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https://www.readbyqxmd.com/read/27898665/extending-contact-tracing-into-the-community-within-a-50-metre-radius-of-an-index-tuberculosis-patient-using-xpert-mtb-rif-in-urban-pakistan-did-it-increase-case-detection
#1
Razia Fatima, Ejaz Qadeer, Aashifa Yaqoob, Mahboob Ul Haq, Suman S Majumdar, Hemant D Shewade, Robert Stevens, Jacob Creswell, Nasir Mahmood, Ajay M V Kumar
BACKGROUND: Currently, only 62% of incident tuberculosis (TB) cases are reported to the national programme in Pakistan. Several innovative interventions are being recommended to detect the remaining 'missed' TB cases. One such intervention involved expanding contact investigation to the community using the Xpert MTB/RIF test. METHODS: This was a before and after intervention study involving retrospective record review. Passive case finding and household contact investigation was routinely done in the pre-intervention period July 2011-June 2013...
2016: PloS One
https://www.readbyqxmd.com/read/27891336/mycobacterium-tuberculosis-beijing-genotype-in-western-iran-distribution-and-drug-resistance
#2
Parviz Mohajeri, Sakineh Moradi, Sara Atashi, Abbas Farahani
INTRODUCTION: Mycobacterium tuberculosis Beijing genotype is gaining importance all over the world because this genotype is highly prevalent in several areas and is also frequently associated with drug resistance. AIM: To identify and determine the frequency of Beijing genotype and mix infection with Beijing and non-Beijing in west of Iran and analyse the association between Beijing genotype and drug resistance. MATERIALS AND METHODS: This cross-sectional study was conducted on 146 Tuberculosis (TB) samples collected at the TB reference laboratory in Kermanshah west of Iran from January 2014 to February 2015, Mycobacterium tuberculosis isolates from sputum samples, detected by microcopy, biochemical tests and solid culture were included and then the confirmed samples with Cepheid Xpert MTB/RIF assay were subjected to drug susceptibility tests for rifampicin, isoniazid, ethambutol using proportional method...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27874159/evaluation-of-genexpert-mtb-rif-for-detection-of-mycobacterium-tuberculosis-complex-and-rpo-b-gene-in-respiratory-and-non-respiratory-clinical-specimens-at-a-tertiary-care-teaching-hospital-in-saudi-arabia
#3
Ali M Somily, Mazin A Barry, Hanan A Habib, Fawzia E Alotaibi, Fahad A Al-Zamil, Mohammed A Khan, Mohammed S Sarwar, Nawab D Bakhash, Abdulkarim A Alrabiaah, Zahid A Shakoor, Abiola C Senok
To assess the performance of Xpert MTB/RIF, an automated molecular test for Mycobacterium tuberculosis (MTB) and resistance to rifampin (RIF), against smear microscopy and culture method for diagnosis of MTB infection. Methods: This is a retrospective analysis of 103 respiratory and 137 non-respiratory patient specimens suspected of tuberculosis at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia performed between April 2014 and March 2015. Each sample underwent smear microscopy, mycobacterial culture, and GeneXpert MTB/RIF test...
December 2016: Saudi Medical Journal
https://www.readbyqxmd.com/read/27866961/paradoxical-results-of-two-automated-real-time-pcr-assays-in-the-diagnosis-of-pleural-tuberculosis
#4
Soraya Morales-López, Jayr A Yepes, Anzola Irina, Hernán Aponte, Claudia R Llerena-Polo
Tuberculosis (TB) is a major cause of worldwide mortality. We report the case of a non-HIV-infected woman with clinical suspicion of pleural tuberculosis and contradictory results between Xpert® MTB/RIF and Abbott RealTime MTB assays from pleural fluid specimen. Liquid and solid cultures for tuberculosis were performed with negative results. The patient received treatment and clinical improvement was observed. Both techniques detect Mycobacterium tuberculosis complex, but they have different targets and limits of detection...
