痰
医学
GeneXpert MTB/RIF公司
内科学
肺结核
无症状的
胃肠病学
结核分枝杆菌
聚合酶链反应
粪便
实时聚合酶链反应
置信区间
微生物学
病理
生物
基因
生物化学
作者
Andrew R. DiNardo,Alexander Kay,Gugu Maphalala,Nadine M. Harris,Celia Fung,Godwin Mtetwa,Pilar Ustero,Sindisiwe Dlamini,Ngan P. Ha,Edward A. Graviss,Rojelio Mejía,Anna M. Mandalakas
出处
期刊:American Journal of Tropical Medicine and Hygiene
[American Society of Tropical Medicine and Hygiene]
日期:2018-08-02
卷期号:99 (2): 310-316
被引量:25
标识
DOI:10.4269/ajtmh.18-0004
摘要
A quantifiable, stool-based, Mycobacterium tuberculosis (Mtb) test has potential complementary value to respiratory specimens. Limit of detection (LOD) was determined by spiking control stool. Clinical test performance was evaluated in a cohort with pulmonary tuberculosis (TB) (N = 166) and asymptomatic household TB child contacts (N = 105). Stool-quantitative polymerase chain reaction (qPCR) results were compared with sputum acid-fast bacilli (AFB) microscopy, GeneXpert MTB/RIF (Xpert MTB/RIF), and cultures. In Mtb stool-spiking studies, the LOD was 96 colony-forming units/50 mg of stool (95% confidence interval [CI]: 84.8–105.6). Among specimens collected within 72 hours of antituberculosis treatment (ATT) initiation, stool qPCR detected 22 of 23 (95%) of culture-positive cases. Among clinically diagnosed cases that were Xpert MTB/RIF and culture negative, stool qPCR detected an additional 8% (3/37). Among asymptomatic, recently TB-exposed participants, stool PCR detected Mtb in two of 105 (1.9%) patients. Two months after ATT, the Mtb quantitative burden in femtogram per microliters decreased (Wilcoxon signed-rank P < 0.001) and persistent positive stool PCR was associated with treatment failure or drug resistance (relative risk 2.8, CI: 1.2–6.5; P = 0.012). Stool-based qPCR is a promising complementary technique to sputum-based diagnosis. It detects and quantifies low levels of stool Mtb DNA, thereby supporting adjunct diagnosis and treatment monitoring in pulmonary TB.
科研通智能强力驱动
Strongly Powered by AbleSci AI