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古巴基层医疗环境中成年消化不良患者感染的诊断检测准确性

Diagnostic Testing Accuracy for Infection among Adult Patients with Dyspepsia in Cuba's Primary Care Setting.

作者信息

Duquesne Amílcar, Falcón Rosabel, Galindo Belkys, Feliciano Onelkis, Gutiérrez Oderay, Baldoquín Waldemar, Fonseca Magile C, Llanes Rafael, Sarmiento Luis

机构信息

Teaching Orthopedical Hospital Fructuoso Rodríguez, Havana City 10400, Cuba.

Department of Microbiology, Center for Research, Diagnosis and Reference, "Pedro Kourí" Institute of Tropical Medicine, Havana City 11400, Cuba.

出版信息

Microorganisms. 2023 Apr 11;11(4):997. doi: 10.3390/microorganisms11040997.

Abstract

Evidence of the effectiveness of the tests used to diagnose () in primary healthcare is limited. This cross-sectional study aims to assess the accuracy of tests used for to diagnose infection in primary care patients and its relationship with gastroduodenal pathologies. Over 12 months, 173 primary care patients with dyspeptic symptoms were referred for upper gastrointestinal endoscopy to obtain gastric biopsies, and venous blood was extracted from them. infection was detected using a rapid urease test (RUT), real-time polymerase chain reaction (RT-PCR), -IgG ELISA, and Western blot (WB). The culture and histological findings were used as the reference standard for infection. prevalence was 50%. There were no significant differences between men and women overall or by age group. The presence of was associated with chronic moderate gastritis and its absence with chronic inactive gastritis, as well as the combination of gastritis and gastric lesions ( 0.05). RUT and ELISA -IgG tests showed the highest overall performance (accuracy 98.9% and 84.4%), followed by WB and RT-PCR (accuracy 79.3% and 73.9%). These findings support the notion that combined invasive and noninvasive methods, such as RUT and -IgG ELISA, can be a primary diagnostic screening tool for detecting among adult dyspeptic patients in Cuba's primary care setting.

摘要

用于在初级医疗保健中诊断()的检测方法有效性的证据有限。这项横断面研究旨在评估用于诊断初级保健患者感染的检测方法的准确性及其与胃十二指肠病变的关系。在12个月的时间里,173名有消化不良症状的初级保健患者被转诊进行上消化道内镜检查以获取胃活检样本,并从他们身上采集静脉血。使用快速尿素酶试验(RUT)、实时聚合酶链反应(RT-PCR)、-IgG酶联免疫吸附测定(ELISA)和蛋白质印迹法(WB)检测感染情况。培养和组织学检查结果被用作感染的参考标准。感染率为50%。总体上以及按年龄组划分,男性和女性之间均无显著差异。感染的存在与慢性中度胃炎相关,不存在感染则与慢性非活动性胃炎相关,以及与胃炎和胃部病变的组合相关(P<0.05)。RUT和ELISA -IgG检测显示出最高的总体性能(准确率分别为98.9%和84.4%),其次是WB和RT-PCR(准确率分别为79.3%和73.9%)。这些发现支持这样一种观点,即联合使用侵入性和非侵入性方法,如RUT和-IgG ELISA,可作为古巴初级保健环境中成年消化不良患者检测感染的主要诊断筛查工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2291/10146794/a453abeb589e/microorganisms-11-00997-g001.jpg

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