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伤寒诊断:当前挑战与未来方向。

Enteric Fever Diagnosis: Current Challenges and Future Directions.

作者信息

Neupane Durga P, Dulal Hari P, Song Jeongmin

机构信息

Department of Microbiology and Immunology, Cornell University, Ithaca, NY 14853, USA.

出版信息

Pathogens. 2021 Apr 1;10(4):410. doi: 10.3390/pathogens10040410.

Abstract

Enteric fever is a life-threatening systemic febrile disease caused by serovars Typhi and Paratyphi ( Typhi and Paratyphi). Unfortunately, the burden of the disease remains high primarily due to the global spread of various drug-resistant strains despite continuous advancement in the field. An accurate diagnosis is critical for effective control of the disease. However, enteric fever diagnosis based on clinical presentations is challenging due to overlapping symptoms with other febrile illnesses that are also prevalent in endemic areas. Current laboratory tests display suboptimal sensitivity and specificity, and no diagnostic methods are available for identifying asymptomatic carriers. Several research programs have employed systemic approaches to identify more specific biomarkers for early detection and asymptomatic carrier detection. This review discusses the pros and cons of currently available diagnostic tests for enteric fever, the advancement of research toward improved diagnostic tests, and the challenges of discovering new ideal biomarkers and tests.

摘要

伤寒是一种由伤寒杆菌和副伤寒杆菌(伤寒杆菌和副伤寒杆菌血清型)引起的危及生命的全身性发热疾病。不幸的是,尽管该领域不断取得进展,但由于各种耐药菌株在全球范围内的传播,该疾病的负担仍然很高。准确的诊断对于有效控制该疾病至关重要。然而,由于在流行地区也普遍存在的其他发热性疾病症状重叠,基于临床表现的伤寒诊断具有挑战性。目前的实验室检测显示出不理想的敏感性和特异性,并且没有可用于识别无症状携带者的诊断方法。几个研究项目采用了系统方法来识别更特异的生物标志物用于早期检测和无症状携带者检测。本综述讨论了目前可用的伤寒诊断测试的优缺点、改进诊断测试的研究进展以及发现新的理想生物标志物和测试的挑战。

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