风中低语：用于检测儿童肺结核患者结核分枝杆菌的面罩采样
Whispers in the Wind: Face Mask Sampling for Mycobacterium tuberculosis Detection in Children With Pulmonary Tuberculosis.
作者信息
Meiwes Lennard, Kontsevaya Irina, Chesov Dumitru, Kulciţkaia Stela, Dreyer Viola, Hillemann Doris, Dlamini Qiniso, Williams Caroline, Barer Michael, Brinkmann Folke, Krüger Renate, Thee Stephanie, Kay Alexander, Mandalakas Anna Maria, Lange Christoph
机构信息
Clinical Infectious Diseases, Research Centre Borstel, Borstel, Germany.
Clinical Tuberculosis Unit, German Centre for Infection Research, Borstel, Germany.
出版信息
J Infect Dis. 2024 Dec 16;230(6):1510-1517. doi: 10.1093/infdis/jiae282.
BACKGROUND
Recently, face mask sampling (FMS) confirmed detection of Mycobacterium tuberculosis DNA from exhaled breath in adults with tuberculosis. To date, no study has evaluated the use of FMS to detect pulmonary tuberculosis in children. We developed a method for FMS of M. tuberculosis-specific DNA in children and performed a clinical exploration to assess feasibility in children.
METHODS
Face masks were spiked, analyzed on GeneXpert-Ultra, quantitative polymerase chain reaction, and targeted next-generation sequencing. Children with pulmonary tuberculosis were asked to wear 3 modified FFP2 masks for 30 minutes as part of an exploratory clinical study.
RESULTS
Experiments with H37Ra M. tuberculosis strain showed a limit of 95% detection of 3.75 colony-forming units (95% confidence interval, 4.85-3.11) on GeneXpert-Ultra. Ten children with pulmonary tuberculosis participated in the clinical study. M. tuberculosis-specific DNA was detected on none of the face masks.
CONCLUSIONS
Pediatric FMS has a low limit of detection for M. tuberculosis-specific DNA in vitro. However, M. tuberculosis DNA was not detected in any of 30 masks worn by children with pulmonary tuberculosis. This suggests that FMS in this form may not be more effective for detecting M. tuberculosis in children with tuberculosis than existing methods.
背景
最近，面罩采样（FMS）证实可从患有结核病的成年人呼出气体中检测出结核分枝杆菌DNA。迄今为止，尚无研究评估FMS用于检测儿童肺结核的情况。我们开发了一种用于儿童结核分枝杆菌特异性DNA的FMS方法，并进行了一项临床探索以评估其在儿童中的可行性。
方法
对面罩进行加样，采用GeneXpert-Ultra、定量聚合酶链反应和靶向新一代测序进行分析。作为一项探索性临床研究的一部分，要求患有肺结核的儿童佩戴3个改良的FFP2口罩30分钟。
结果
对H37Ra结核分枝杆菌菌株进行的实验显示，在GeneXpert-Ultra上检测限为95%时为3.75个菌落形成单位（95%置信区间，4.85 - 3.11）。10名患有肺结核的儿童参与了临床研究。在任何一个面罩上均未检测到结核分枝杆菌特异性DNA。
结论
儿科FMS对体外结核分枝杆菌特异性DNA的检测限较低。然而，患有肺结核的儿童佩戴的30个口罩中，任何一个都未检测到结核分枝杆菌DNA。这表明这种形式的FMS在检测患有结核病的儿童中的结核分枝杆菌方面可能并不比现有方法更有效。
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