Stool-based Xpert MTB/RIF Ultra assay as a tool for detecting pulmonary tuberculosis in children with abnormal chest imaging: A prospective cohort study
| Autor: | Yuanlin Song, Tao Li, Douglas B. Lowrie, Shuihua Lu, Xuhui Liu, Heng Wang, Shanqun Li, Bin Song, Lu Xia, Xiao-Yong Fan, Jian-hao Wei, Xiuhong Xi, Xue-qin Qian |
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| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Abnormal chest China medicine.medical_specialty Tuberculosis Stool sample Concordance 030106 microbiology Sensitivity and Specificity 03 medical and health sciences 0302 clinical medicine Pulmonary tuberculosis Internal medicine Humans Medicine Prospective Studies 030212 general & internal medicine Child Prospective cohort study Antibiotics Antitubercular Tuberculosis Pulmonary Reference standards business.industry Sputum Mycobacterium tuberculosis medicine.disease Infectious Diseases Rifampin business |
| Zdroj: | Journal of Infection. 82:84-89 |
| ISSN: | 0163-4453 |
| DOI: | 10.1016/j.jinf.2020.10.036 |
| Popis: | To evaluate the diagnostic efficacy of stool-based Xpert MTB/RIF Ultra assay versus other assays for the detection of paediatric pulmonary tuberculosis (PTB).A prospective head-to-head comparative study was conducted from Dec 2017 to May 2019 in Shanghai Public Health Clinical Centre. Samples were collected from children (15 years) with abnormal chest imaging (X-ray or CT scan) results for the following tests: Ultra on stool sample (Ultra-Stool), Ultra on respiratory tract sample (Ultra-RTS), Xpert MTB/RIF assay (Xpert) on RTS (Xpert-RTS), acid-fast bacilli smear on RTS (AFB-RTS), and Mycobacterium tuberculosis (Mtb) culture on RTS (Culture-RTS). The results were compared with a composite reference standard.A total of 126 cases with paired results were analysed. Against a composite reference standard, Ultra-RTS demonstrated the highest sensitivity (52%) and specificity (100%). Ultra-Stool showed 84.1% concordance with Ultra-RTS, demonstrating 45.5% sensitivity and 94.7% specificity (kappa = 0.65, 95% CI= 0.51-0.79). The sensitivity of Ultra-Stool was similar to Mtb culture (45.5%, p = 1.000) and higher than AFB-RTS (27.3%, p0.05). Assay positivity was associated with age and infiltration range in chest imaging.When RTS is difficult to obtain, stool sample-based Ultra is a comparable alternative. |
| Databáze: | OpenAIRE |
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