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结核病诊断的进展:结核分枝杆菌分子诊断的最新进展。

Advances in diagnosis of Tuberculosis: an update into molecular diagnosis of Mycobacterium tuberculosis.

机构信息

Clinical Laboratory, Bassett Healthcare Network, Cooperstown, NY, 13226, USA.

General Welfare Pratisthan, Kathmandu, Nepal.

出版信息

Mol Biol Rep. 2020 May;47(5):4065-4075. doi: 10.1007/s11033-020-05413-7. Epub 2020 Apr 4.

Abstract

Tuberculosis (TB) is a major cause of deaths by a single infectious agent and has now been a global public health problem due to increasing numbers of drug-resistant cases. Early and effective treatment is crucial to prevent the emergence of drug-resistance strains. This demands the availability of fast and reliable point-of-care (POC) diagnostic methods for effective case management. Commonly used methods to screen and diagnose TB are clinical, immunological, microscopy, radiography, and bacterial culture. In addition, recent advances in molecular diagnostic methods including MTBDRplus, loop-mediated isothermal amplification (LAMP), line probe assay (LPA), GeneXpert, and whole genome sequencing (WGS) have been employed to diagnose and characterize TB. These methods can simultaneously identify Mycobacterium tuberculosis (MTB) and mutation(s) associated with routinely used anti-TB drugs. Here, we review the use of currently available diagnostic methods and strategies including conventional to recently implemented next-generation sequencing (NGS) methods used to detect MTB in clinical perspective.

摘要

结核病(TB)是单一传染病病原体导致死亡的主要原因,由于耐药病例的数量不断增加,现已成为全球公共卫生问题。早期和有效的治疗对于防止耐药菌株的出现至关重要。这需要有快速可靠的即时护理(POC)诊断方法来进行有效的病例管理。常用的筛查和诊断结核病的方法包括临床、免疫、显微镜检查、影像学和细菌培养。此外,最近在分子诊断方法方面的进展,包括 MTBDRplus、环介导等温扩增(LAMP)、线探针分析(LPA)、GeneXpert 和全基因组测序(WGS),已被用于诊断和表征结核病。这些方法可以同时识别结核分枝杆菌(MTB)和与常规抗结核药物相关的突变。在这里,我们从临床角度回顾了目前可用的诊断方法和策略,包括从传统到最近实施的下一代测序(NGS)方法,用于检测 MTB。

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