中国防痨杂志2025，Vol.47Issue(1)：61-65,5.DOI:10.19982/j.issn.1000-6621.20240300
涂片阳性/Xpert阴性结果早期预测临床标本中存在非结核分枝杆菌的可靠性
The evaluation of the smear-positive and Xpert-negative outcome as an early indicator of nontuberculous mycobacteria existence in clinical specimen
摘要
Abstract
Objective:To evaluate the diagnostic reliability of smear-positive/Xpert-negative results as an early predictor for the presence of non-tuberculous mycobacteria(NTM)in clinical specimens.Methods:A retrospective analysis was conducted on laboratory examination data from patients newly diagnosed with pulmonary diseases at Henan Chest Hospital between January 2019 and April 2024.The dataset included cases with positive smear microscopy results and those with NTM confirmed by isolation and culture.The accuracy of smear-positive/Xpert-negative results as a predictive indicator for NTM isolation and identification was assessed.The proportion of patients diagnosed with NTM during the study period who presented smear-positive/Xpert-negative results was analyzed to evaluate the sensitivity of this predictive indicator.Additionally,the proportion of smear-positive tuberculosis patients with negative Xpert test results was examined to determine the specificity of this indicator.Results:Among the smear-positive patients included in the study,8.22％(202/2458)exhibited negative Xpert test results during the same period.Of the 148 patients with smear-positive/Xpert-negative results and concurrent cult ure-based identification,138 cases(93.24％)were confirmed as NTM through culture,demonstrating the high accuracy of smear-positive/Xpert-negative results as an early predictor for NTM in clinical specimens.When the additional criterion of a negative interferon-gamma release assay(IGRA)result was applied,the predictive accuracy increased to 100.00％(73/73).However,this refinement significantly reduced the sensitivity of the prediction to 37.61％(44/117).The sensitivity of smear-positive/Xpert-negative results in predicting the presence of NTM was 39.78％(109/274)among patients with NTM disease.Conversely,the specificity of this indicator was remarkably high at 99.56％(2256/2266)among patients with smear-positive tuberculosis.Conclusion:In patients suspected of tuberculosis,smear-positive/Xpert-negative results serve as an early and reliable predictor for the identification of NTM.关键词
非典型性细菌/分枝杆菌属/诊断,鉴别/预测Key words
Atypical bacterial forms/Mycobacterium/Diagnosis,differential/Forecasting分类
基础医学引用本文复制引用
赵悦,王昊然,程美锦,王伟,梁瑞霞,黄海荣..涂片阳性/Xpert阴性结果早期预测临床标本中存在非结核分枝杆菌的可靠性[J].中国防痨杂志,2025,47(1):61-65,5.基金项目
国家重点研发计划(2022YFC2305203) （2022YFC2305203）
北京市卫生健康委员会高层次公共卫生人才(G2023-2-002) The National Key Research and Development Program of China(2022YFC2305203) （G2023-2-002）
Beijing Public Health Experts Project(G2023-2-002) （G2023-2-002）
