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Diagnosing Pulmonary Tuberculosis with the Xpert MTB/RIF Test
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Diagnosing Pulmonary Tuberculosis with the Xpert MTB/RIF Test

Published on: April 9, 2012

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Stool-based Xpert MTB/RIF Ultra assay as a tool for detecting pulmonary tuberculosis in children with abnormal chest

Xu-Hui Liu1, Lu Xia2, Bin Song3

  • 1Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China; Shanghai Zhongshan Hospital, Fudan University, Shanghai, China.

The Journal of Infection
|December 4, 2020
PubMed

Insights

The Xpert MTB/RIF Ultra assay on stool samples is a viable alternative for diagnosing pediatric pulmonary tuberculosis (PTB) when respiratory samples are challenging to obtain. This stool-based test shows comparable sensitivity to Mycobacterium tuberculosis culture.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pediatric Pulmonology

Background:

  • Pediatric pulmonary tuberculosis (PTB) diagnosis can be challenging due to difficulties in obtaining respiratory samples.
  • The Xpert MTB/RIF Ultra assay offers a rapid diagnostic tool for tuberculosis.

Purpose of the Study:

  • To evaluate the diagnostic performance of the stool-based Xpert MTB/RIF Ultra assay compared to other methods for detecting PTB in children.
  • To assess the utility of stool samples as an alternative when respiratory tract samples are difficult to collect.

Main Methods:

  • A prospective, head-to-head comparative study analyzed 126 children (<15 years) with abnormal chest imaging.
  • Tests included Xpert MTB/RIF Ultra on stool (Ultra-Stool) and respiratory tract samples (Ultra-RTS), Xpert MTB/RIF on respiratory samples (Xpert-RTS), acid-fast bacilli smear (AFB-RTS), and Mycobacterium tuberculosis culture (Culture-RTS).
  • Results were compared against a composite reference standard.

Main Results:

  • Ultra-RTS showed the highest sensitivity (52%) and specificity (100%).
  • Ultra-Stool demonstrated 84.1% concordance with Ultra-RTS, with 45.5% sensitivity and 94.7% specificity.
  • The sensitivity of Ultra-Stool was comparable to Mtb culture (45.5%) and superior to AFB-RTS (27.3%).

Conclusions:

  • Stool sample-based Xpert MTB/RIF Ultra assay is a comparable alternative for PTB diagnosis when respiratory tract samples are difficult to obtain.
  • Assay positivity correlated with patient age and chest imaging findings.
Abstract

Keywords:
ChildrenStoolTrace-positiveTuberculosisXpert MTB/RIF Ultra

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