴性预测值分别为 88.89%、98.04%、84.21%和 98.68%。在 1-5 岁和 6-10 岁儿童以及胃液抽吸物中，Xpert 的敏感性为 100%。
结论
Xpert 是儿童结核病的一种有效诊断工具。
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