November 17, 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/27865403/propidium-monoazide-and-xpert-mtb-rif-to-quantify-mycobacterium-tuberculosis-cells
#5
Xavier A Kayigire, Sven O Friedrich, Miriam N Karinja, Lize van der Merwe, Neil A Martinson, Andreas H Diacon
Propidium monoazide (PMA) penetrates non-viable cells with compromised membranes. PMA has been proposed to improve the specificity of Xpert MTB/RIF (Xpert) for the detection of viable Mycobacterium tuberculosis. This study assessed the effect of PMA on Xpert cycle thresholds (CT) of M. tuberculosis made non-viable under antibiotic pressure. In vitro, we measured the difference between CT with and without PMA (ΔCT) in liquid cultures treated with one of six anti-tuberculosis drugs (isoniazid, rifampin, pyrazinamide, ethambutol, streptomycin, moxifloxacin) and found significant ΔCT only with isoniazid and ethambutol for pan-susceptible M...
December 2016: Tuberculosis
https://www.readbyqxmd.com/read/27865380/highly-sensitive-sequence-specific-qpcr-detection-of-mycobacterium-tuberculosis-complex-in-respiratory-specimens
#6
Jennifer L Reed, Zachary J Walker, Debby Basu, Veronica Allen, Mark P Nicol, David M Kelso, Sally M McFall
Nucleic acid amplification tests for Mycobacterium tuberculosis (MTB) detection from sputum are highly sensitive and specific with smear microscopy positive specimens, but their sensitivity with smear-negative/culture-positive specimens is much lower; therefore, these tests cannot rule out a tuberculosis diagnosis. Co-extraction of PCR inhibitors may be a cause of decreased test sensitivity. Here the design and early validation of a MTB screening assay with sample preparation and qPCR methods designed to specifically address this diagnostic gap is reported...
December 2016: Tuberculosis
https://www.readbyqxmd.com/read/27847005/epidemiology-of-multidrug-resistant-extensively-drug-resistant-and-totally-drug-resistant-tuberculosis-in-middle-east-countries
#7
REVIEW
Mohanad M Ahmed, Ali A Velayati, Suhad H Mohammed
The 2015 represent the deadline for the global tuberculosis (TB) targets set through the Millennium Development Goals (MDG). From 2016 and onward, new goals were set to end the global TB epidemic via implementing new campaign entitled "the End TB Strategy". The major hurdle to end TB epidemic in several parts of the world is the emergence and spread of drug resistant Mycobacterium tuberculosis (MTB) strains. The better understanding of the actual global burden of drug resistant tuberculosis would feed into better implementing the End TB Strategy...
September 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/27829072/autopsy-prevalence-of-tuberculosis-and-other-potentially-treatable-infections-among-adults-with-advanced-hiv-enrolled-in-out-patient-care-in-south-africa
#8
Aaron S Karat, Tanvier Omar, Anne von Gottberg, Mpho Tlali, Violet N Chihota, Gavin J Churchyard, Katherine L Fielding, Suzanne Johnson, Neil A Martinson, Kerrigan McCarthy, Nicole Wolter, Emily B Wong, Salome Charalambous, Alison D Grant
BACKGROUND: Early mortality among HIV-positive adults starting antiretroviral therapy (ART) remains high in resource-limited settings, with tuberculosis (TB) the leading cause of death. However, current methods to estimate TB-related deaths are inadequate and most autopsy studies do not adequately represent those attending primary health clinics (PHCs). This study aimed to determine the autopsy prevalence of TB and other infections in adults enrolled at South African PHCs in the context of a pragmatic trial of empiric TB treatment ("TB Fast Track")...
2016: PloS One
https://www.readbyqxmd.com/read/27812140/early-outcomes-of-decentralized-care-for-rifampicin-resistant-tuberculosis-in-johannesburg-south-africa-an-observational-cohort-study
#9
Rebecca Berhanu, Kathryn Schnippel, Erika Mohr, Kamban Hirasen, Denise Evans, Sydney Rosen, Ian Sanne
OBJECTIVE: We describe baseline characteristics, time to treatment initiation and interim patient outcomes at a decentralized, outpatient treatment site for rifampicin-resistant TB (RR-TB). METHODS: Prospective observational cohort study of RR-TB patients from March 2013 until December 2014. Study subjects were followed until completion of the intensive phase of treatment (6 months), transfer out, or a final outcome (loss from treatment (LFT) or death). RESULTS: 214 patients with RR-TB were enrolled in the study...
