Comparison of the Mycobacterium tuberculosis molecular bacterial load assay, microscopy and GeneXpert versus liquid culture for viable bacterial load quantification before and after starting pulmonary tuberculosis treatment
Comparison of the Mycobacterium tuberculosis molecular bacterial load assay, microscopy and GeneXpert versus liquid culture for viable bacterial load quantification before and after starting pulmonary tuberculosis treatment
复制标题
DOI：
10.1016/j.tube.2019.101864
复制
发表时间：
2019-12-01
期刊：
影响因子：
3.2
通讯作者：
Thuong, Nguyen T. T.
中科院分区：
文献类型：
--
作者：
Hai, Hoang T.;Vinh, Dao N.;Thuong, Nguyen T. T.
分子细菌负荷分析(MBLA)快速定量结核分枝杆菌活菌(Mtb)，可用于监测治疗反应和治疗效果。我们对56例成人肺结核患者进行了一项前瞻性研究，在治疗前和治疗1个月期间从其中收集了244份痰样本。我们评价了MBLA用于早期监测细菌负荷的作用，并调查了一线治疗对感染药物敏感和耐药菌株的杀菌活性。MBLA测定的结核分枝杆菌载量与治疗后1周(r=0.56)和1个月(r=0.73)的结核分枝杆菌载量呈正相关。在治疗期间，培养与GeneXpert或显微镜检查之间的相关性较弱。一周后(2.73Ct，P<；0.001；0.95Ct，P=0.297)和一个月后(8.94Ct，P<；0.001；6.78Ct，P<；0.001)，MBLA的结核分枝杆菌载量下降速度快于GeneXpert。在治疗1周(P=0.02)和1个月(P=0.001)后，多药耐药(MDR)感染的结核分枝杆菌载量显著高于敏感和多/单耐药的结核分枝杆菌(P<；0.02)。在定量检测治疗期间存活的结核分枝杆菌方面，MBLA优于GeneXpert和显微镜。它可用于监测结核病治疗过程中的细菌负荷，有助于及早发现治疗失败，从而改善结果。
Molecular bacterial load assay (MBLA) rapidly quantifies viable Mycobacterium tuberculosis (Mtb) and may be useful for monitoring treatment response and treatment efficacy.We conducted a prospective study in 56 adults with pulmonary tuberculosis from whom 244 sputum samples were collected before and during the first month of treatment. We evaluated MBLA for early monitoring of bacterial burden and investigated bactericidal activities of first-line therapy in patients infected with drug susceptible and resistant isolates.Mtb loads measured by MBLA and culture were correlated after one-week (r = 0.56) and one-month (r = 0.73) of treatment. Correlations between culture and GeneXpert or microscopy were weaker during treatment. Mtb load by MBLA declined more rapidly than GeneXpert after one-week (2.73 Ct, P < 0.001; 0.95 Ct, P = 0.297, respectively) and one-month (8.94 Ct, P < 0.001; 6.78 Ct, P < 0.001). Mtb loads in multidrug resistant (MDR) infections were significantly greater than in both sensitive and poly/mono-resistance after one-week (P < 0.02) and one-month treatment (P = 0.001).MBLA performed better than GeneXpert and microscopy in comparison to culture for quantifying viable Mtb during treatment. It can be used for monitoring bacterial load during TB treatment, facilitating early detection of treatment failure thus improving outcomes.