scholarly journals Performance Comparison of GeneXpert MTB/RIF and ProbeTec ET Tests for Rapid Molecular Diagnosis of Extrapulmonary Tuberculosis in a Low TB/MDR-TB Incidence Country

2021 ◽  
Author(s):  
Eiman Mokaddas ◽  
Suhail Ahmad ◽  
Hanaa Eldeen
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
Performance Comparison ◽  
Nucleic Acid Detection ◽  
Smear Microscopy ◽  
Tissue Biopsy ◽  
Negative Culture ◽  
Mdr Tb ◽  
Culture Positive ◽  
Histopathological Evidence ◽  
Better Than

Objective: Early detection and effective treatment are essential for global tuberculosis control. This study evaluated the performance of GeneXpert MTB/RIF (Xpert) and ProbeTec ET (PTec-ET) assays in diagnosing extrapulmonary tuberculosis (EPTB) in Kuwait. Materials and Methods: Nonrespiratory clinical specimens (n=3995) collected from 3995 patients suspected to have EPTB were tested. These included cavitary fluids (n=2054), fine needle aspirate (FNA)/pus/tissue biopsy (n=1461), urine (n=302), cerebrospinal fluid (CSF, n=118), and others (n=60). All specimens were processed for acid-fast bacilli (AFB), culture in MGIT 960 system and nucleic acid detection by Xpert and PTec-ET according to manufacturer’s instructions. Results: Of 3995 specimens, 95 were AFB-positive, 403 were culture-positive and an additional 86 samples had histopathology suggestive of TB. Using culture as reference, the sensitivity and specificity values were 88.33% and 97.3% for Xpert and 72.95% and 97.80% for PTec-ET, respectively. Although performance of both tests was comparable in AFB-positive samples, Xpert detected significantly more cases in culture-positive samples. Among culture-negative samples, Xpert detected 18 more cases including 16 with histopathological evidence of TB. Lowest positivity was detected for both tests in cavitary fluids. Xpert performed better than PTec-ET in culture-positive FNA/pus/tissue biopsy and CSF samples. Conclusions: Although performance of both tests was suboptimal for AFB-negative/culture-positive samples, Xpert performed better than PTec-ET and also detected more cases of AFB-negative/culture-nagative/histopathology-positive samples. PTec-ET was positive in three while Xpert was positive in all six culture-positive CSF specimens for rapid diagnosis of TB meningitis. Xpert was thus superior to PTec-ET or smear microscopy in rapidly diagnosing EPTB.

scholarly journals Inaccuracy of Death Certificate Diagnosis of Tuberculosis and Potential Underdiagnosis of TB in a Region of High HIV Prevalence

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Theresa T. Liu ◽  
Douglas Wilson ◽  
Halima Dawood ◽  
D. William Cameron ◽  
Gonzalo G. Alvarez
Keyword(s):  
South African ◽  
Death Certificate ◽  
Population Based ◽  
Drug Resistant ◽  
Negative Culture ◽  
Mdr Tb ◽  
Hospital Deaths ◽  
Smear Negative ◽  
Culture Positive ◽  
Antiretroviral Therapy Rollout

Despite the South African antiretroviral therapy rollout, which should reduce the incidence of HIV-associated tuberculosis (TB), the number of TB-attributable deaths in KwaZuluNatal (KZN) remains high. TB is often diagnosed clinically, without microbiologic confirmation, leading to inaccurate estimates of TB-attributed deaths. This may contribute to avoidable deaths, and impact population-based TB mortality estimates.Objectives. (1) To measure the number of cases with microbiologically confirmed TB in a retrospective cohort of deceased inpatients with TB-attributed hospital deaths. (2) To estimate the rates of multi-drug resistant (MDR) and extensively drug resistant (XDR) TB in this cohort.Results. Of 2752 deaths at EDH between September 2006 and March 2007, 403 (15%) were attributed to TB on the death certificate. 176 of the TB-attributed deaths (44%) had a specimen sent for smear or culture; only 64 (36%) had a TB diagnosis confirmed by either test. Of the 39 culture-confirmed cases, 27/39 (69%) had fully susceptible TB and 27/39 (69%) had smear-negative culture-positive TB (SNTB). Two patients had drug monoresistance, three patients had MDR-TB, and one had XDR-TB.Conclusions. Most TB-attributed deaths in this cohort were not microbiologically confirmed. Of confirmed cases, most were smear-negative, culture positive and were susceptible to all first line drugs.

scholarly journals Comparison of MGIT 960 with Lowenstein Jensen Media for Recovery of Mycobacteria from Extrapulmonary Specimens in Southern India

