结核分枝杆菌分子诊断方法研究进展

Research Progress in Molecular Diagnostic Methods of Mycobacterium Tuberculosis

结核病是目前单一传染病的主要死因,在全球范围内仍是一个重要的公共卫生问题。因此,早期、快速、准确地鉴定结核分枝杆菌(MTB)并确定其药物敏感性对该病的治疗和管理至关重要。虽然涂片镜检和细菌培养仍是结核病实验室诊断不可缺少的手段,但存在阳性率低、培养时间长等缺点,易延误诊治。近年来,随着分子诊断技术的进步,MTB检测从经典的实时荧光聚合酶链反应技术发展为新一代全基因组测序,后者可以同时识别与常规抗结核药物相关的耐药基因突变,提高诊断性能、早期检测和混合感染检测能力。根据患者的情况个性化选择诊断效能高、成本效益佳的分子检测技术,以及联合应用不同的检测技术进一步提高MTB和耐药结核的检出率是目前亟待解决的问题。

Tuberculosis is currently the leading cause of death from a single infectious disease and remains a major public health problem globally.Early,rapid and accurate identification of Mycobacterium tuberculosis(MTB)and its drug susceptibility are critical for the treatment and management of the disease.Although smear microscopy and bacterial culture are still indispensable in tuberculosis laboratory diagnosis,there are still some shortcomings,such as low positive rate and long culture time,which are easy to cause delayed diagnosis and treatment.In recent years,thanks to the rapid development of molecular diagnostic technology,MTB detection walks into the era of molecular detection,from the classical real-time fluorescent polymerase chain reaction technology to the next generation whole genome sequencing,these methods can identify both MTB and mutations associated with conventional anti-tuberculosis drugs,thus improving the diagnostic performance,as well as the capability of early detection and detection of mixed infections.How to select the molecular detection technology with high diagnostic efficiency and good cost-effectiveness according to the situation of the patients,and how to combine different detection technologies to further improve the detection rate of MTB and drug-resistant tuberculosis are currently the urgent problems to be solved.