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结核病实验室诊断的演变

Evolution of Laboratory Diagnosis of Tuberculosis.

作者信息

Zaporojan Natalia, Negrean Rodica Anamaria, Hodișan Ramona, Zaporojan Claudiu, Csep Andrei, Zaha Dana Carmen

机构信息

Doctoral School of Biomedical Sciences, University of Oradea, Str. Universitatii 1, 410087 Oradea, Romania.

Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, P-ta 1 December 10, 410087 Oradea, Romania.

出版信息

Clin Pract. 2024 Feb 23;14(2):388-416. doi: 10.3390/clinpract14020030.

Abstract

Tuberculosis (TB) is an infectious disease of global public health importance caused by the complex. Despite advances in diagnosis and treatment, this disease has worsened with the emergence of multidrug-resistant strains of tuberculosis. We aim to present and review the history, progress, and future directions in the diagnosis of tuberculosis by evaluating the current methods of laboratory diagnosis of tuberculosis, with a special emphasis on microscopic examination and cultivation on solid and liquid media, as well as an approach to molecular assays. The microscopic method, although widely used, has its limitations, and the use and evaluation of other techniques are essential for a complete and accurate diagnosis. Bacterial cultures, both in solid and liquid media, are essential methods in the diagnosis of TB. Culture on a solid medium provides specificity and accuracy, while culture on a liquid medium brings rapidity and increased sensitivity. Molecular tests such as LPA and Xpert MTB/RIF have been found to offer significant benefits in the rapid and accurate diagnosis of TB, including drug-resistant forms. These tests allow the identification of resistance mutations and provide essential information for choosing the right treatment. We conclude that combined diagnostic methods, using several techniques and approaches, provide the best result in the laboratory diagnosis of TB. Improving the quality and accessibility of tests, as well as the implementation of advanced technologies, is essential to help improve the sensitivity, efficiency, and accuracy of TB diagnosis.

摘要

结核病(TB)是一种由结核分枝杆菌复合体引起的具有全球公共卫生重要性的传染病。尽管在诊断和治疗方面取得了进展,但随着耐多药结核菌株的出现,这种疾病的情况仍在恶化。我们旨在通过评估结核病的当前实验室诊断方法,介绍并回顾结核病诊断的历史、进展和未来方向,特别强调显微镜检查以及在固体和液体培养基上的培养,还有分子检测方法。显微镜检查方法虽然被广泛使用,但有其局限性,使用和评估其他技术对于完整、准确的诊断至关重要。在固体和液体培养基上进行细菌培养都是结核病诊断的重要方法。在固体培养基上培养可提供特异性和准确性,而在液体培养基上培养则具有快速性和更高的敏感性。诸如线性探针分析(LPA)和Xpert MTB/RIF等分子检测已被发现对结核病(包括耐药形式)的快速、准确诊断具有显著益处。这些检测能够识别耐药突变,并为选择正确的治疗方法提供重要信息。我们得出结论,采用多种技术和方法的联合诊断方法在结核病的实验室诊断中能提供最佳结果。提高检测的质量和可及性,以及实施先进技术,对于提高结核病诊断的敏感性、效率和准确性至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c348/10961697/52bc238c0870/clinpract-14-00030-g001.jpg

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