2021 ◽  
Author(s):  
Kalpana Thangavelu ◽  
Imola Jamir ◽  
Kalaiarasan Ellappan ◽  
Krishnapriya Krishnakumariamma ◽  
Pallam Gopichand ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
Smear Microscopy ◽  
Care Hospital ◽  
Lowenstein Jensen ◽  
Time To Detection ◽  
Culture Positive ◽  
Indicator Tubes ◽  
Growth Indicator

Introduction: Prevalence of Extrapulmonary Tuberculosis (EPTB) due to Mycobacteriumtuberculosis and Non-Tuberculous Mycobacteria (NTM) are on the rise especially in a developing country like India. Smear Microscopy (SM) is commonly used for detection of mycobacteria. Due to the paucibacillary nature in the extrapulmonary specimens SM pose a problem in detection. Though molecular methods are increasingly used now-a-days but there are possibilities that these reactions may get inhibited due to the presence of inhibitors in the extrapulmonary specimens. Aim: To compare Mycobacterium Growth Indicator Tubes (MGIT 960) with Lowenstein Jensen (LJ) medium for the detection of mycobacteria. Materials and Methods: The current prospective study was conducted on 1879 extrapulmonary specimens collected from a tertiary care hospital during the study period from July 2018 to March 2020. Specimens were subjected to Ziehl Neelsen (ZN) staining and Auramine Phenol (AP) staining. Culture was done in both LJ media and MGIT 960 culture. Positive mycobacterial cultures were subjected to MPT64 Immunochromatographic Test (ICT). Data were analysed using the Statistical Package for Social Sciences (SPSS®) for Windows® release 21.0 (SPSS Inc., Chicago, IL, USA). Results: A total of 129 (6.9%) and 105 (5.6%) mycobacteria was isolated by MGIT 960 and by LJ culture respectively among 1879 extrapulmonary specimens. MGIT 960 identified 118 (91.5%) as Mycobacterium tuberculosis complex and 11 (8.5%) as NTM among the total mycobacteria isolated. Out of 105 mycobacteria grown by LJ culture, 95 (90.5%) and 10 (9.5%) were identified as Mycobacterium tuberculosis and NTM, respectively. The rate of contamination associated with MGIT 960 and LJ culture was 4.6% and 4.3% respectively. The Time to Detection (TTD) was found to be significantly shorter for isolation of Mycobacterium tuberculosis by MGIT 960 culture compared to LJ culture. Conclusion: In the current study, authors compared MGIT 960 with solid LJ culture for recovery of both Mycobacterium tuberculosisComplex and NTM from extrapulmonary specimens and authors found increased recovery by MGIT 960 compared to LJ culture and also shorter duration of detection for Mycobacterium tuberculosis by MGIT 960 with comparable contamination rates.

The structures of benzimidazole derivatives and their potential as tuberculostatics

2018 ◽  
Vol 74 (12) ◽  
pp. 1684-1691
Author(s):  
Marek L. Główka ◽  
Sylwia Kałużyńska ◽  
Malwina Krause ◽  
Katarzyna Gobis ◽  
Henryk Foks ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
Benzimidazole Derivatives ◽  
X Ray Diffraction ◽  
Intermolecular Hydrogen Bonds ◽  
X Ray ◽  
Resistant Varieties ◽  
Different Types ◽  
Mdr Tb ◽  
Aromatic Systems ◽  
Better Than

Tuberculosis still remains a very important problem, especially its multidrug resistant varieties (MDR-TB). Among the potential tuberculostatics, there are two benzimidazole derivatives, namely 5,6-dimethyl-2-phenylethylbenzo[d]imidazole (1) and (E)-5,6-dimethyl-2-styryl-1H-benzo[d]imidazole (2) which showed significant tuberculostatic activities, better than those of Pyrazinamide and Isoniazyd. Also, the cytotoxicity of 1 appeared promising. The compounds were studied (with the use of X-ray diffraction) in the form of the hemihydrate of 1, C17H18N2·0.5H2O (1a), the methanol hemisolvate of 2, C17H16N2·0.5CH3OH (2a), and the acid oxalate salt of 2, namely (E)-5,6-dimethyl-2-styryl-1H-benzo[d]imidazolium hydrogen oxalate, C17H17N2 +·C2HO4 − (2b). All three structures reveal a similar extended conformation, despite the flexible linker between the two aromatic systems and the different types of strong intermolecular hydrogen bonds. The molecules of 2a are practically planar due to the double bond in the linker, which enables conjugation along the whole molecule, while the molecules of 1a exhibit the possibility of parallel orientations of their aromatic systems, despite the aliphatic (ethyl) linker.

