Molina-Moya Barbara, Ciobanu Nelly, Hernandez Marta, Prat-Aymerich Cristina, Crudu Valeriu, Adams Emily R, Codreanu Alexandru, Sloan Derek J, Cuevas Luis E, Dominguez Jose
Institut d'Investigació Germans Trias i Pujol, CIBER Enfermedades Respiratorias (CIBERES), Carretera del Canyet s/n, Camí de les Escoles s/n, Badalona, 08916 Barcelona, Spain.
Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, Carretera del Canyet s/n Badalona, 08916 Barcelona, Spain.
J Clin Med. 2020 Dec 21;9(12):4124. doi: 10.3390/jcm9124124.
Tuberculosis (TB) diagnosis is increasingly based on the detection of complex (MTBC) DNA in sputum using molecular diagnostic tests as the first test for diagnosis. However, sputum can be difficult to obtain in children, patients without productive cough, and the elderly and approaches testing non-sputum samples are needed. We evaluated whether TB can be detected from the oral mucosa of patients with TB. Adults with presumptive TB were examined using culture, Xpert MTB/RIF, smear microscopy and X-Rays. Oral mucosa swabs collected on PrimeStore-MTM, stored at room temperature if tested within 30 days or at -20 °C if examined at a later time. RT-PCR was performed to detect DNA. Eighty patients had bacteriologically-confirmed TB, 34 had bacteriologically-negative TB (negative tests but abnormal X-rays) and 152 were considered not to have TB (not TB). Oral swabs RT-PCR were positive in 29/80 (36.3%) bacteriologically-confirmed, 9/34 (26.5%) bacteriologically-negative and 29/152 (19.1%) not TB. The yield varied among samples stored for less and more than 30 days ( = 0.013) from 61% (11/18) and 29% (18/62) among bacteriologically confirmed, and 30.8% (4/13) and 23.8% (5/21) among bacteriologically-negative participants. Among not TB patients, the specificity was 80.9% (123/152), being 78.3% (18/23) among samples stored less than 30 days and 81.4% (105/129) among samples stored for more than 30 days ( = 0.46). The detection of in oral mucosa samples is feasible, but storage conditions may affect the yield.
结核病(TB)的诊断越来越多地基于使用分子诊断测试检测痰液中的复合(MTBC)DNA作为诊断的首要测试。然而,在儿童、无咳痰的患者以及老年人中,痰液可能难以获取,因此需要采用检测非痰液样本的方法。我们评估了是否可以从结核病患者的口腔黏膜中检测出结核病。对疑似患有结核病的成年人进行了培养、Xpert MTB/RIF检测、涂片显微镜检查和X射线检查。在PrimeStore-MTM上采集口腔黏膜拭子,如果在30天内进行检测则在室温下保存,如果稍后进行检测则在-20°C下保存。进行逆转录聚合酶链反应(RT-PCR)以检测DNA。80例患者经细菌学确诊为结核病,34例为细菌学阴性结核病(检测结果为阴性但X射线异常),152例被认为没有结核病(非结核病)。口腔拭子RT-PCR检测在29/80(36.3%)经细菌学确诊的患者、9/34(26.5%)细菌学阴性患者和29/152(19.1%)非结核病患者中呈阳性。在储存时间少于30天和多于30天的样本中,检出率有所不同(P = 0.013),在经细菌学确诊的患者中分别为61%(11/18)和29%(18/62),在细菌学阴性参与者中分别为30.8%(4/13)和23.8%(5/21)。在非结核病患者中,特异性为80.9%(123/152),在储存时间少于30天的样本中为78.3%(18/23),在储存时间多于30天的样本中为81.4%(105/129)(P = 0.46)。从口腔黏膜样本中检测出MTBC是可行的,但储存条件可能会影响检出率。