Comella-Del-Barrio Patricia, Molina-Moya Bárbara, Gautier Jacqueline, Villar-Hernández Raquel, Doresca Mariette Jean Coute, Sallés-Mingels Beatriz, Canales-Aliaga Lydia, Narcisse Margareth, Pérez-Porcuna Tomás M, Creswell Jacob, Cuevas Luis E, Domínguez José
Institut d'Investigació Germans Trias i Pujol, CIBER Enfermedades Respiratorias, Universitat Autònoma de Barcelona, 08916 Barcelona, Spain.
Department of Pediatrics, Division of Tuberculosis, Hôpital Saint-Damien, Nos Petits-Frères et Sœurs, Port-au-Prince 6112, Haiti.
J Clin Med. 2021 Apr 28;10(9):1914. doi: 10.3390/jcm10091914.
Current diagnostics for tuberculosis (TB) only manage to confirm a small proportion of children with TB and require respiratory samples, which are difficult to obtain. There is a need for non-invasive biomarker-based tests as an alternative to sputum testing. Fujifilm SILVAMP TB lipoarabinomannan (FujiLAM), a lateral-flow test to detect lipoarabinomannan in urine, is a novel non-sputum-based point-of-care diagnostic reported to have increased sensitivity for the diagnosis of TB among human immunodeficiency virus (HIV)-infected adults. We evaluate the performance of FujiLAM in children with presumptive TB. Fifty-nine children attending a paediatric hospital in Haiti with compatible signs and symptoms of TB were examined using Xpert MTB/RIF, smear microscopy and X-rays, and classified according to the certainty of diagnosis into bacteriologically confirmed TB ( = 5), unconfirmed TB (bacteriologically negative, = 50) and unlikely TB ( = 4). Healthy children ( = 20) were enrolled as controls. FujiLAM sensitivity and specificity were 60% and 95% among children with confirmed TB. FujiLAM's high specificity and its characteristics as a point-of-care indicate the test has a good potential for the diagnosis of TB in children.
目前的结核病（TB）诊断方法仅能确诊一小部分患有结核病的儿童，且需要呼吸道样本，而获取这些样本很困难。因此，需要基于非侵入性生物标志物的检测方法来替代痰液检测。富士胶片SILVAMP TB脂阿拉伯甘露聚糖检测（FujiLAM）是一种用于检测尿液中脂阿拉伯甘露聚糖的侧向流动检测方法，是一种新型的非痰液即时诊断方法，据报道，该方法在人类免疫缺陷病毒（HIV）感染的成年人中对结核病诊断的敏感性有所提高。我们评估了FujiLAM在疑似结核病儿童中的性能。对海地一家儿科医院的59名有结核病相关体征和症状的儿童进行了Xpert MTB/RIF检测、涂片显微镜检查和X射线检查，并根据诊断的确定性分为细菌学确诊的结核病（n = 5）、未确诊的结核病（细菌学阴性，n = 50）和疑似结核病（n = 4）。招募了20名健康儿童作为对照。在确诊为结核病的儿童中，FujiLAM的敏感性和特异性分别为60%和95%。FujiLAM的高特异性及其即时诊断的特点表明，该检测方法在儿童结核病诊断方面具有良好的潜力。
