TB or not TB? Definitive determination of species within the Mycobacterium tuberculosis complex in unprocessed sputum from adults with presumed multidrug-resistant tuberculosis.
TB or not TB? Definitive determination of species within the Mycobacterium tuberculosis complex in unprocessed sputum from adults with presumed multidrug-resistant tuberculosis.
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TB还是TB？对假定为耐多药结核病的成人未处理痰液中结核分枝杆菌复合群内的菌种进行连续测定
DOI：
10.1111/tmi.13638
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发表时间：
2021-09
期刊：
影响因子：
--
通讯作者：
Mpagama S
中科院分区：
文献类型：
--
作者：
Mbelele PM;Sauli E;Mpolya EA;Mohamed SY;Addo KK;Mfinanga SG;Heysell SK;Mpagama S
结核分枝杆菌复合群（MTC）物种之间的差异可能预测耐药性或治疗成功。因此，我们优化并部署了基因型MTBC检测（gMTBC），以在物种水平上识别MTC，然后通过MTBDRplus/sl参考方法对来自推定耐多药结核病（MDR-TB）患者的直接痰液的抗结核药物进行比较基因型药物敏感性试验。Xpert® MTB/RIF（Xpert）结果阳性的患者同意提供清晨痰液供gMTBC和参考MTBDRplus/sl检测。卡方或Fisher精确检验比较比例。改进的泊松回归模型通过gMTBC检测MTC。在73例患者中，53例（73%）为男性，平均年龄为43岁（95% CI; 40-45）。总共有34例（47%）、36例（49%）和38例（55%）分别具有gMTBC、培养和MTBDR阳性。Xpert检测40例患者（55%）有低数量MTC，包括31例（78%）培养阴性。gMTBC在以下患者中更可能为阳性：胸腔4.18（1.31-13.32，P = 0.016）、Xpert检测的高量MTC 3.03（1.35-6.82，P = 0.007）和痰涂片阳性1.93（1.19-3.14，P = 0.008）。与MTBDRplus/sl相比，gMTBC检测MTC的准确性为95%（95% CI; 86-98; κ = 0.89）。通过gMTB鉴定的所有结核分枝杆菌/卡氏分枝杆菌均对氟喹诺酮类和氨基糖苷类/卷曲霉素敏感。gMTBC检测试剂盒与MTBDRplus/sl检测MTC的一致性较高，但落后于Xpert MTB/RIF的产率。所有结核分枝杆菌/卡氏分枝杆菌均对氟喹诺酮类药物敏感，氟喹诺酮类药物是MDR-TB治疗方案的核心药物。
Differences among Mycobacterium tuberculosis complex (MTC) species may predict drug resistance or treatment success. Thus, we optimised and deployed the genotype MTBC assay (gMTBC) to identify MTC to the species level, and then performed comparative genotypic drug‐susceptibility testing to anti‐tuberculosis drugs from direct sputum of patients with presumed multidrug‐resistant tuberculosis (MDR‐TB) by the MTBDRplus/sl reference method. Patients with positive Xpert® MTB/RIF (Xpert) results were consented to provide early‐morning‐sputum for testing by the gMTBC and the reference MTBDRplus/sl. Chi‐square or Fisher’s exact test compared proportions. Modified Poisson regression modelled detection of MTC by gMTBC. Among 73 patients, 53 (73%) were male and had a mean age of 43 (95% CI; 40–45) years. In total, 34 (47%), 36 (49%) and 38 (55%) had positive gMTBC, culture and MTBDR respectively. Forty patients (55%) had low quantity MTC by Xpert, including 31 (78%) with a negative culture. gMTBC was more likely to be positive in patients with chest cavity 4.18 (1.31–13.32, P = 0.016), high‐quantity MTC by Xpert 3.03 (1.35–6.82, P = 0.007) and sputum smear positivity 1.93 (1.19–3.14, P = 0.008). The accuracy of gMTBC in detecting MTC was 95% (95% CI; 86–98; κ = 0.89) compared to MTBDRplus/sl. All M. tuberculosis/canettii identified by gMTB were susceptible to fluoroquinolone and aminoglycosides/capreomycin. The concordance between the gMTBC assay and MTBDRplus/sl in detecting MTC was high but lagged behind the yield of Xpert MTB/RIF. All M. tuberculosis/canettii were susceptible to fluoroquinolones, a core drug in MDR‐TB treatment regimens.
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影响因子：
30.8
作者：
Manson AL;Cohen KA;Abeel T;Desjardins CA;Armstrong DT;Barry CE 3rd;Brand J;TBResist Global Genome Consortium;Chapman SB;Cho SN;Gabrielian A;Gomez J;Jodals AM;Joloba M;Jureen P;Lee JS;Malinga L;Maiga M;Nordenberg D;Noroc E;Romancenco E;Salazar A;Ssengooba W;Velayati AA;Winglee K;Zalutskaya A;Via LE;Cassell GH;Dorman SE;Ellner J;Farnia P;Galagan JE;Rosenthal A;Crudu V;Homorodean D;Hsueh PR;Narayanan S;Pym AS;Skrahina A;Swaminathan S;Van der Walt M;Alland D;Bishai WR;Cohen T;Hoffner S;Birren BW;Earl AM
通讯作者：
Earl AM
DOI：
10.5588/ijtld.20.0906
发表时间：
2021-04-01
期刊：
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
影响因子：
--
作者：
Allwood BW;Stolbrink M;Baines N;Louw E;Wademan DT;Lupton-Smith A;Nel S;Maree D;Mpagama S;Osman M;Marx FM;Hoddinott G;Lesosky M;Rylance J;Mortimer K
通讯作者：
Mortimer K
影响因子：
3.6
作者：
Alipanah, Narges;Shete, Priya B.;Nahid, Payam
通讯作者：
Nahid, Payam
影响因子：
4.9
作者：
Loiseau, Chloe;Brites, Daniela;Koser, Claudio U.
通讯作者：
Koser, Claudio U.
影响因子：
3.1
作者：
Hoza, Ha Abubakar S.;Mfinanga, Sayoki G. M.;Koenig, Brigitte
通讯作者：
Koenig, Brigitte