Molecular detection of Mycobacterium tuberculosis from sputum transported in Prime Store from rural settings
Molecular detection of Mycobacterium tuberculosis from sputum transported in Prime Store from rural settings
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DOI：
10.5588/ijtld.14.0769
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发表时间：
2015-05-01
影响因子：
4
通讯作者：
Fischer, G. W.
中科院分区：
文献类型：
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作者：
Daum, L. T.;Peters, R. P. H.;Fischer, G. W.
周边环境：南非莫帕尼区。目的：与使用显微镜或Xpert (R) MTB/RIF作为基线测试的设置相比，探索使用PrimeStore (R)分子传输介质（PS-MTM）运输的痰液中结核分枝杆菌的远程分子检测。设计：在南非农村的诊所收集两份痰标本，患者咳嗽bb0 = 2周。在咳痰后不久，在使用Xpert、显微镜和液体培养处理之前，在每个样本中旋转一根棉签，并将其放置在PS-MTM中。将拭子储存并在室温下运往美国进行实时PrimeMix (R)聚合酶链反应（PM-PCR）。结果：132例患者中，镜检阳性23例（17%），Xpert阳性39例（30%），PS-MTM/PM-PCR阳性44例（33%）。PS-MTM/PM-PCR与阳性镜检和Xpert的符合率分别为96%和85%。107份显微镜阴性样品中，22份（21%）PS-MTM/PM-PCR阳性，11/91份（12%）xpert阴性样品PS-MTM/PM-PCR阳性。PS-MTM/PM-PCR阳性显著高于涂片镜检阳性（P < 0.001），与Xpert相似（P = 0.33）。结论：用PS-MTM运输的标本进行PCR检测，可在涂片镜检为基线诊断检测的环境中提高结核病诊断，并可在无法使用Xpert检测的环境中提供替代方法。
SETTING: Mopani District, South Africa.OBJECTIVE: To explore remote, molecular detection of Mycobacterium tuberculosis from sputum transported using PrimeStore (R) Molecular Transport Medium (PS-MTM) compared to settings where microscopy or Xpert (R) MTB/RIF is used as the baseline test.DESIGN: Two sputum specimens were collected from patients with cough of >= 2 weeks at clinics in rural South Africa. Shortly after expectoration and before processing using Xpert, microscopy and liquid culture, a flocked swab was swirled in each of these specimens and placed in PS-MTM. Swabs were stored and transported to the United States at ambient temperature for real-time PrimeMix (R) polymerase chain reaction (PM-PCR).RESULTS: Of 132 patients, 23 (17%) were positive on microscopy, 39 (30%) on Xpert and 44 (33%) by PS-MTM/PM-PCR. Concordance of PS-MTM/PM-PCR with positive microscopy and Xpert was respectively 96% and 85%. Of 107 microscopy-negative samples, 22 (21%) were positive using PS-MTM/PM-PCR, while 11/91 (12%) Xpert-negative samples were PS-MTM/ PM-PCR-positive. PS-MTM/PM-PCR positivity was significantly higher than smear microscopy positivity (P < 0.001), but similar to Xpert (P = 0.33).CONCLUSION: PCR testing of specimens transported in PS-MTM would enhance TB diagnosis in settings where smear microscopy is the baseline diagnostic test, and could provide an alternative in settings where Xpert testing is not available.