Improving tuberculosis management in prisons: Impact of a rapid molecular point-of-care test
| Autor: | Pierre-Louis Nivose, Vallier Sordoillet, Guillaume Mellon, Florence Doucet-Populaire, Christelle Guillet-Caruba, Marine Evrevin, Loïc Hermet, Anne Dulioust |
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| Přispěvatelé: | Institut de Biologie Intégrative de la Cellule (I2BC), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS), Endotoxines, Structures et Réponses de l'hôte (ESHR), Département Microbiologie (Dpt Microbio), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS)-Institut de Biologie Intégrative de la Cellule (I2BC), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS) |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Microbiology (medical) medicine.medical_specialty Tuberculosis [SDV]Life Sciences [q-bio] medicine.medical_treatment media_common.quotation_subject Point-of-care testing Concordance 030106 microbiology Prison Microbial Sensitivity Tests Sensitivity and Specificity 03 medical and health sciences 0302 clinical medicine Positive predicative value molecular diagnosis medicine Humans 030212 general & internal medicine Antibiotics Antitubercular Tuberculosis Pulmonary media_common Xpert®MTB/RIF Ultra business.industry screening Sputum Mycobacterium tuberculosis Drug susceptibility medicine.disease 3. Good health Infectious Diseases Point-of-Care Testing Prisons Emergency medicine Tuberculosis management prison Rifampin medicine.symptom business |
| Zdroj: | The Journal of Infection The Journal of Infection, 2020, ⟨10.1016/j.jinf.2020.11.042⟩ |
| ISSN: | 0163-4453 |
| DOI: | 10.1016/j.jinf.2020.11.042 |
| Popis: | Summary Objective To improve tuberculosis (TB) diagnosis in prison, we evaluate the value of the XpertⓇMTB/RIF Ultra assay (Xpert) as point-of-care (POC) in a French prison hospital. Methods We first validated Xpert use on raw sputum at the referent laboratory. Secondly, trained physicians at the prison hospital performed Xpert tests for each patient presenting TB symptoms. The results were compared with Xpert, microscopic examination, culture and drug susceptibility testing on the corresponding decontaminated specimens. Results 76 inmates were included in 15 months and 21 were diagnosed with TB. The overall sensitivity, specificity, positive and negative predictive values of Xpert were respectively: 92.3%, 100%, 100% and 98.7% on raw sputum. The efficiency of the molecular POC was confirmed by a concordance of 97% between Xpert findings from the prison hospital and culture results. Delay of microbiological diagnosis was reduced by about 18 days for 13 inmates with smear-negative sputum that avoid the mobilization of major means (escort, transport) to perform fibroscopic samples. Repeated Xpert negative results helped to speed the lifting of inmate isolation. Conclusions The implementation of Xpert in prison could optimize the management of incarcerated patients and thus limit the spread of TB among inmates, carers and other staff. |
| Databáze: | OpenAIRE |
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