The Diagnosis of Extrapulmonary Tuberculosis in Malawi

2003 ◽  
Vol 33 (1) ◽  
pp. 7-11 ◽  
Author(s):  
Anthony D Harries ◽  
Nicola J Hargreaves ◽  
John H Kwanjana ◽  
Felix M Salaniponi
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Smear Microscopy ◽  
Cross Sectional ◽  
Extra Pulmonary Tuberculosis ◽  
Diagnostic Practices ◽  
Hospital Resources ◽  
Sub Saharan ◽  
Made In

There is little information on a country-wide basis in sub-Saharan Africa about how the diagnosis of extra-pulmonary tuberculosis (EPTB) is made. A country-wide cross-sectional study was carried out in 40 non-private hospitals in Malawi which register and treat (TB) patients in order to assess diagnostic practices in adults registered with EPTB. All patients aged 15 years and above in hospital on treatment for EPTB were reviewed using TB registers, case note files and clinical assessment. There were 244 patients, 132 men and 112 women whose mean age was 36 years. In 138 (57%) patients, all appropriate procedures and investigations, commensurate with hospital resources, had been carried out. Of 171 EPTB patients with cough for 3 weeks or longer, 138 (81%) submitted sputum specimens for smear microscopy of acid-fast bacilli (AFB). A confirmed diagnosis of TB was made in 15 (6%) patients based on finding AFB or caseating granulomas in specimens. In 157 (64%) patients, the diagnosis of EPTB was considered to be correct. In 46 (19%) patients the diagnosis was considered to be TB, although different from the type of EPTB with which the patient was registered. In 39 (16%) patients an alternative non-TB diagnosis was made and in two (1%) patients it was not possible to make a decision. Diagnostic practices need to be improved, and ways of doing this are discussed.

scholarly journals Smear-negative, culture positive TB: diagnosis improvement by Xpert MTB/RIF assay

2015 ◽  
Vol 25 (suppl_3) ◽  
Author(s):  
P Dal Monte ◽  
G Lombardi ◽  
V Di Gregori ◽  
G Martelli ◽  
M Tadolini ◽  
...  
Keyword(s):  
Negative Culture ◽  
Smear Negative ◽  
Culture Positive

scholarly journals Comparison of Led Fluorescent Microscopy and the Gene Xpert MTB/RIF Assay in Diagnosis of Pulmonary and Extrapulmonary Tuberculosis

2019 ◽  
Vol 6 ◽  
pp. 127-132
Author(s):  
Sanam Thapa Magar ◽  
Gokarna Ghimire ◽  
Pradeep Kumar Shah
Keyword(s):  
Pulmonary Tuberculosis ◽  
Extrapulmonary Tuberculosis ◽  
Fluorescent Microscopy ◽  
Cross Sectional Study ◽  
Smear Microscopy ◽  
Cross Sectional ◽  
Female Ratio ◽  
Standard Guideline ◽  
National Tuberculosis ◽  
Male To Female

Objectives: The objective of this study was to evaluate Gene Xpert MTB/RIF Assay and anid fast staining (AFB) for rapid detection of Mycobacterium tuberculosis in specimen of patients suspected of pulmonary tuberculosis (PTB) and extra pulmonary tuberculosis (EPTB). Methods: A comparative cross-sectional study of 400 samples (PTB-365 and EPTB-35) of patients visiting National Tuberculosis Centre (NTC) was conducted from July 2018 to December 2018. Gene Xpert MTB/ RIF Assay, smear microscopy were performed under standard guideline inside biosafety cabinet class II. The result obtained from both the tests were analyzed using SPSS 20.0 software and Excel 2019. Results: Of the total samples, 18% (72/400) and 39% (156/400) were positive by AFB smear microscopy and Xpert MTB/RIF assay respectively. Prevalence of MTB positive was highest in the age group 35-44 years, 33 cases (17.74%) were detected in total, with a male to female ratio of 2.3:1. Pleural fluid, pus, and CSF fluid also yielded positive results with the Gene Xpert MTB/RIF assay accounting 1.28%, 0.64% and 1.28% of MTB positive case respectively. Rifampicin resistance was observed in 1.28% of the cases. Conclusion: The key findings of this study suggest that Gene Xpert test should be implemented as primary diagnostic test for PTB and EPTB.

scholarly journals Comparative Evaluation of Enteric Bacterial Culture and a Molecular Multiplex Syndromic Panel in Children with Acute Gastroenteritis

