Kashyap Bineeta, Goyal Nisha, Hyanki Puneeta, Singh N P, Khanna Ashwani
Associate Professor, Department of Microbiology, University College of Medical Sciences & Guru Teg Bahadur Hospital, New Delhi, India.
Senior Resident, Department of Microbiology, University College of Medical Sciences & Guru Teg Bahadur Hospital, New Delhi, India.
Trop Doct. 2019 Oct;49(4):274-281. doi: 10.1177/0049475519859958. Epub 2019 Jul 10.
Despite efforts to limit the morbidity and mortality from tuberculosis (TB), it continues to be an important cause of death. There is an urgent need for a diagnostic test that accurately and quickly diagnoses TB, especially if it is also a near-point-of-care test. The GeneXpert polymerase chain reaction test (known in India as CBNAAT [cartridge-based nucleic acid amplification test] and is capable of diagnosing TB and rifampicin resistance within 2 h) is a promising tool. The duration of our study was two years and was carried out in the DOTS centre of a tertiary care hospital in India. A total of 5449 samples were processed using CBNAAT. Of the total samples tested, 2068 were extra-pulmonary. The following information was collected: number of extra-pulmonary samples processed; number of ()-positive samples; patterns of rifampicin sensitivity; number of people living with HIV (PLHIV); and number of children. Of the samples, 62.1% were from suspected pulmonary TB patients. Out of the total samples tested using CBNAAT, 21.8% were positive for . Rifampicin resistance was seen in 9.2%, 8.5% and 10.3% of the total, pulmonary and extra-pulmonary samples, respectively, in -positive samples. Overall, 36.9% samples were from the paediatric population and 5.7% belonged to PLHIV. Rifampicin resistance was seen in 8.8% and 8.3% of the -positive paediatric and PLHIV samples, respectively.
尽管人们努力降低结核病(TB)的发病率和死亡率,但它仍是一个重要的死亡原因。迫切需要一种能够准确、快速诊断结核病的检测方法,尤其是一种近乎即时检测的方法。GeneXpert聚合酶链反应检测(在印度称为CBNAAT[基于 cartridge 的核酸扩增检测],能够在2小时内诊断结核病和利福平耐药性)是一种很有前景的工具。我们的研究为期两年,在印度一家三级护理医院的直接观察短程治疗(DOTS)中心进行。使用CBNAAT共处理了5449份样本。在所有检测样本中,2068份为肺外样本。收集了以下信息:处理的肺外样本数量;()阳性样本数量;利福平敏感性模式;艾滋病毒感染者(PLHIV)数量;以及儿童数量。在这些样本中,62.1%来自疑似肺结核患者。在使用CBNAAT检测的所有样本中,21.8%的样本呈()阳性。在()阳性样本中,利福平耐药率在所有样本、肺内样本和肺外样本中分别为9.2%、8.5%和10.3%。总体而言,36.9%的样本来自儿科人群,5.7%属于艾滋病毒感染者。在()阳性的儿科样本和艾滋病毒感染者样本中,利福平耐药率分别为8.8%和8.3%。