Service de microbiologie, hôpital Beaujon, AP-HP, Clichy, France.
Service de microbiologie, hôpital Beaujon, AP-HP, Clichy, France.
Med Mal Infect. 2019 Sep;49(6):467-470. doi: 10.1016/j.medmal.2018.11.004. Epub 2018 Dec 6.
To evaluate a new tool for the early diagnosis of tuberculosis.
A total of 374 smear-negative clinical specimens from patients with suspected tuberculosis were evaluated using a new procedure consisting of a preliminary step of culture in broth bottles followed by the detection of Mycobacterium tuberculosis complex (Mtb) and rifampicin resistance by the Xpert MTB/RIF assay (XMTB-RIF).
A total of 30 Mtb strains were isolated, all susceptible to rifampicin. When broth cultures were subjected to XMTB-RIF analysis after 15 days of incubation, sensitivity, specificity, PPV, and NPV were each 100% when compared with liquid culture.
The XMTB-RIF assay used in 15-day broth cultures may provide a final culture result for smear-negative specimens. This process, combined with clinical signs, may contribute to rapidly diagnosing tuberculosis and also to the early reevaluation of empirical antituberculosis treatment.
评估一种用于结核病早期诊断的新工具。
对 374 份疑似结核病患者的阴性涂片临床标本进行评估，采用一种新程序，包括在肉汤瓶中进行初步培养，然后使用 Xpert MTB/RIF assay（XMTB-RIF）检测结核分枝杆菌复合群（Mtb）和利福平耐药性。
共分离出 30 株 Mtb 菌株，均对利福平敏感。当肉汤培养物在孵育 15 天后进行 XMTB-RIF 分析时，与液体培养相比，其灵敏度、特异性、PPV 和 NPV 均为 100%。
在 15 天的肉汤培养物中使用 XMTB-RIF assay 可能为阴性涂片标本提供最终的培养结果。这一过程结合临床症状，可能有助于快速诊断结核病，并对经验性抗结核治疗进行早期重新评估。
