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J Infect Dis:代谢性弱的结核杆菌竟然传染性更强?

2017-05-22 MedSci MedSci原创

结核分枝杆菌的亚群分为有代谢活性和无代谢活性群,但目前它们的传染性还没有准确评估出来。那么,菌体的代谢活性和其传染性有何关联?

结核分枝杆菌的亚群分为有代谢活性和无代谢活性群,但目前它们的传染性还没有被准确评估。那么,菌体的代谢活性和其传染性有何关联?

近期一项发表在感染病学领域权威期刊《The Journal of Infectious Diseases》的研究提出了一项新的评估方法来检测结核患者痰液中的结核分歧杆菌代谢活性,以预测其感染性。

研究人员用荧光素二乙酸酯(FDA,评估结核分枝杆菌代谢活性)染色痰液中结核分歧杆菌,后在显微镜下观察并进行活性评估,以预测感染性。分别使用FDA染色显微镜、培养和抗酸染色显微镜等方法来评估在结核病患者的预处理痰中的定量结核分枝杆菌。并且对参与研究的35名患者的209名家庭接触者进行6年的流行病调查来确定是否患上结核病。

研究结果显示,平均119个细菌/μL痰(四分位数范围,IQR = 47-386)的FDA显微镜检查呈阳性,占抗酸染色显微镜观察阳性细菌总数(2069个细菌 /μl,IQR = 1358-3734)的比例为5.1%(IQR = 2.4%-11%)。 随访结果显示,6.4%(13/209)的患者接触者在随访期间诊断出了结核病。但是在细菌阳性数值低于FDA显微镜阳性结核分枝杆菌中位浓度的患者中,有10%的接触者发展为结核病。该项数据明显超过了FDA显微镜检查结果中位数的2.7%以上。在调整疾病严重程度,化学预防,耐药性和社会决定因素(调整危险比= 3.9,p = 0.02)后,该数据仍保持统计学意义。

研究人员表示,这些预处理样品中的FDA显微镜阴性细菌可能是不着色的,缓慢代谢的表型,更适应于空气传播,因此会有更高的感染性。这提示我们,FDA显微镜检测阴性的结核分枝杆菌会有更大的感染性。

原始出处:

Sumona Datta, Jonathan M Sherman, et al. Sputum microscopy with fluorescein diacetate predicts tuberculosis infectiousness. J Infect Dis jix229. DOI: https://doi.org/10.1093/infdis/jix229 Published: 16 May 2017

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    2018-02-04 xzw113
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    2017-08-07 sodoo
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    2017-05-24 惠映实验室

    TB的预防和治疗,两手抓,两手都要硬。

    0

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    2017-05-24 doctorJiangchao

    谢谢分享。

    0

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