Diagnostic accuracy of different bronchoscopic specimens in sputum Xpert MBT/RIF- negative pulmonary TB patients.

Autor: Badr OI; Department of Chest Medicine, Mansoura University, Faculty of Medicine, Mansoura, Egypt.; Department of Pulmonary Medicine, Al-Noor Specialist Hospital, Mecca, Saudi Arabia., Elrefaey WA; Department of Pulmonary Medicine, Al-Noor Specialist Hospital, Mecca, Saudi Arabia., Shabrawishi M; Department of Pulmonary Medicine, Al-Noor Specialist Hospital, Mecca, Saudi Arabia., Assaggaf HM; Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia The study was conducted at the Al-Noor specialist tertiary hospital in Mecca, Saudi Arabia., Minshawi F; Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia The study was conducted at the Al-Noor specialist tertiary hospital in Mecca, Saudi Arabia.
Jazyk: angličtina
Zdroj: Multidisciplinary respiratory medicine [Multidiscip Respir Med] 2022 Oct 28; Vol. 17 (1), pp. 872. Date of Electronic Publication: 2022 Oct 28 (Print Publication: 2022).
DOI: 10.4081/mrm.2022.872
Abstrakt: Background: Tuberculosis (TB) control remains a critical public health problem worldwide. Rapid diagnosis and proper treatment are beneficial for the effective control of tuberculosis transmission. Diagnostic challenges arise when a patient has a clinical and radiological suspicion of tuberculosis but cannot produce sputum, sputum acid-fast bacilli, or Xpert Mycobacterium tuberculosis /rifampicin (Xpert MTB/RIF) is negative, resulting in suboptimal management. As a result, more invasive techniques must be used on these patients to establish the diagnosis.
Methods: A retrospective study recruited 330 suspected pulmonary TB patients with negative sputum of Xpert MBT/RIF who underwent bronchoscopy between March 2018 and December 2021. The diagnostic yields of bronchoalveolar lavage fluid (acid-fast bacilli, Xpert MTB/RIF, and culture) and histopathologic examination (HPE) were calculated and compared to the final diagnosis and culture as a gold standard.
Results: Out of 330 suspected pulmonary TB patients, 181 had a final diagnosis of TB, and 149 had non-TB. The sensitivity of BALF (culture, Xpert, acid-fast bacilli) and trans-bronchial lung biopsy (HPE) was 80.7%, 72.9%, 21.1%, and 87.1%, respectively. Multiple nodules were associated with significantly higher BALF Xpert MTB, bronchoalveolar lavage fluid culture, and trans-bronchial lung biopsy (HPE) positivity.
Conclusions: Bronchoscopic specimens are essential for accurate and rapid diagnosis of sputum Xpert MBT/RIF negative patients with high clinical and radiological suspicion of tuberculosis.
(©Copyright: the Author(s).)
Databáze: MEDLINE
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