<span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Background: </span></b></span><span><span><span style="font-family:&...<span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Background: </span></b></span><span><span><span style="font-family:""><span style="font-family:Verdana;">Due to the limitations of diagnosis by Xpert MTB/RIF assay, WHO suggests Loop</span><b><span style="font-family:Verdana;">—</span></b><span style="font-family:Verdana;">Mediated Isothermal Amplification (TB-LAMP) instead of sputum-smear microscopy for pulmonary TB diagnosis in patients. Dr. Thongchai Kaewphinit <i></span><i><span style="font-family:Verdana;">et al</span></i><span style="font-family:Verdana;"></i></span><i><span style="font-family:Verdana;">.</span></i><span style="font-family:Verdana;"> invented a fast TB detection kit called TB d-tect (LAMP-LFD assay). There was no clinical trial to estimate the performance of TB d-tect. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> This study was aimed to find the performance of LFD assay and Xpert MTB/RIF ultra for pulmonary TB. </span><b><span style="font-family:Verdana;">Material</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">methods:</span></b><span style="font-family:Verdana;"> A cross-sectional study was conducted. Suggestive pulmonary TB patients were enrolled from June 2020-28 February 2021.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Respiratory specimen</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> were collected from each patient and sent for AFB smear, LAMP-LFD assay, Xpert MTB/RIF ultra and culture TB. </span><b><span style="font-family:Verdana;">Result:</span></b><span style="font-family:Verdana;"> 139 patients with suspected pulmonary TB were enrolled.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">51% of patients were diagnosed with pulmonary tuberculosis. Based on culture TB as a gold standard, the sensitivity and specificity of LAMP-LFD assay were 85.4% (95% CI:</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">70.8% - 94.4%) and 87.8% (95% CI:</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">79.6 - 93.5), respectively. The sensitivity and specificity of Xpert MTB/RIF ultra were 95.1% (95% CI: 83.5% - 99.4%) and 74.5% (95% CI: 64.7 - 82.8), respectively. According to ROC curve, it was found that the areas under the curve of LAMP-LFD assay and Xpert MTB/RIF ultra were 0.866 and 0.848, respectively (</span><span style="font-family:Verdana;">p</span><span style="font-family:Verdana;"> = 0.546). </span><b><span style="font-family:Verdana;">Conclusion</span></b><span style="font-family:Verdana;">: The diagnostic sensitivity and specificity of LAMP-LFD assay appeared to be comparable to those of Xpert MTB/RIF ultra. LAMP-LFD assay could be used in resource limiting laboratory.展开更多
目的探讨Xpert MTB/RIF联合宏基因组高通量测序对菌阴肺结核的诊断价值。方法回顾性分析2019年12月至2022年5月诊断为菌阴肺结核的70例患者,分别进行XpertMTB/RIF检测、宏基因组高通量测序及二者联合检测。采用固体培养法和比例法对生...目的探讨Xpert MTB/RIF联合宏基因组高通量测序对菌阴肺结核的诊断价值。方法回顾性分析2019年12月至2022年5月诊断为菌阴肺结核的70例患者,分别进行XpertMTB/RIF检测、宏基因组高通量测序及二者联合检测。采用固体培养法和比例法对生化病原菌进行诊断并分析诊断效能。采用预测值绘制受试者操作特征曲线。结果Xpert MTB/RIF诊断阳性率75.57%,阴性率21.43%;宏基因组高通量测序诊断阳性率78.57%,阴性率21.43%;联合诊断阳性率88.57%,阴性率11.43%。Xpert MTB/RIF检测敏感度为77.55%、特异性为59.86%,曲线下面积(area under the curve,AUC)为0.827;宏基因组高通量测序检测敏感度为77.47%、特异性为61.02%,AUC为0.808;联合检测敏感度为89.75%、特异性为89.57%,AUC为0.925。结果显示Xpert MTB/RIF联合宏基因组高通量测序在菌阴肺结核中诊断的敏感度、特异性均高于单一检测(P<0.05)。结论XpertMTB/RIF联合宏基因组高通量测序在菌阴肺结核诊断中具有较好的应用价值,值得临床推广使用。展开更多
Today, tuberculosis (TB) remains a global public health threat associated with significantly high rates of morbidity and mortality. The World Health Organization's (WHO) Global Tuberculosis Report 2018[1] has repo...Today, tuberculosis (TB) remains a global public health threat associated with significantly high rates of morbidity and mortality. The World Health Organization's (WHO) Global Tuberculosis Report 2018[1] has reported that in 2017, 10.0 million people across the world had developed TB diseases that resulted in an estimated 1.6 million deaths, and 889, 000 people developed TB in China that led to 39, 000 TB-related deaths. Therefore, rapid and accurate detection of Mycobacterium tuberculosis (MTB) is important for initiating early treatment and reducing mortality. Traditional diagnostic methods for pulmonary TB incorporate chest radiography and sputum smear microscopy;however, several cases of tuberculosis go undiagnosed because of the low sensitivity of smear microscopy[2].展开更多
