Lin Li , Liyan Mao , Marieke M. van der Zalm , Juan Olivo , Shan Liu , Carlos Vergara , Megan Palmer , Qingbo Shu , Anne-Marie Demers , Christopher J. Lyon , Pierre Goussard , H. Simon Schaaf , Anneke C. Hesseling , Sharon Nachman , Eddy Pérez-Then , Charles D. Mitchell , Elisabetta Ghimenton , Tony Y. Hu
{"title":"儿童结核病的血液诊断：南非和多米尼加共和国的前瞻性队列研究。","authors":"Lin Li , Liyan Mao , Marieke M. van der Zalm , Juan Olivo , Shan Liu , Carlos Vergara , Megan Palmer , Qingbo Shu , Anne-Marie Demers , Christopher J. Lyon , Pierre Goussard , H. Simon Schaaf , Anneke C. Hesseling , Sharon Nachman , Eddy Pérez-Then , Charles D. Mitchell , Elisabetta Ghimenton , Tony Y. Hu","doi":"10.1016/j.jinf.2024.106404","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>Pediatric tuberculosis (TB) diagnosis is complicated by challenges in obtaining invasive respiratory specimens that frequently contain few <em>Mycobacterium tuberculosis</em> (<em>Mtb</em>) bacilli. We report the diagnostic performance of an <em>Mtb</em> antigen<em>-</em>derived peptide (MAP-TB) assay and its ability to monitor TB treatment response.</div></div><div><h3>Methods</h3><div>Study cohorts enrolled children who presented with presumptive TB at two hospitals in South Africa from 2012 to 2017 (157 children aged <13 years) and at community-based clinics in the Dominican Republic from 2019 to 2023 (101 children aged <18 years). Children were evaluated for TB at enrollment and six months post-enrollment and assigned confirmed, unconfirmed, or unlikely TB diagnoses using the 2015 NIH diagnostic criteria for pediatric TB. MAP-TB assay performance was evaluated using serum collected at baseline and at regular intervals post-enrollment following STARD guidelines.</div></div><div><h3>Results</h3><div>MAP-TB sensitivity for confirmed and unconfirmed TB was comparable to culture and Xpert sensitivity for confirmed TB, but MAP-TB specificity revealed age-dependence, decreasing from 98·1% to 78·4%, when including children aged <1 year. MAP-TB values decreased by six months post-treatment initiation in children with symptom improvement.</div></div><div><h3>Conclusions</h3><div>Serum MAP-TB results can effectively diagnose pediatric TB, including unconfirmed and extrapulmonary TB missed by current methods, and correspond to effective treatment.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"90 2","pages":"Article 106404"},"PeriodicalIF":14.3000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Blood-based diagnosis of pediatric tuberculosis: A prospective cohort study in South Africa and Dominican Republic\",\"authors\":\"Lin Li , Liyan Mao , Marieke M. van der Zalm , Juan Olivo , Shan Liu , Carlos Vergara , Megan Palmer , Qingbo Shu , Anne-Marie Demers , Christopher J. Lyon , Pierre Goussard , H. Simon Schaaf , Anneke C. Hesseling , Sharon Nachman , Eddy Pérez-Then , Charles D. Mitchell , Elisabetta Ghimenton , Tony Y. Hu\",\"doi\":\"10.1016/j.jinf.2024.106404\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><div>Pediatric tuberculosis (TB) diagnosis is complicated by challenges in obtaining invasive respiratory specimens that frequently contain few <em>Mycobacterium tuberculosis</em> (<em>Mtb</em>) bacilli. We report the diagnostic performance of an <em>Mtb</em> antigen<em>-</em>derived peptide (MAP-TB) assay and its ability to monitor TB treatment response.</div></div><div><h3>Methods</h3><div>Study cohorts enrolled children who presented with presumptive TB at two hospitals in South Africa from 2012 to 2017 (157 children aged <13 years) and at community-based clinics in the Dominican Republic from 2019 to 2023 (101 children aged <18 years). Children were evaluated for TB at enrollment and six months post-enrollment and assigned confirmed, unconfirmed, or unlikely TB diagnoses using the 2015 NIH diagnostic criteria for pediatric TB. MAP-TB assay performance was evaluated using serum collected at baseline and at regular intervals post-enrollment following STARD guidelines.</div></div><div><h3>Results</h3><div>MAP-TB sensitivity for confirmed and unconfirmed TB was comparable to culture and Xpert sensitivity for confirmed TB, but MAP-TB specificity revealed age-dependence, decreasing from 98·1% to 78·4%, when including children aged <1 year. MAP-TB values decreased by six months post-treatment initiation in children with symptom improvement.</div></div><div><h3>Conclusions</h3><div>Serum MAP-TB results can effectively diagnose pediatric TB, including unconfirmed and extrapulmonary TB missed by current methods, and correspond to effective treatment.</div></div>\",\"PeriodicalId\":50180,\"journal\":{\"name\":\"Journal of Infection\",\"volume\":\"90 2\",\"pages\":\"Article 106404\"},\"PeriodicalIF\":14.3000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Infection\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0163445324003396\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Infection","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0163445324003396","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Blood-based diagnosis of pediatric tuberculosis: A prospective cohort study in South Africa and Dominican Republic
Objectives
Pediatric tuberculosis (TB) diagnosis is complicated by challenges in obtaining invasive respiratory specimens that frequently contain few Mycobacterium tuberculosis (Mtb) bacilli. We report the diagnostic performance of an Mtb antigen-derived peptide (MAP-TB) assay and its ability to monitor TB treatment response.
Methods
Study cohorts enrolled children who presented with presumptive TB at two hospitals in South Africa from 2012 to 2017 (157 children aged <13 years) and at community-based clinics in the Dominican Republic from 2019 to 2023 (101 children aged <18 years). Children were evaluated for TB at enrollment and six months post-enrollment and assigned confirmed, unconfirmed, or unlikely TB diagnoses using the 2015 NIH diagnostic criteria for pediatric TB. MAP-TB assay performance was evaluated using serum collected at baseline and at regular intervals post-enrollment following STARD guidelines.
Results
MAP-TB sensitivity for confirmed and unconfirmed TB was comparable to culture and Xpert sensitivity for confirmed TB, but MAP-TB specificity revealed age-dependence, decreasing from 98·1% to 78·4%, when including children aged <1 year. MAP-TB values decreased by six months post-treatment initiation in children with symptom improvement.
Conclusions
Serum MAP-TB results can effectively diagnose pediatric TB, including unconfirmed and extrapulmonary TB missed by current methods, and correspond to effective treatment.
期刊介绍：
The Journal of Infection publishes original papers on all aspects of infection - clinical, microbiological and epidemiological. The Journal seeks to bring together knowledge from all specialties involved in infection research and clinical practice, and present the best work in the ever-changing field of infection.
Each issue brings you Editorials that describe current or controversial topics of interest, high quality Reviews to keep you in touch with the latest developments in specific fields of interest, an Epidemiology section reporting studies in the hospital and the general community, and a lively correspondence section.
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