Department of Medical Mycology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.
Front Cell Infect Microbiol. 2023 Jul 1;13:1183078. doi: 10.3389/fcimb.2023.1183078. eCollection 2023.
The clinical practicability of DNA microarray chip in detecting the presence of mycobacterial species/isolates directly in the skin tissues has not been evaluated, nor the efficacy of DNA microarray chip as a novel diagnostic tool for the early diagnosis of cutaneous mycobacterial infections is known.
The present study analyzed the incidence of cutaneous mycobacterial infections in Shanghai and explored the efficacy of a novel DNA microarray chip assay for the clinical diagnosis of the disease from skin tissue specimens compared to traditional detection methods. A total of 60 participants fulfilling the defined diagnostic criteria and confirmed positive for cutaneous mycobacterial infections from 2019 to 2021 were enrolled in the study. Subsequent to recording the participants' medical history and clinical characteristics, the skin tissue specimens were collected for analyses. The specimens underwent histopathological analyses, skin tissue culture, and DNA microarray chip assay.
Increased incidence of cutaneous mycobacterial infection was detected from 2019 to 2021. The most common infecting pathogen was followed by . The sensitivity, specificity and accuracy of the skin tissue culture method were 70%, 100% and 76.62%, respectively, while that of the DNA microarray chip assay were 91.67%, 100% and 93.51%, respectively. The sensitivity and accuracy of the DNA microarray chip assay were significantly higher than those of the skin tissue culture method. The positive likelihood and diagnostic odds ratio were >10 and >1, respectively for both the methods. The negative likelihood ratio was significantly higher (30% vs 8.33%) and the Youden's index was significantly lower (70.00% vs 91.67%) in the skin culture method compared to that of the DNA microarray chip assay. There was a significant association of false negative results with a history of antibiotic use in the skin tissue culture method.
Given the increasing incidence of cutaneous mycobacterial infections, early diagnosis remains a prime clinical focus. The DNA microarray chip assay provides a simple, rapid, high-throughput, and reliable method for the diagnosis of cutaneous mycobacterial infections with potential for clinical application.
DNA 微阵列芯片在直接检测皮肤组织中的分枝杆菌种/分离株的临床实用性尚未得到评估，也不知道 DNA 微阵列芯片作为一种早期诊断皮肤分枝杆菌感染的新型诊断工具的效果。
本研究分析了上海地区皮肤分枝杆菌感染的发生率，并探讨了新型 DNA 微阵列芯片检测方法与传统检测方法相比对皮肤组织标本临床诊断皮肤分枝杆菌感染的效果。本研究共纳入 2019 年至 2021 年确诊为皮肤分枝杆菌感染的 60 名符合既定诊断标准的患者。在记录患者的病史和临床特征后，采集皮肤组织标本进行分析。标本进行组织病理学分析、皮肤组织培养和 DNA 微阵列芯片检测。
2019 年至 2021 年检测到皮肤分枝杆菌感染的发病率增加。最常见的感染病原体是 ，其次是 。皮肤组织培养法的敏感性、特异性和准确性分别为 70%、100%和 76.62%，而 DNA 微阵列芯片法分别为 91.67%、100%和 93.51%。DNA 微阵列芯片法的敏感性和准确性明显高于皮肤组织培养法。两种方法的阳性似然比和诊断优势比均>10 和>1。皮肤组织培养法的阴性似然比显著较高（30%比 8.33%），Youden 指数显著较低（70.00%比 91.67%）。皮肤组织培养法中假阴性结果与抗生素使用史有显著相关性。
鉴于皮肤分枝杆菌感染的发病率不断增加，早期诊断仍是临床重点。DNA 微阵列芯片检测法为皮肤分枝杆菌感染的诊断提供了一种简便、快速、高通量、可靠的方法，具有临床应用潜力。
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