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分子遗传学检测 GeneXpert MTB/RIF 和 Xpert MTB/RIF(Ultra)在结核病诊断中的应用(文献综述)。

Molecular genetic tests GeneXpert MTB/RIF and Xpert MTB/RIF (Ultra) in the diagnosis of tuberculosis (review of literature).

机构信息

Samara State Medical University.

出版信息

Klin Lab Diagn. 2022 Sep 12;67(9):544-549. doi: 10.51620/0869-2084-2022-67-9-544-549.

DOI:10.51620/0869-2084-2022-67-9-544-549
PMID:36099465
Abstract

In recent tuberculosis years is the main cause of morbidity and death among patients with HIV infection. Modern diagnostics of tuberculosis includes mass screening of the population: digital fluorography from the age of 15 and immunodiagnostics in children and adolescents. Detection of mycobacterium tuberculosis by microscopy occurs in forms of tuberculosis with the decay of lung tissue. Such patients represent a high epidemic risk. To improve the verification of diagnosis in the practice of a phthisiologist, molecular genetic methods for the search for mycobacteria are increasingly used, based on the identification of specific fragments of the DNA chain in the diagnostic material. The most widely used method is the polymerase chain reaction (PCR), which is based on directed DNA amplification. The latest innovation is fully automated systems using cartridge technology GeneXpert. The advantages of GeneXpert are high sensitivity, speed (result in 2 hours), real-time PCR detection, exclusion of sample contamination. The technique of cartridge technology is constantly being improved, various cartridges are used on its platform, which not only detect M. tuberculosis, but also determine the sensitivity to anti-tuberculosis drugs - rifampicin (MTB / RIF cartridge) or several anti-TB drugs (MTB / XDR). Cartridges have been developed that are able to detect Mycobacterium tuberculosis (MBT) at an even lower concentration in the test material - MTB / RIF (Ultra). GeneXpert technology can be used to diagnose extrapulmonary tuberculosis by examining various biological materials, which are more effective in detecting tuberculosis in children and adolescents, in HIV-positive individuals.

摘要

近年来,结核病是导致 HIV 感染者发病和死亡的主要原因。结核病的现代诊断包括对人群进行大规模筛查:15 岁以上人群进行数字化荧光透视检查,儿童和青少年进行免疫诊断。通过显微镜检测分枝杆菌发生在肺组织坏死的结核病形式中。此类患者具有较高的流行风险。为了提高在肺病学家实践中诊断的验证,越来越多地使用基于在诊断材料中鉴定特定 DNA 链片段的寻找分枝杆菌的分子遗传学方法。应用最广泛的方法是聚合酶链反应(PCR),它基于定向 DNA 扩增。最新的创新是使用盒式技术 GeneXpert 的全自动系统。GeneXpert 的优势在于高灵敏度、速度(2 小时内得出结果)、实时 PCR 检测、排除样本污染。盒式技术不断得到改进,各种盒式在其平台上使用,不仅可以检测结核分枝杆菌,还可以确定对抗结核药物的敏感性-利福平(MTB / RIF 盒)或几种抗 TB 药物(MTB / XDR)。已经开发出能够在测试材料中以更低浓度检测结核分枝杆菌(MBT)的盒式- MTB / RIF(Ultra)。GeneXpert 技术可用于通过检查各种生物材料来诊断肺外结核病,在检测儿童和青少年、HIV 阳性个体中的结核病方面更有效。

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