Sun Lin, Zhu Yu, Fang Min, Shi Yan, Peng Xiaoshan, Liao Qiong, Wang Xingyun, Quan Shuting, Wang Yacui, Duan Li, Shi Xiaomei, Zhao Zhipeng, Chen Lanqin, Xu Yongsheng, Zhang Tongqiang, Cui Xiaojian, Wan Chaomin, Shen Adong
Beijing Children's Hospital, Capital Medical University, Beijing, China.
West China Second Hospital, Sichuan University, Chengdu, Sichuan, China.
J Clin Microbiol. 2020 Aug 24;58(9). doi: 10.1128/JCM.00702-20.
A multicenter study was performed to evaluate the value of testing gastric aspirate (GA) with Xpert MTB/RIF Ultra assay (Ultra) for childhood tuberculosis (TB) detection in China. In total, 129 children with active TB and 173 children without TB were enrolled. The sensitivity of Ultra in bacteriologically confirmed TB and probable TB cases was 87.5% (42/48) and 44.4% (36/81), respectively. The specificity of Ultra was high (99.4%, 172/173). When Ultra, culture, and acid-fast bacilli outcomes were integrated as a composite reference standard, the percentage of children with definite TB increased from 37.2% (48/129) to 67.4% (87/129). The sensitivity of Ultra is 80.0% (40/50) in children aged <4 years, which is significantly higher than that in older children (48.1%, 38/79) (0.001). Ultra conducted using GA samples can provide faster results, allowing an early and accurate TB diagnosis, especially in younger children with difficulty producing sputum.
在中国，开展了一项多中心研究，以评估采用Xpert MTB/RIF Ultra检测法（Ultra）检测胃抽吸物（GA）用于儿童结核病（TB）诊断的价值。总共纳入了129例活动性结核病患儿和173例未患结核病的儿童。Ultra检测法在细菌学确诊的结核病和疑似结核病病例中的敏感性分别为87.5%（42/48）和44.4%（36/81）。Ultra检测法的特异性较高（99.4%，172/173）。当将Ultra检测结果、培养结果和抗酸杆菌检测结果整合为一个综合参考标准时，确诊结核病的儿童比例从37.2%（48/129）增至67.4%（87/129）。在年龄<4岁的儿童中，Ultra检测法的敏感性为80.0%（40/50），显著高于年龄较大儿童（48.1%，38/79）（P=0.001）。使用GA样本进行Ultra检测可更快得出结果，有助于早期准确诊断结核病，尤其是对于咳痰困难的年幼儿童。
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