scholarly journals Assessing the utility of the Xpert Mycobacterium tuberculosis /rifampin assay for analysis of bronchoalveolar lavage fluid in patients with suspected pulmonary tuberculosis

Author(s):  
Wenjing Bai ◽  
Lingling Liu ◽  
Lianpeng Wu ◽  
Shanshan Chen ◽  
Shuangliao Wu ◽  
...  
2005 ◽  
Vol 58 (5-6) ◽  
pp. 231-235 ◽  
Author(s):  
Slobodanka Petrovic

Introduction The aim of this study was to find out if bronchoalveolar lavage (BL) is better than gastric lavage (GL) or sputum (SP) examination for isolation of Mycobacterium tuberculosis in childhood pulmonary tuberculosis. Material and methods The study included a group of 30 children with suspected pulmonary tuberculosis, aged 6 months to 18 years. Gastric lavage was done on 4 consecutive mornings after overnight fast. Sputum was examined in 12 patients older than 10 years, (4 consecutive samples). BL was performed on the same day as the last GL and SP, using a rigid bronchoscope. Specimens were examined for the existence of BL acid fast bacilli (AFB) and culture for Mycobacterium tb. Results Out of 30 cases, Mycobacterium tb was grown in 13 BL samples (43.33%), and in 10 GL samples from the same patients (33.33%). Comparative analysis of microbiological samples of sputum and bronchoalveolar lavage fluid in 12 children showed that 6 patients had SP+ cultures and 6 patients had SP-cultures of Mycobacterium tb. All SP+ patients where also BL+, but 1 SP- patient was BL+. Smear examination of BL fluid samples was positive for AFB in 10 patients with positive cultures for Mycobacterium tb. Conclusion The results of our study indicate that BL examination is better than GL and SP examination for bacteriological diagnosis of childhood tuberculosis. .


Author(s):  
Hong-Chao Liu ◽  
Yu-Lu Gao ◽  
Dan-Feng Li ◽  
Xi-Yi Zhao ◽  
Yuan-Qing Pan ◽  
...  

Background: The performance of Xpert MTB/RIF using bronchoalveolar lavage fluid (BAL) for the diagnosis of pulmonary tuberculosis (PTB) remains unclear. Therefore, a systematic review/meta-analysis was conducted. Methods: Studies published before December 31, 2019, were retrieved from the PubMed, Embase, and Web of Science databases using the keywords “pulmonary tuberculosis,” “Xpert MTB/RIF,” and “BAL.” Two independent evaluators extracted the data and assessed the bias risk of the included studies. A random-effects model was used to calculate the overall sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR, respectively), diagnostic odds ratio (DOR), and the area under the curve (AUC), as well as the respective 95% confidence intervals (CIs). Results: Nineteen trials involving 3019 participants met the inclusion criteria. Compared to the culture method, the pooled sensitivity, specificity, PLR, NLR, DOR, and the AUC with 95% CIs of Xpert MTB/RIF were 0.87 (0.84–0.90), 0.92 (0.91–0.93), 10.21 (5.78–18.02), 0.16 (0.12–0.22), 78.95 (38.59–161.53), and 0.9467 (0.9462-0.9472), respectively. Relative to the composite reference standard, the observed values were 0.69 (0.65–0.72), 0.98 (0.98–0.99), 37.50 (18.59–75.62), 0.30 (0.21–0.43), 171.98 (80.82–365.96), and 0.9691 (0.9683–0.9699), respectively. All subgroups, except children, showed high sensitivity and specificity. Conclusions: The use of Xpert MTB/RIF in the context of BAL samples has a high diagnostic performance for PTB (except for children) and may serve as an alternative rapid diagnostic tool.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Qing-Qin Yin ◽  
Wei-Wei Jiao ◽  
Rui Han ◽  
An-Xia Jiao ◽  
Lin Sun ◽  
...  

In order to evaluate the diagnostic accuracy of the Xpert MTB/RIF assay on childhood pulmonary tuberculosis (PTB) using bronchoalveolar lavage fluid (BALF), we evaluated the sensitivity, specificity, positive predictive value, and negative predictive value of Xpert MTB/RIF assay using BALF in comparison with acid-fast bacilli (AFB) microscopy andMycobacterium tuberculosis(MTB) culture for diagnosing childhood PTB using Chinese “composite clinical reference standard” (CCRS) as reference standard. Two hundred fifty-five children with suspected PTB were enrolled at Beijing Children’s Hospital from September 2010 to July 2013. Compared with Chinese CCRS, the sensitivity of AFB microscopy, MTB culture, and Xpert MTB/RIF assay was 8.4%, 28.9%, and 53.0%, respectively. The specificity of three assays was all 100%. Xpert MTB/RIF assay could detect 33.9% of cases with negative MTB culture, and 48.7% of cases with negative AFB microscopy. Younger age (<3 years), absence of BCG scar, and contact with TB patient were found significantly associated with a positive result of Xpert MTB/RIF assay. In conclusion, Xpert MTB/RIF assay using BALF can assist in diagnosing childhood PTB much faster when fiberoptic bronchoscopy is necessary according to the chest radiograph.


Medicine ◽  
2021 ◽  
Vol 100 (20) ◽  
pp. e25821
Author(s):  
Feng Zhu ◽  
Qinfang Ou ◽  
Jian Zheng ◽  
Min Zhou ◽  
Huaxin Chen ◽  
...  

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