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评估 Xpert MTB/RIF assay 在缅甸儿童肺结核诊断中的应用。

Evaluation of Xpert MTB/RIF assay as a diagnostic test for pulmonary tuberculosis in children in Myanmar.

机构信息

Department of Paediatrics, University of Medicine, Mandalay, 550-Bedded Children's Hospital, Mandalay.

Tuberculosis Hospital, Mandalay.

出版信息

Int J Tuberc Lung Dis. 2018 Sep 1;22(9):1051-1055. doi: 10.5588/ijtld.18.0024.

DOI:10.5588/ijtld.18.0024

PMID:30092871

Abstract

BACKGROUND

The Xpert® MTB/RIF assay has been recommended for the diagnosis of pulmonary tuberculosis (PTB). However, there are limited data from the South-East Asian region.

SETTING

This study was carried out at a tertiary-level children's hospital in Mandalay, Myanmar.

OBJECTIVE

To evaluate the performance of Xpert as a diagnostic test for PTB in children.

METHODS

A cross-sectional descriptive study of children with suspected PTB. Gastric lavage aspirate samples were tested using Xpert, solid culture and smear microscopy. The performance of Xpert, solid culture and smear microscopy were evaluated using the revised National Institute of Health classification for intrathoracic TB in children as the reference standard.

RESULTS

TB was bacteriologically confirmed in 38 (16.5%) of 231 children with suspected PTB. Of the 38 children with confirmed TB, 36 cases were identified using Xpert, 16 using solid culture and 12 using smear microscopy. With confirmed TB as the reference standard, the sensitivity of Xpert, solid culture and smear microscopy was respectively 94.7% (95%CI 80.9-99.1), 42.1% (95%CI 26.7-59.1) and 31.6% (95%CI 18.0-48.8).

CONCLUSION

Xpert has improved the bacteriological confirmation of PTB among hospitalised children in Myanmar.

摘要

背景

Xpert® MTB/RIF 检测法已被推荐用于诊断肺结核（PTB）。然而，来自东南亚地区的数据有限。

地点

本研究在缅甸曼德勒的一家三级儿童医院进行。

目的

评估 Xpert 作为儿童肺结核诊断检测方法的性能。

方法

对疑似肺结核的儿童进行横断面描述性研究。使用 Xpert、固体培养和涂片显微镜检查对胃抽吸物样本进行检测。使用修订后的国家儿童胸内结核分类作为参考标准，评估 Xpert、固体培养和涂片显微镜检查的性能。

结果

在 231 名疑似肺结核的儿童中，有 38 名（16.5%）经细菌学证实患有结核病。在 38 名确诊结核病的儿童中，有 36 例使用 Xpert 检测到，16 例使用固体培养检测到，12 例使用涂片显微镜检测到。以确诊结核病为参考标准，Xpert、固体培养和涂片显微镜检查的灵敏度分别为 94.7%（95%CI 80.9-99.1）、42.1%（95%CI 26.7-59.1）和 31.6%（95%CI 18.0-48.8）。