Face Mask Sampling for the Detection of Mycobacterium tuberculosis in Expelled Aerosols
Face Mask Sampling for the Detection of Mycobacterium tuberculosis in Expelled Aerosols
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DOI：
10.1371/journal.pone.0104921
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发表时间：
2014-08-14
期刊：
影响因子：
3.7
通讯作者：
Barer, Michael R.
中科院分区：
文献类型：
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作者：
Williams, Caroline M. L.;Cheah, Eddy S. G.;Barer, Michael R.
背景：虽然结核病是通过空中传播的，但有关源病例向空气中自然输出杆菌的直接信息非常有限。我们试图通过对口罩中排出的气雾剂进行采样来解决这个问题，随后对其进行分枝杆菌污染分析。方法：在系列1中，17名涂片镜检阳性患者佩戴一次或两次标准外科口罩，持续时间为10分钟至5小时；使用噬菌体检测分枝杆菌污染。在系列2中，19名疑似肺结核患者在英国莱斯特被研究，10名至少有一次涂片阳性的患者在冈比亚被研究。这些受试者戴上一个改装成含有明胶过滤器的FFP30口罩1小时，然后用Xpert MTB/RIF系统进行分析。结果：在系列1中，噬菌体试验在11/17名患者中检测到活的分枝杆菌，佩戴时间在10到120分钟之间。在同一患者的多个样本中检测到的口罩阳性和污染水平存在差异。两名患者为非结核分枝杆菌感染。在系列2中，13/20例肺结核患者产生阳性MASK，9例肺外或非结核诊断的患者MASK阳性。总体而言，65%的确诊肺部分枝杆菌感染患者使用了阳性口罩，其中3/6的患者接受了诊断用的支气管肺泡灌洗液。结论：口罩采样提供了一种简单的方法来评估非痰痰中的分枝杆菌产量。该方法在空气传播研究和诊断中显示出潜在的应用前景。
Background: Although tuberculosis is transmitted by the airborne route, direct information on the natural output of bacilli into air by source cases is very limited. We sought to address this through sampling of expelled aerosols in face masks that were subsequently analyzed for mycobacterial contamination.Methods: In series 1, 17 smear microscopy positive patients wore standard surgical face masks once or twice for periods between 10 minutes and 5 hours; mycobacterial contamination was detected using a bacteriophage assay. In series 2, 19 patients with suspected tuberculosis were studied in Leicester UK and 10 patients with at least one positive smear were studied in The Gambia. These subjects wore one FFP30 mask modified to contain a gelatin filter for one hour; this was subsequently analyzed by the Xpert MTB/RIF system.Results: In series 1, the bacteriophage assay detected live mycobacteria in 11/17 patients with wearing times between 10 and 120 minutes. Variation was seen in mask positivity and the level of contamination detected in multiple samples from the same patient. Two patients had non-tuberculous mycobacterial infections. In series 2, 13/20 patients with pulmonary tuberculosis produced positive masks and 0/9 patients with extrapulmonary or non-tuberculous diagnoses were mask positive. Overall, 65% of patients with confirmed pulmonary mycobacterial infection gave positive masks and this included 3/6 patients who received diagnostic bronchoalveolar lavages.Conclusion: Mask sampling provides a simple means of assessing mycobacterial output in non-sputum expectorant. The approach shows potential for application to the study of airborne transmission and to diagnosis.