Afsar I, Gunes M, Er H, Gamze Sener A
Ihan Afsar, Atatürk Training and Research Hospital,Department of Microbiology , Izmir, Turkey.
Rev Esp Quimioter. 2018 Oct;31(5):435-438. Epub 2018 Sep 19.
Tuberculosis (TB) is a public health problem worldwide, with the highest mortality . The development of nucleic acid-based tests for detection of Mycobacterium tuberculosis complex (MTBC) has significantly increased sensitivity compared to conventional smear microscopy and provides results within a matter of hours compared to weeks for solid culture, which is the current gold standart. The aim of this study was to compare the culture, microscopic smear and molecular method in the diagnosis of TB.
Seven hundred ninety specimens belonging to clinically suspected cases of TB were studied retrospectively. The specimens were grouped as respiratory and non-respiratory and the groups were compared for mycobacterial detection assays. The culture and the molecular diagnostic GeneXpert MTB/RIF (GX) assay method were compared.
When culture was used as the reference standart, 32 (4.05%) specimens were positive for MTBC. Of the 32 culture positive clinical specimens 24 (3.03%) were respiratory and 8 (1.01%) were non-respiratory specimens. All 24 of the 24 respiratory specimens were positive by the GX test, Seven of the eight non-respiratory specimens positive for culture were positive by GX assay. Five of the seven hundred fifty-eight samples of culture negative were positive with GX assay. Sensitivity and specificity of GX were found to be 96.8 % and 99.3 %, respectively.
Molecular methods to acquire time in diagnosis as well as the increase in linearity gives a different perspective to the diagnosis of tuberculosis. The GX assay has a diagnostic utility for rapid diagnosis of TB.
结核病是全球公共卫生问题，死亡率最高。与传统涂片显微镜检查相比，基于核酸的结核分枝杆菌复合群（MTBC）检测方法的灵敏度显著提高，且与固体培养（目前的金标准，结果需数周时间）相比，能在数小时内得出结果。本研究旨在比较培养法、显微镜涂片法和分子方法在结核病诊断中的应用。
回顾性研究790份临床疑似结核病病例的标本。将标本分为呼吸道标本和非呼吸道标本两组，并对两组进行分枝杆菌检测分析。比较培养法和分子诊断GeneXpert MTB/RIF（GX）检测方法。
以培养法作为参考标准时，32份（4.05%）标本MTBC呈阳性。在这32份培养阳性的临床标本中，24份（3.03%）为呼吸道标本，8份（1.01%）为非呼吸道标本。24份呼吸道标本经GX检测全部呈阳性，8份培养阳性的非呼吸道标本中有7份经GX检测呈阳性。758份培养阴性的标本中有5份经GX检测呈阳性。GX的灵敏度和特异性分别为96.8%和99.3%。
分子方法在诊断中节省时间且线性度提高，为结核病诊断提供了不同视角。GX检测在结核病快速诊断中具有诊断价值。
