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首页> 外文期刊>International journal of infectious diseases : >Xpert MTB/RIF and GenoType MTBDRplus assays for the rapid diagnosis of bone and joint tuberculosis
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Xpert MTB/RIF and GenoType MTBDRplus assays for the rapid diagnosis of bone and joint tuberculosis

机译：Xpert MTB / RIF和GenoType MTBDRplus测定法可快速诊断骨和关节结核

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Background: Bone and joint tuberculosis (BJTB) constitutes about 10-20% of the extrapulmonary tuberculosis (EPTB) cases in China. The GenoType MTBDRplus assay (MTBDR) has been endorsed by the World Health Organization (WHO) for the diagnosis of pulmonary TB (PTB), while the Xpert MTB/RIF assay (Xpert) has also been endorsed by the WHO for the diagnosis of both PTB and EPTB. The diagnostic utility of these two techniques for BJTB was investigated prospectively. Methods: Sixty pus specimens were obtained from orthopedic patients. Smear, culture, Xpert, and MTBDR assays were performed for each specimen, and MGIT 960-based drug susceptibility testing (DST) was conducted for all of the isolates recovered. The diagnostic efficiency of Xpert and MTBDR was evaluated on the basis of bacteriological examination and the composite reference standard (CRS). Results: Fifty of the 60 patients were considered to have BJTB according to the CRS. The sensitivities of smear, culture, Xpert, and MTBDR were 26% (13/50), 48% (24/50), 82% (41/50), and 72% (36/50) respectively, while the specificities of all of the tests were 100% (10/10). Xpert was 100% concordant with MGIT 960-based DST for the detection of rifampicin resistance. MTBDR had a sensitivity of 83.3% and a specificity of 100% for the detection of rifampicin resistance and a sensitivity of 85.7% and specificity of 100% for the detection of isoniazid resistance. Conclusion: With their high sensitivities, short turnaround times, and ability to diagnose TB and detect drug resistance simultaneously, both Xpert and MTBDR are feasible as diagnostic tools for BJTB in clinical practice.
机译：背景：骨关节结核（BJTB）约占中国肺外结核（EPTB）病例的10-20％。 GenoType MTBDRplus测定法（MTBDR）已被世界卫生组织（WHO）认可用于肺结核（PTB）的诊断，而Xpert MTB / RIF测定法（Xpert）也已被WHO认可用于两者的诊断。 PTB和EPTB。前瞻性地研究了这两种技术对BJTB的诊断实用性。方法：从整形外科患者中收集60份脓液标本。对每个样品进行涂片，培养，Xpert和MTBDR分析，并对所有回收的分离物进行基于MGIT 960的药敏试验（DST）。 Xpert和MTBDR的诊断效率是根据细菌学检查和复合参考标准（CRS）进行评估的。结果：根据CRS，在60例患者中有50例被认为患有BJTB。涂片，培养物，Xpert和MTBDR的敏感性分别为26％（13/50），48％（24/50），82％（41/50）和72％（36/50），而所有测试均为100％（10/10）。 Xpert与基于MGIT 960的DST 100％一致，用于检测利福平的耐药性。 MTBDR对利福平耐药性的检测灵敏度为83.3％，特异性为100％，对异烟肼耐药性的检测灵敏度为85.7％，特异性为100％。结论：Xpert和MTBDR具有较高的敏感性，较短的周转时间以及能够同时诊断TB和检测耐药性，因此在临床实践中均可作为BJTB的诊断工具。

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