Diagnostic efficiency of Xpert MTB/RIF assay for osteoarticular tuberculosis in patients with inflammatory arthritis in China

Autor: Guirong Wang, Shibing Qin, Dan Zhao, Guohua Lei, Yuan Li, Wenyun Jia
Jazyk: angličtina
Rok vydání: 2018
Předmět:
0301 basic medicine
Bacterial Diseases
Male
Inflammatory arthritis
Arthritis
lcsh:Medicine
Drug resistance
Pathology and Laboratory Medicine
Tuberculosis
Osteoarticular
0302 clinical medicine
Medicine and Health Sciences
Inflammatory Arthritis
030212 general & internal medicine
Prospective Studies
Prospective cohort study
lcsh:Science
Multidisciplinary
biology
Middle Aged
Bacterial Pathogens
Actinobacteria
Infectious Diseases
Medical Microbiology
Tuberculosis Diagnosis and Management
Female
Pathogens
Rifampin
medicine.drug
Research Article
Adult
DNA
Bacterial
medicine.medical_specialty
China
Tuberculosis
Immunology
Rheumatoid Arthritis
Microbial Sensitivity Tests
Research and Analysis Methods
Real-Time Polymerase Chain Reaction
Microbiology
Sensitivity and Specificity
Autoimmune Diseases
Mycobacterium tuberculosis
03 medical and health sciences
Rheumatology
Diagnostic Medicine
Internal medicine
Drug Resistance
Bacterial
medicine
Humans
Microbial Pathogens
Antibiotics
Antitubercular
Aged
Bacteria
business.industry
lcsh:R
Organisms
Osteoarticular tuberculosis
Biology and Life Sciences
Mycobacteria
medicine.disease
biology.organism_classification
Tropical Diseases
030104 developmental biology
Specimen Preparation and Treatment
lcsh:Q
Clinical Immunology
Dried Blood Spot Testing
Clinical Medicine
business
Rifampicin
Zdroj: PLoS ONE
PLoS ONE, Vol 13, Iss 6, p e0198600 (2018)
ISSN: 1932-6203
Popis: BACKGROUND Both osteoarticular tuberculosis (OA-TB) and inflammatory arthritis can lead to osteoarticular structural damage. These conditions exhibit similar symptoms, physical signs, and imaging features. Rapidly and accurately diagnosing OA-TB in patients with inflammatory arthritis presents a challenge to clinicians. Xpert MTB/RIF (Xpert) has been endorsed by the World Health Organization (WHO) as a rapid diagnostic tool for diagnosis of pulmonary and extrapulmonary TB. This study was designed to investigate diagnostic efficiency of Xpert for OA-TB in patients with inflammatory arthritis in China. METHODS A total of 83 consecutive patients with inflammatory arthritis and suspected OA-TB were enrolled prospectively from June 2014 to May 2018. Demographic, clinical, and biological data were recorded. Xpert assay, smear microscopy examination (smear), BACTEC MGIT 960 (MGIT 960), pathological examination, and T-SPOT.TB test were performed for each patient who received operations. Diagnostic efficiency of Xpert was evaluated based on a composite reference standard (CRS). RESULTS A total of 49 out of 83 patients with inflammatory arthritis and suspected OA-TB received operations, and 49 specimens were obtained during operations. According to CRS, 36 out of 49 patients with inflammatory arthritis were diagnosed with OA-TB, and 13 were not affected by the condition. Sensitivity of Xpert assay, smear, MGIT 960, pathological examination, and T-SPOT.TB test reached 66.70% (24/36), 25.00% (9/36), 30.55% (11/36), 47.22% (17/36), and 80.55% (29/36), respectively. Specificity of Xpert assay, smear, MGIT 960, and pathological examination was all 100% (13/13). Specificity of T-SPOT.TB test was 53.84% (7/13). Sensitivity of Xpert was higher than that of smear, MGIT 960 and pathological examination, but the sensitivity of Xpert was lower than that of T-SPOT.TB. Sensitivity of Xpert was statistically different from that of smear and MGIT 960 (P
Databáze: OpenAIRE
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