Nucleic acid amplification tests reduce delayed diagnosis and misdiagnosis of pulmonary tuberculosis.

Autor: Feng JY; Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.; Institute of Emergency and Critical Care Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC., Lin CJ; Tao-Yuan General Hospital, Ministry of Health and Welfare, Tao-Yuan, Taiwan, ROC., Wang JY; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, ROC.; School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan, ROC., Chien ST; Chest Hospital, Ministry of Health and Welfare, Tainan, Taiwan, ROC., Lin CB; Division of Chest Medicine, Department of Internal Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan, ROC.; School of Medicine, Tzu Chi University, Hualien, Taiwan, ROC., Huang WC; Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan, ROC.; Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.; Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan, ROC.; Master Program for Health Administration, Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan, ROC., Lee CH; Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, ROC.; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, 111 Hsin-Long Road, Section 3, Taipei 116, Taiwan, ROC., Shu CC; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, ROC., Yu MC; Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, ROC.; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, 111 Hsin-Long Road, Section 3, Taipei 116, Taiwan, ROC.; School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC., Lee JJ; Division of Chest Medicine, Department of Internal Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan, ROC., Chiang CY; Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, ROC. cychiang@tmu.edu.tw.; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, 111 Hsin-Long Road, Section 3, Taipei 116, Taiwan, ROC. cychiang@tmu.edu.tw.; International Union Against Tuberculosis and Lung Disease, Paris, France. cychiang@tmu.edu.tw.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2022 Jul 14; Vol. 12 (1), pp. 12064. Date of Electronic Publication: 2022 Jul 14.
DOI: 10.1038/s41598-022-16319-8
Abstrakt: The clinical impact of nucleic acid amplification (NAA) tests on reducing delayed diagnosis and misdiagnosis of pulmonary TB (PTB) has rarely been investigated. PTB patients were classified into a frontline NAA group, an add-on NAA group, and a no NAA group. The outcomes of interest were the proportion of PTB case died before anti-TB treatment, the interval between sputum examination and initiation of treatment, and misdiagnosis of PTB. A total of 2192 PTB patients were enrolled, including 282 with frontline NAA, 717 with add-on NAA, and 1193 with no NAA tests. Patients with NAA tests had a lower death rate before treatment initiation compared to those without NAA tests (1.6% vs. 4.4%, p < 0.001) in all cases. Patients with frontline NAA compared to those with add-on NAA and those without NAA, had a shorter interval between sputum examination and treatment initiation in all cases (3 days vs. 6 days (p < 0.001), vs 18 days (p < 0.001)), and less misdiagnosis in smear-positive cases (1.8% vs. 5.6% (p = 0.039), vs 6.5% (p = 0.026)). In conclusion, NAA tests help prevent death before treatment initiation. Frontline NAA tests perform better than add-on NAA and no NAA in avoiding treatment delay in all cases, and misdiagnosis of PTB in smear-positive cases.
(© 2022. The Author(s).)
Databáze: MEDLINE
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