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Laboratory comparison of stool processing methods for Xpert® Ultra.

C L Jasumback1,2, Q Dlamini2, J Kahari2

  • 1United States Peace Corps, Mbabane, Eswatini.

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|June 23, 2021
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Summary
This summary is machine-generated.

Diagnosing childhood tuberculosis (TB) is challenging. This study evaluated four methods for processing stool samples, a non-invasive option, for TB detection using the Xpert Ultra assay, assessing their accuracy and error rates.

Keywords:
childdiagnosistuberculosis

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Area of Science:

  • Microbiology
  • Pediatric Infectious Diseases
  • Molecular Diagnostics

Background:

  • Childhood tuberculosis diagnosis is complicated by vague symptoms and the need for invasive procedures.
  • Stool is a readily available, non-invasive specimen, making it a promising alternative for pediatric TB diagnosis.
  • Existing stool processing methods for TB detection require further evaluation for accuracy and reliability.

Purpose of the Study:

  • To assess the performance of four distinct stool processing techniques for diagnosing childhood tuberculosis.
  • To determine the detection and error rates of the Xpert Ultra assay when applied to processed stool samples.
  • To identify the most effective stool processing method for reliable TB diagnosis in children.

Main Methods:

  • Four different published stool processing protocols were applied to stool samples.
  • Bacille Calmette-Guérin (BCG) vaccine, a surrogate for Mycobacterium tuberculosis, was spiked into stool samples at known concentrations.
  • Processed stool samples were analyzed using the Xpert Ultra assay to evaluate detection and error rates.

Main Results:

  • The study compared the efficiency of four stool processing methods in detecting spiked BCG concentrations.
  • The Xpert Ultra assay's performance varied depending on the stool processing method used.
  • Specific methods demonstrated differential detection limits and error profiles, impacting diagnostic accuracy.

Conclusions:

  • Stool processing methods significantly influence the performance of molecular assays like Xpert Ultra for childhood TB detection.
  • Further optimization and validation of stool processing techniques are crucial for establishing reliable, non-invasive TB diagnostics in children.
  • Selecting an appropriate stool processing method is essential for maximizing the sensitivity and specificity of molecular TB testing in pediatric populations.