文摘<span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Background: </span></b></span><span><span><span style="font-family:""><span style="font-family:Verdana;">Due to the limitations of diagnosis by Xpert MTB/RIF assay, WHO suggests Loop</span><b><span style="font-family:Verdana;">—</span></b><span style="font-family:Verdana;">Mediated Isothermal Amplification (TB-LAMP) instead of sputum-smear microscopy for pulmonary TB diagnosis in patients. Dr. Thongchai Kaewphinit <i></span><i><span style="font-family:Verdana;">et al</span></i><span style="font-family:Verdana;"></i></span><i><span style="font-family:Verdana;">.</span></i><span style="font-family:Verdana;"> invented a fast TB detection kit called TB d-tect (LAMP-LFD assay). There was no clinical trial to estimate the performance of TB d-tect. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> This study was aimed to find the performance of LFD assay and Xpert MTB/RIF ultra for pulmonary TB. </span><b><span style="font-family:Verdana;">Material</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">methods:</span></b><span style="font-family:Verdana;"> A cross-sectional study was conducted. Suggestive pulmonary TB patients were enrolled from June 2020-28 February 2021.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Respiratory specimen</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> were collected from each patient and sent for AFB smear, LAMP-LFD assay, Xpert MTB/RIF ultra and culture TB. </span><b><span style="font-family:Verdana;">Result:</span></b><span style="font-family:Verdana;"> 139 patients with suspected pulmonary TB were enrolled.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">51% of patients were diagnosed with pulmonary tuberculosis. Based on culture TB as a gold standard, the sensitivity and specificity of LAMP-LFD assay were 85.4% (95% CI:</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">70.8% - 94.4%) and 87.8% (95% CI:</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">79.6 - 93.5), respectively. The sensitivity and specificity of Xpert MTB/RIF ultra were 95.1% (95% CI: 83.5% - 99.4%) and 74.5% (95% CI: 64.7 - 82.8), respectively. According to ROC curve, it was found that the areas under the curve of LAMP-LFD assay and Xpert MTB/RIF ultra were 0.866 and 0.848, respectively (</span><span style="font-family:Verdana;">p</span><span style="font-family:Verdana;"> = 0.546). </span><b><span style="font-family:Verdana;">Conclusion</span></b><span style="font-family:Verdana;">: The diagnostic sensitivity and specificity of LAMP-LFD assay appeared to be comparable to those of Xpert MTB/RIF ultra. LAMP-LFD assay could be used in resource limiting laboratory.
文摘目的探讨Xpert MTB/RIF联合宏基因组高通量测序对菌阴肺结核的诊断价值。方法回顾性分析2019年12月至2022年5月诊断为菌阴肺结核的70例患者,分别进行XpertMTB/RIF检测、宏基因组高通量测序及二者联合检测。采用固体培养法和比例法对生化病原菌进行诊断并分析诊断效能。采用预测值绘制受试者操作特征曲线。结果Xpert MTB/RIF诊断阳性率75.57%,阴性率21.43%;宏基因组高通量测序诊断阳性率78.57%,阴性率21.43%;联合诊断阳性率88.57%,阴性率11.43%。Xpert MTB/RIF检测敏感度为77.55%、特异性为59.86%,曲线下面积(area under the curve,AUC)为0.827;宏基因组高通量测序检测敏感度为77.47%、特异性为61.02%,AUC为0.808;联合检测敏感度为89.75%、特异性为89.57%,AUC为0.925。结果显示Xpert MTB/RIF联合宏基因组高通量测序在菌阴肺结核中诊断的敏感度、特异性均高于单一检测(P<0.05)。结论XpertMTB/RIF联合宏基因组高通量测序在菌阴肺结核诊断中具有较好的应用价值,值得临床推广使用。
基金supported by the National Science and Technology Major Project [2018ZX10103001]the National Natural Science Foundation of China [8161101571]
文摘Today, tuberculosis (TB) remains a global public health threat associated with significantly high rates of morbidity and mortality. The World Health Organization's (WHO) Global Tuberculosis Report 2018[1] has reported that in 2017, 10.0 million people across the world had developed TB diseases that resulted in an estimated 1.6 million deaths, and 889, 000 people developed TB in China that led to 39, 000 TB-related deaths. Therefore, rapid and accurate detection of Mycobacterium tuberculosis (MTB) is important for initiating early treatment and reducing mortality. Traditional diagnostic methods for pulmonary TB incorporate chest radiography and sputum smear microscopy;however, several cases of tuberculosis go undiagnosed because of the low sensitivity of smear microscopy[2].
