Department of Materials Science and Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, 21218, MD, USA.
Institute for NanoBioTechnology, Johns Hopkins University, Baltimore, 21218, MD, USA.
J Mater Sci Mater Med. 2024 Sep 30;35(1):57. doi: 10.1007/s10856-024-06829-4.
Tuberculosis (TB) is the top cause of death from a single infectious pathogen after COVID-19. Despite molecular diagnostic advances, two-thirds of the 10 million annual TB cases are still diagnosed using direct smear microscopy which has ~50% sensitivity. To increase the analytical performance of smear microscopy, we developed and characterized a novel polymer (Polydiallyldimethylammonium chloride [PDADMAC]) engraftment on inexpensive polystyrene (PS) specifically functionalized for mycobacterial capture. Engraftment is achieved via UV photopolymerization of DADMAC monomer on plasma-activated PS. The platform was tested on sputum from presumptive TB cases in Kampala, Uganda (n = 50), with an increased overall sensitivity of 81.8% (27/33) vs. fluorescent smear microscopy 57% (19/33) compared to a molecular (Cepheid GeneXpert MTB/RIF) gold standard. Frugal smear diagnostic innovation that is rapid and does not require dedicated instrumentation may offer an important solution to bridge the TB diagnostic gap.
结核病（TB）是继 COVID-19 之后单一感染病原体导致死亡的首要原因。尽管分子诊断技术取得了进步，但在每年 1000 万例结核病病例中，仍有三分之二是通过直接涂片显微镜检查诊断的，其敏感性约为 50%。为了提高涂片显微镜检查的分析性能，我们开发并表征了一种新型聚合物（聚二烯丙基二甲基氯化铵[PDADMAC]），该聚合物专门嫁接到经过等离子体功能化的廉价聚苯乙烯（PS）上，用于分枝杆菌捕获。通过在等离子体处理的 PS 上光聚合 DADMAC 单体来实现接枝。该平台在乌干达坎帕拉疑似结核病病例的痰液中进行了测试（n=50），与荧光涂片显微镜检查相比，总体敏感性提高了 81.8%（27/33），荧光涂片显微镜检查为 57%（19/33），而分子（Cepheid GeneXpert MTB/RIF）金标准。快速且不需要专用仪器的节俭涂片诊断创新可能为解决结核病诊断差距提供重要解决方案。
