Rapid Diagnosis of Mycobacterium tuberculosis Infection and Drug Susceptibility Testing
Rapid Diagnosis of Mycobacterium tuberculosis Infection and Drug Susceptibility Testing
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DOI：
10.5858/arpa.2011-0578-ra
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发表时间：
2013-06-01
影响因子：
4.6
通讯作者：
Wilson, Michael L.
中科院分区：
文献类型：
--
作者：
Wilson, Michael L.
背景。从诊断、检测耐药性和治疗的角度来看，结核病的全球控制仍然是一个挑战。这是妇女和儿童健康特别关注的一个领域，特别是在世界上婴儿死亡率高的地区，妇女获得保健的机会有限。由于只有在检测到感染时才能开始治疗，并且由抗菌药物敏感性测试的结果指导，因此最近在开发和测试用于检测结核分枝杆菌复合群的新型检测方法方面有了显著增加，同时检测或不检测对异烟肼和/或利福平的耐药性。已经开发了非分子和分子测定。本综述将总结目前使用快速检测结核分枝杆菌和耐药性的知识。数据来源。回顾最新的世界卫生组织全球结核病报告，以及主要研究文献，荟萃分析和综述文章中的选定出版物。在很大程度上，非分子方法是对传统方法的改进或修改，其主要目标是提供更快速的测试结果。相比之下，分子方法使用新技术来检测结核分枝杆菌复合体和赋予耐药性的基因的存在。分子检测的评价通常表明，这些检测方法对于检测结核分枝杆菌复合群的存在具有可变的灵敏度，特别是当与涂片阴性标本一起使用时不敏感。作为一个群体，分子检测已被证明是高灵敏度检测利福平耐药性，但可变的灵敏度检测异烟肼耐药性。
Context.-The global control of tuberculosis remains a challenge from the standpoint of diagnosis, detection of drug resistance, and treatment. This is an area of special concern to the health of women and children, particularly in regions of the world with high infant mortality rates and where women have limited access to health care.Objective.-Because treatment can only be initiated when infection is detected, and is guided by the results of antimicrobial susceptibility testing, there recently has been a marked increase in the development and testing of novel assays designed to detect Mycobacterium tuberculosis complex, with or without simultaneous detection of resistance to isoniazid and/or rifampin. Both nonmolecular and molecular assays have been developed. This review will summarize the current knowledge about the use of rapid tests to detect M tuberculosis and drug resistance.Data Sources.-Review of the most recent World Health Organization Global Tuberculosis Report, as well as selected publications in the primary research literature, meta-analyses, and review articles.Conclusions.-To a large extent, nonmolecular methods are refinements or modifications of conventional methods, with the primary goal of providing more rapid test results. In contrast, molecular methods use novel technologies to detect the presence of M tuberculosis complex and genes conferring drug resistance. Evaluations of molecular assays have generally shown that these assays are of variable sensitivity for detecting the presence of M tuberculosis complex, and in particular are insensitive when used with smear-negative specimens. As a group, molecular assays have been shown to be of high sensitivity for detecting resistance to rifampin, but of variable sensitivity for detecting resistance to isoniazid.