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Evaluation of different diagnostic methods for spinal tuberculosis infection
Zhaoxin Li1, Jin Wang1, Xin Xiu1
1Shandong University of Traditional Chinese Medicine, Shandong, China.
BMC Infectious Diseases
|October 18, 2023
Summary
T-SPOT.TB shows high effectiveness for diagnosing spinal tuberculosis (STB), while Xpert MTB/RIF offers reliability and rifampin resistance detection. Combining Xpert MTB/RIF with Metagenomic Next-Generation Sequencing (mNGS) improves early diagnosis and treatment for STB patients.
Area of Science:
- Infectious Diseases
- Microbiology
- Diagnostic Medicine
Background:
- Tuberculosis (TB) is a leading global infectious cause of mortality.
- Extrapulmonary TB accounts for 24.6% of cases, with spinal TB (STB) being predominant.
- Accurate and timely diagnosis of STB remains a significant clinical challenge.
Purpose of the Study:
- To evaluate and compare the diagnostic performance of four methods for STB detection.
- Methods evaluated include Mycobacteria Growth Indicator Tube (MGIT)-960 culture, T-SPOT.TB, Xpert Mycobacterium tuberculosis complex (MTB)/resistance to rifampin (RIF), and Metagenomic Next-Generation Sequencing (mNGS).
- To assess the utility of combinations of these diagnostic tools.
Main Methods:
- A cohort of 126 patients with suspected STB was analyzed.
- Diagnostic performance metrics (sensitivity, specificity, PPV, NPV) were calculated for each method and combinations.
- Clinical diagnosis served as the reference standard for comparison.
Main Results:
- T-SPOT.TB demonstrated high sensitivity (92.7%) and NPV (95.9%).
- Xpert MTB/RIF showed high specificity (100%) and PPV (100%), with rifampin resistance detection.
- Combination of Xpert MTB/RIF and mNGS yielded 73.2% sensitivity and 100% specificity; mNGS + T-SPOT.TB achieved 97.6% sensitivity and 100% specificity.
Conclusions:
- T-SPOT.TB is highly effective for STB diagnosis, while Xpert MTB/RIF is reliable and detects drug resistance.
- Metagenomic Next-Generation Sequencing (mNGS) aids in identifying pathogens, particularly in non-STB cases.
- Combining Xpert MTB/RIF with mNGS enhances early diagnosis, drug resistance detection, and reduces diagnostic time for STB.
Keywords:
DiagnosisMetagenomic next-generation sequencingMycobacterium tuberculosisSpinal tuberculosisXpert MTB/RIFMore Related Videos
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