2019 ◽  
Vol 57 (6) ◽  
Author(s):  
Thomas Kellner ◽  
Brendon Parsons ◽  
Linda Chui ◽  
Byron M. Berenger ◽  
Jianling Xie ◽  
...  
Keyword(s):  
Pathogen Detection ◽  
Rectal Swab ◽  
Bacterial Pathogen ◽  
Positive Culture ◽  
Content Type ◽  
Negative Culture ◽  
Percent Agreement ◽  
Stool Samples ◽  
Culture Positive ◽  
Culture Negative

ABSTRACTAlthough enteric multianalyte syndromic panels are increasingly employed, direct comparisons with traditional methods and the inclusion of host phenotype correlations are limited. Luminex xTAG gastrointestinal pathogen panel (GPP) and culture results are highly concordant. However, phenotypic and microbiological confirmatory testing raises concerns regarding the accuracy of the GPP, especially forSalmonellaspp. A total of 3,089 children with gastroenteritis submitted stool specimens, rectal swab specimens, and clinical data. The primary outcome was bacterial pathogen detection agreement for shared targets between culture and the Luminex xTAG GPP. Secondary analyses included phenotype assessment, additional testing of GPP-negative/culture-positive isolate suspensions with the GPP, and in-house and commercial confirmatory nucleic acid testing of GPP-positive/culture-negative extracts. The overall percent agreement between technologies was >99% for each pathogen.Salmonellaspp. were detected in specimens from 64 participants: 12 (19%) by culture only, 9 (14%) by GPP only, and 43 (67%) by both techniques. Positive percent agreement forSalmonellaspp. was 78.2% (95% confidence interval [CI], 64.6%, 87.8%). Isolate suspensions from the 12 participants with specimens GPP negative/culture positive forSalmonellatested positive by GPP. Specimens GPP positive/culture negative forSalmonellaoriginated in younger children with less diarrhea and more vomiting. GPP-positive/culture-negative specimen extracts tested positive using additional assays for 0/2Campylobacter-positive specimens, 0/4Escherichia coliO157-positive specimens, 0/9Salmonella-positive specimens, and 2/3Shigella-positive specimens. For both rectal swab and stool samples, the median cycle threshold (CT) values, determined using quantitative PCR, were higher for GPP-negative/culture-positive samples than for GPP-positive/culture-positive samples (for rectal swabs, 36.9 [interquartile range {IQR}, 33.7, 37.1] versus 30.0 [IQR, 26.2, 33.2], respectively [P = 0.002]; for stool samples, 36.9 [IQR, 33.7, 37.1] versus 29.0 [IQR, 24.8, 30.8], respectively [P = 0.001]). GPP and culture have excellent overall agreement; however, for specific pathogens, GPP is less sensitive than culture and, notably, identifies samples false positive forSalmonellaspp.

scholarly journals Feasibility and Performance of Loop-Mediated Isothermal Amplification Assay in the Diagnosis of Pulmonary Tuberculosis in Decentralized Settings in Eastern China

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Zhongdong Wang ◽  
Haiyan Sun ◽  
Zhisheng Ren ◽  
Bai Xue ◽  
Jie Lu ◽  
...  
Keyword(s):  
Eastern China ◽  
Isothermal Amplification ◽  
Smear Microscopy ◽  
Loop Mediated Isothermal Amplification ◽  
Resource Limited ◽  
Control And Prevention ◽  
Amplification Assay ◽  
Smear Negative ◽  
And Performance ◽  
Culture Positive

Early diagnosis is essential for the control and prevention of tuberculosis (TB). The objective of this study was to investigate the feasibility and performance of loop-mediated isothermal amplification (LAMP) in the diagnosis of pulmonary TB in county-level microscopy centers in Qingdao, Eastern China. A total of 523 presumptive TB patients were consecutively recruited between July 2017 and April 2018, and 22 patients were excluded from the analysis. Of 102 culture-positive cases, TB-LAMP identified 91 cases, demonstrating a sensitivity of 89.2%. In comparison, the sensitivity of routine smear microscopy was 69.6% (71/102), which was significantly lower than that of TB-LAMP (P=0.001). In addition, TB-LAMP sensitivities in smear-positive and smear-negative samples were 98.6% and 67.7%, respectively. In conclusion, our data demonstrate that TB-LAMP outperforms conventional smear microscopy in TB diagnosis, which could be used as an alternative method for smear microscopy in resource-limited settings in China.

Smear Negative, Culture Positive AFB Bronchial Washings

CHEST Journal ◽  
1996 ◽  
Vol 109 (5) ◽  
pp. 1410-1411
Author(s):  
Inge Gurevich ◽  
Evelyn Jacobsen ◽  
Antonio Ortega ◽  
Burke A. Cunha
Keyword(s):  
Negative Culture ◽  
Smear Negative ◽  
Culture Positive
Sign in / Sign up

Export Citation Format

Share Document