Xpert MTB/RIF Ultra assay for the detection of Mycobacterium tuberculosis in people with negative conventional Xpert MTB/RIF but chest imaging suggestive of tuberculosis in Dhaka, Bangladesh.
In: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, Jg. 114 (2022), S. 244-251
Online
academicJournal
Zugriff:
Background: The World Health Organization is considering substituting Xpert MTB/RIF (Xpert) with Xpert MTB/RIF Ultra (Ultra) for tuberculosis (TB) diagnosis, but supportive evidence is scarce, particularly among people more likely (presumptive) to have paucibacillary pulmonary TB (PTB).
Methods: During January-July 2018, presumptive PTB patients visiting TB Screening and Treatment Centres of Dhaka for routine chest X-ray (CXR) and conventional Xpert were enrolled. Sputum specimens were additionally tested with microscopy, culture, and Ultra. Specimens with "Trace call" by Ultra (Ultra-trace) were retested. Yield and diagnostic accuracy using various approaches to Ultra-trace and concordance of Ultra with bacteriological-positive PTB were assessed.
Results: Altogether, 1,083 participants (104 'Xpert-positive'; 979 'Xpert-negative and CXR-suggestive') were enrolled. All Xpert-positives and 900 (92%) Xpert-negatives were concordant with Ultra, however, seventy-nine (8.1%) Xpert-negative specimens tested positive with Ultra; 37 (46.8%) were categorically positives, and 42 (53.2%) were Ultra-trace. Sixteen of the 42 were retested, of whom eight (50.1%) Ultra-trace turned categorically positive, leading to 45 (4.6%) additionally detected by Ultra. Ultra sensitivity and specificity were 93.9% and 94.6%, and it additionally detected 5.4% more TB patients with a concordance of 94.6% (kappa, □=0.78) compared to any bacteriologically positive specimen (microscopy, culture, or Xpert).
Conclusion: Ultra exhibited improved detection and accuracy among Xpert-negatives in a cohort with a high likelihood of PTB.
Competing Interests: Conflict of interest None declared.
(Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
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Xpert MTB/RIF Ultra assay for the detection of Mycobacterium tuberculosis in people with negative conventional Xpert MTB/RIF but chest imaging suggestive of tuberculosis in Dhaka, Bangladesh.
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Autor/in / Beteiligte Person: | Biswas, S ; Uddin, MKM ; Paul, KK ; Ather, MF ; Ahmed, S ; Nasrin, R ; Kabir, S ; Heysell, SK ; Banu, S |
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Zeitschrift: | International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, Jg. 114 (2022), S. 244-251 |
Veröffentlichung: | Hamilton, ON : Elsevier ; <i>Original Publication</i>: Hamilton, ON : Decker, c1996-, 2022 |
Medientyp: | academicJournal |
ISSN: | 1878-3511 (electronic) |
DOI: | 10.1016/j.ijid.2021.11.010 |
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