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Related Concept Videos

Pulmonary Tuberculosis IV01:26

Pulmonary Tuberculosis IV

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Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
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Description
Sputum culture and sensitivity is a medical procedure used to diagnose bacterial infections in the respiratory tract and select the most appropriate antibiotics for treatment. This process involves analyzing sputum samples of thick and opaque secretions produced in the lungs and airways. These samples are collected from patients and then sent to the laboratory for analysis.
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Gastrointestinal (GI) diagnostic studies are pivotal in confirming, ruling out, diagnosing, or staging various diseases, including cancers. Following diagnosis, allocating time for discussions with the patient and providing informational resources is crucial. Diagnostic assessments of the GI tract often occur in outpatient settings like endoscopy suites or GI labs. Preparation for these tests may include dietary restrictions, fasting, liquid bowel preparations, laxatives, enemas, and the...
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Diagnosing Pulmonary Tuberculosis with the Xpert MTB/RIF Test
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Stool processing methods for Xpert Ultra testing in childhood tuberculosis: A prospective, multi-country accuracy

Devan Jaganath1,2, Pamela Nabeta3, Mark P Nicol4

  • 1Division of Pediatric Infectious Diseases, University of California, San Francisco, San Francisco, USA.

Medrxiv : the Preprint Server for Health Sciences
|January 7, 2025
PubMed
Summary

Centrifuge-free stool processing methods for childhood tuberculosis (TB) testing using Xpert Ultra were found to be acceptable and usable. Performance was similar across methods, with higher sensitivity in culture-positive TB cases.

Keywords:
Xpert Ultracentrifuge-freechilddiagnosticsstooltuberculosis

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Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pediatrics

Background:

  • Centrifuge-free methods for stool Xpert Ultra testing in childhood tuberculosis (TB) are emerging.
  • Limited data exist on the accuracy, acceptability, and usability of these novel TB diagnostic approaches.

Purpose of the Study:

  • To prospectively evaluate the accuracy, acceptability, and usability of three centrifuge-free stool processing methods for Xpert Ultra testing in children with presumptive TB.
  • To compare the performance of Stool Processing Kit (SPK), Simple One-Step (SOS), and Optimized Sucrose Flotation (OSF) against reference standards.

Main Methods:

  • A prospective study involving 607 children (<15 years) with presumptive TB across India, South Africa, and Uganda.
  • Stool samples were processed using SPK, SOS, and OSF, followed by Xpert Ultra testing.
  • Accuracy was assessed against a microbiological reference standard (MRS) and a composite reference standard (CRS); laboratory staff usability and acceptability were surveyed.

Main Results:

  • Sensitivities for SPK, SOS, and OSF against MRS were 36.9%, 38.6%, and 31.3%, respectively; specificities were high (97.1-98.2%).
  • Laboratory staff found the methods acceptable and usable, with SOS noted as most feasible for peripheral settings.
  • Sensitivity improved significantly in culture-positive children (55-77.3%) but remained low against the CRS (13-16.7%).

Conclusions:

  • Centrifuge-free stool processing methods (SPK, SOS, OSF) for Xpert Ultra are acceptable and usable for childhood TB diagnosis.
  • The methods demonstrated similar performance, with notable improvements in sensitivity for culture-positive TB cases.
  • Further research may be needed to optimize sensitivity, particularly against composite reference standards.