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首页> 外文期刊>Expert Review of Molecular Diagnostics >Screening for latent infection with Mycobacterium tuberculosis: A plea for targeted testing in low endemic regions
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Screening for latent infection with Mycobacterium tuberculosis: A plea for targeted testing in low endemic regions

机译：筛查结核分枝杆菌潜伏感染：在低流行地区进行针对性检测的呼吁

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摘要

The higher specificity proposed for IFN-γ-release assays (IGRAs) compared with tuberculin skin testing (TST) may indicate superiority in identifying patients at risk for progression towards active tuberculosis. Unfortunately, available assays may frequently show discordant results. To aid in interpreting discordant results, the article under evaluation has comparatively analyzed results of the TST and two commercially available IGRAs in a low-risk population for tuberculosis. TST-positive/IGRA-negative results were strongly associated with bacillus Calmette-Guérin vaccination or nontuberculous mycobacteria sensitization, whereas the etiology of TST-negative/IGRA-positive results or discrepancies among IGRAs remain unresolved. As the three tests identified different individuals in the majority of positive cases, this indicates that most positive results obtained in the absence of additional risk factors are falsely positive. By contrast, increasing concordance of positive results was associated with tuberculosis risk factors. This has direct implications for screening practices in low prevalence regions where a targeted screening approach may reduce both unnecessary testing and treatment.
机译：与结核菌素皮肤试验（TST）相比，建议的IFN-γ释放测定（IGRA）更高的特异性可能表明在鉴定有活动性结核病风险的患者中具有优势。不幸的是，可用的测定可能经常显示不一致的结果。为了帮助解释不一致的结果，被评估的文章对结核病低危人群中的TST和两种市售IGRA的结果进行了比较分析。 TST阳性/ IGRA阴性结果与卡介苗的免疫接种或非结核分枝杆菌致敏性密切相关，而TST阴性/ IGRA阳性结果的病因或IGRA之间的差异仍未解决。由于这三种测试在大多数阳性病例中确定了不同的个体，这表明在没有其他风险因素的情况下获得的大多数阳性结果都是假阳性。相反，增加阳性结果的一致性与结核病危险因素有关。这对低患病率地区的筛查实践具有直接影响，在该地区，有针对性的筛查方法可以减少不必要的检测和治疗。

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