Song Yanhua, Ma Yifeng, Liu Rongmei, Shang Yuanyuan, Ma Liping, Huo Fengmin, Li Yunxu, Shu Wei, Wang Yufeng, Gao Mengqiu, Pang Yu
Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing, People's Republic of China.
Clinical Laboratory, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, People's Republic of China.
Infect Drug Resist. 2021 Jan 12;14:89-95. doi: 10.2147/IDR.S284157. eCollection 2021.
A prospective study was conducted to ascertain the accuracy of oral swab specimens collected in the early morning, spot and at night for detecting pulmonary tuberculosis (TB).
We prospectively enrolled patients with symptoms suggestive of pulmonary TB in Beijing Chest Hospital. An early morning sputum specimen was collected from each patient for GeneXpert MTB/RIF (Xpert) and mycobacterial culture. In addition, three oral swabs were collected for TB-LAMP testing.
With the combined results of three oral swab specimens, the proportion of (MTB)-positive cases achieved 40.6%, which was comparable to results for Xpert and MGIT (=0.603). Using Xpert plus MGIT as reference, the sensitivity of OS-LAMP on a single specimen ranged from 32.6% on the night oral swab to 50.0% on the morning swab. The combination of three oral swab specimens correctly identified 38 MTB-positive cases, indicating an overall sensitivity of 82.6%, which was significantly higher than that of a single oral swab specimen (<0.001, =0.001).
Oral swab can be used as an alternative specimen for diagnosis of pulmonary TB using TB-LAMP. Morning oral swab exhibits the highest sensitivity, and the inclusion of more specimens at different time points provides compensation in diagnostic sensitivity with single oral swab.
开展一项前瞻性研究，以确定清晨、即时和夜间采集的口腔拭子标本检测肺结核（TB）的准确性。
我们前瞻性纳入了北京胸科医院有肺结核疑似症状的患者。从每位患者采集一份清晨痰标本用于GeneXpert MTB/RIF（Xpert）检测和分枝杆菌培养。此外，采集三份口腔拭子用于TB-LAMP检测。
三份口腔拭子标本的综合结果显示，结核分枝杆菌（MTB）阳性病例的比例达到40.6%，与Xpert和MGIT的检测结果相当（=0.603）。以Xpert加MGIT检测结果为参照，OS-LAMP在单份标本上的敏感性范围为：夜间口腔拭子为32.6%，清晨拭子为50.0%。三份口腔拭子标本的组合正确识别出38例MTB阳性病例，总体敏感性为82.6%，显著高于单份口腔拭子标本（<0.001，=0.001）。
口腔拭子可作为使用TB-LAMP诊断肺结核的替代标本。清晨口腔拭子的敏感性最高，纳入不同时间点的更多标本可弥补单份口腔拭子在诊断敏感性上不足。
