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分子诊断学的应用和进展:革新非结核分枝杆菌种和亚种鉴定。

Applications and advances in molecular diagnostics: revolutionizing non-tuberculous mycobacteria species and subspecies identification.

机构信息

Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China.

Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China.

出版信息

Front Public Health. 2024 Jun 19;12:1410672. doi: 10.3389/fpubh.2024.1410672. eCollection 2024.

Abstract

Non-tuberculous mycobacteria (NTM) infections pose a significant public health challenge worldwide, affecting individuals across a wide spectrum of immune statuses. Recent epidemiological studies indicate rising incidence rates in both immunocompromised and immunocompetent populations, underscoring the need for enhanced diagnostic and therapeutic approaches. NTM infections often present with symptoms similar to those of tuberculosis, yet with less specificity, increasing the risk of misdiagnosis and potentially adverse outcomes for patients. Consequently, rapid and accurate identification of the pathogen is crucial for precise diagnosis and treatment. Traditional detection methods, notably microbiological culture, are hampered by lengthy incubation periods and a limited capacity to differentiate closely related NTM subtypes, thereby delaying diagnosis and the initiation of targeted therapies. Emerging diagnostic technologies offer new possibilities for the swift detection and accurate identification of NTM infections, playing a critical role in early diagnosis and providing more accurate and comprehensive information. This review delineates the current molecular methodologies for NTM species and subspecies identification. We critically assess the limitations and challenges inherent in these technologies for diagnosing NTM and explore potential future directions for their advancement. It aims to provide valuable insights into advancing the application of molecular diagnostic techniques in NTM infection identification.

摘要

非结核分枝杆菌(NTM)感染在全球范围内构成重大公共卫生挑战,影响着广泛免疫状态的个体。最近的流行病学研究表明,免疫功能低下和免疫功能正常人群的发病率都在上升,这凸显了需要增强诊断和治疗方法。NTM 感染常表现出与结核病相似的症状,但特异性较低,增加了误诊的风险,并可能对患者产生不利后果。因此,快速准确地识别病原体对于精确诊断和治疗至关重要。传统的检测方法,特别是微生物培养,受到较长的孵育期和有限的区分密切相关的 NTM 亚型的能力的限制,从而延迟了诊断和靶向治疗的开始。新兴的诊断技术为 NTM 感染的快速检测和准确鉴定提供了新的可能性,在早期诊断中发挥着关键作用,并提供更准确和全面的信息。本综述描述了用于 NTM 种和亚种鉴定的当前分子方法学。我们批判性地评估了这些技术在诊断 NTM 方面的局限性和挑战,并探讨了它们未来发展的潜在方向。其旨在为推进分子诊断技术在 NTM 感染鉴定中的应用提供有价值的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f698/11220129/0ee31ad47be6/fpubh-12-1410672-g001.jpg

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