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qPCR 检测未经治疗的麻风病患者及其接触者体内麻风分枝杆菌:鼻拭子和腭黏膜刮取物检测结果。

Early detection of M. leprae by qPCR in untreated patients and their contacts: results for nasal swab and palate mucosa scraping.

机构信息

NeoOdontologia Clinics, Tangara da Serra, Brazil.

Instituto Lauro de Souza Lima, Rod. Cmt. João R. de Barros Km 226, Bauru, SP, 17034-971, Brazil.

出版信息

Eur J Clin Microbiol Infect Dis. 2018 Oct;37(10):1863-1867. doi: 10.1007/s10096-018-3320-9. Epub 2018 Jul 14.

DOI:10.1007/s10096-018-3320-9
PMID:30008126
Abstract

To verify if the hard palate mucosa can be a site of relevance in the early molecular detection of Mycobacterium leprae in leprosy cases and their household contacts and if there is a correlation of results in nasal swab with those of the scraping of the palate mucosa. The quantitative polymerase chain reaction technique was used. Sample included 78 patients with untreated leprosy (G1), their 54 household contacts (G2), and 80 healthy individuals for the negative control (G3). The presence of M. leprae in both G1 and G2 was observed with the nasal swab and the palate mucosa scrapings methods, and it was shown that the sensitivity between the qPCR exams for RLEP and 85B genes is equivalent, with no statistically significant differences (G1 positivity of 35% in the hard palate mucosa and 44% for the nasal one, p = 0.3731 and for G2 of 31 and 38%, respectively, p = 0.6774). Results support the fact that the buccal mucosa and nasal mucosa may be important sites of primary infection of leprosy with repercussion in the transmission chain and that asymptomatic household contacts are heavily harbored by the causative agent of leprosy, which has a critical significance in the prevention and control action of this disease, since the evaluation of these sites arises as of importance in the early detection of M. leprae. Close monitoring and chemoprophylaxis of household contacts appear to be critical to attain interruption of the transmission of leprosy in endemic countries.

摘要

为了验证硬腭黏膜是否可以成为麻风病病例及其家庭接触者中麻风分枝杆菌早期分子检测的相关部位,以及鼻拭子与腭黏膜刮片结果之间是否存在相关性。使用了定量聚合酶链反应技术。样本包括 78 例未经治疗的麻风病患者(G1)、他们的 54 名家庭接触者(G2)和 80 名健康个体作为阴性对照(G3)。用鼻拭子和腭黏膜刮片法观察到 G1 和 G2 中均存在麻风分枝杆菌,并且表明 RLEP 和 85B 基因 qPCR 检查之间的敏感性等效,无统计学差异(硬腭黏膜的 G1 阳性率为 35%,鼻黏膜的阳性率为 44%,p=0.3731;G2 的阳性率分别为 31%和 38%,p=0.6774)。结果支持以下事实:颊黏膜和鼻黏膜可能是麻风病原发感染的重要部位,这对传播链有影响,无症状的家庭接触者携带麻风分枝杆菌的可能性很大,这对这种疾病的预防和控制具有重要意义,因为这些部位的评估在麻风分枝杆菌的早期检测中很重要。密切监测和家庭接触者的化学预防似乎对于在流行国家中断麻风病的传播至关重要。

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