Xpert MTB/RIF和Xpert Ultra在对结核病传播给家庭接触者的风险进行分类方面的效用。
Usefulness of Xpert MTB/RIF and Xpert Ultra to Categorize Risk of Tuberculosis Transmission to Household Contacts.
作者信息
Mol Alexander, Sánchez-Montalvá Adrián, Espinosa-Pereiro Juan, Aznar Maria Luisa, Salvador Fernando, Bosch-Nicolau Pau, de Souza-Galvão Maria-Luiza, Jiménez María Ángeles, Rodrigo-Pendás José Ángel, Millet Joan-Pau, Saborit Nuria, Broto Claudia, Molina Israel, Tórtola Teresa
机构信息
International Health Unit Vall D'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain.
Grupo de Estudio de Infecciones por Micobacterias, Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica, Madrid, Spain.
出版信息
Open Forum Infect Dis. 2024 Aug 6;11(8):ofae450. doi: 10.1093/ofid/ofae450. eCollection 2024 Aug.
BACKGROUND
People with pulmonary tuberculosis (PTB) are contagious, particularly to their household contacts. Their infectivity has been associated with the bacterial load in sputum samples. This study investigated if the bacterial load in sputum samples as quantified by Xpert MTB/RIF and Xpert Ultra is correlated with the extent that latent tuberculosis infection (LTBI) occurred in household contacts of people with PTB.
METHODS
A retrospective study was performed including people with PTB presenting at Vall d'Hebron University Hospital, Barcelona, between 2011 and 2021. Their infection ratio, representing the proportion of household members found with LTBI in contact tracing investigation, was compared with the quantitative results of Xpert MTB/RIF and Xpert Ultra using ordinal regression analysis.
RESULTS
A total of 107 people with PTB were included. Among their 398 household contacts, 126 (31.7%) cases of LTBI and 14 cases with active TB disease (3.5%) were reported. Higher bacterial load in Xpert MTB/RIF and Xpert Ultra baseline sputum was significantly associated with increased infection ratios, providing better estimates than conventional acid-fast bacilli (AFB) smear grading.
CONCLUSIONS
Xpert MTB/RIF and Xpert Ultra could serve as an alternative to AFB sputum-smear grading in determining contact tracing priorities.
背景
肺结核患者具有传染性，尤其是对其家庭接触者。他们的传染性与痰标本中的细菌载量有关。本研究调查了采用Xpert MTB/RIF和Xpert Ultra定量的痰标本中的细菌载量是否与肺结核患者家庭接触者中发生潜伏性结核感染（LTBI）的程度相关。
方法
进行了一项回顾性研究，纳入了2011年至2021年间在巴塞罗那的瓦尔德希伯伦大学医院就诊的肺结核患者。使用有序回归分析，将他们的感染率（代表在接触者追踪调查中发现LTBI的家庭成员比例）与Xpert MTB/RIF和Xpert Ultra的定量结果进行比较。
结果
共纳入107例肺结核患者。在他们的398名家庭接触者中，报告了126例（31.7%）LTBI病例和14例活动性结核病病例（3.5%）。Xpert MTB/RIF和Xpert Ultra基线痰标本中较高的细菌载量与感染率增加显著相关，比传统的抗酸杆菌（AFB）涂片分级提供了更好的估计。
结论
在确定接触者追踪优先级方面，Xpert MTB/RIF和Xpert Ultra可作为AFB痰涂片分级的替代方法。
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