2016: PloS One
https://www.readbyqxmd.com/read/27794093/verbal-autopsy-assigned-causes-of-death-among-adults-being-investigated-for-tb-in-south-africa
#10
Noriah Maraba, Aaron S Karat, Kerrigan McCarthy, Gavin J Churchyard, Salome Charalambous, Kathleen Kahn, Alison D Grant, Violet Chihota
BACKGROUND: Adults being investigated for TB in South Africa experience high mortality, yet causes of death (CoD) are not well defined. We determined CoD in this population using verbal autopsy (VA), and compared HIV- and TB-associated CoD using physician-certified verbal autopsy (PCVA) and InterVA-4 software. METHODS: All contactable consenting caregivers of participants who died during a trial comparing Xpert MTB/RIF to smear microscopy were interviewed using the WHO VA tool...
September 2016: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/27782821/implementation-of-a-pragmatic-stepped-wedge-cluster-randomized-trial-to-evaluate-impact-of-botswana-s-xpert-mtb-rif-diagnostic-algorithm-on-tb-diagnostic-sensitivity-and-early-antiretroviral-therapy-mortality
#11
Andrew F Auld, Tefera Agizew, Sherri Pals, Alyssa Finlay, Ndwapi Ndwapi, Rosanna Boyd, Heather Alexander, Anikie Mathoma, Joyce Basotli, Sambayawo Gwebe-Nyirenda, James Shepherd, Tedd V Ellerbrock, Anand Date
BACKGROUND: In 2012, as a pilot for Botswana's national Xpert MTB/RIF (Xpert) rollout plans, intensified tuberculosis (TB) case finding (ICF) activities were strengthened at 22 HIV treatment clinics prior to phased activation of 13 Xpert instruments. Together, the strengthened ICF intervention and Xpert activation are referred to as the "Xpert package". METHODS: The evaluation, called the Xpert Package Rollout Evaluation using a Stepped-wedge design (XPRES), has two key objectives: (1) to compare sensitivity of microscopy-based and Xpert-based pulmonary TB diagnostic algorithms in diagnosing sputum culture-positive TB; and (2) to evaluate impact of the "Xpert package" on all-cause, 6-month, adult antiretroviral therapy (ART) mortality...
October 26, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27776489/respiratory-microbes-present-in-the-nasopharynx-of-children-hospitalised-with-suspected-pulmonary-tuberculosis-in-cape-town-south-africa
#12
Felix S Dube, Mamadou Kaba, F J Lourens Robberts, Lemese Ah Tow, Sugnet Lubbe, Heather J Zar, Mark P Nicol
BACKGROUND: Lower respiratory tract infection in children is increasingly thought to be polymicrobial in origin. Children with symptoms suggestive of pulmonary tuberculosis (PTB) may have tuberculosis, other respiratory tract infections or co-infection with Mycobacterium tuberculosis and other pathogens. We aimed to identify the presence of potential respiratory pathogens in nasopharyngeal (NP) samples from children with suspected PTB. METHOD: NP samples collected from consecutive children presenting with suspected PTB at Red Cross Children's Hospital (Cape Town, South Africa) were tested by multiplex real-time RT-PCR...
October 24, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27763258/tuberculosis-diagnostics-state-of-the-art-and-future-directions
#13
Madhukar Pai, Mark P Nicol, Catharina C Boehme
Rapid and accurate diagnosis is critical for timely initiation of anti-tuberculosis (TB) treatment, but many people with TB (or TB symptoms) do not have access to adequate initial diagnosis. In many countries, TB diagnosis is still reliant on sputum microscopy, a test with known limitations. However, new diagnostics are starting to change the landscape. Stimulated, in part, by the success and rollout of Xpert MTB/RIF, an automated, molecular test, there is now considerable interest in new technologies. The landscape looks promising with a pipeline of new tools, particularly molecular diagnostics, and well over 50 companies actively engaged in product development, and many tests have been reviewed by WHO for policy endorsement...
October 2016: Microbiology Spectrum
https://www.readbyqxmd.com/read/27760181/discordance-between-mtb-rif-and-real-time-tuberculosis-specific-polymerase-chain-reaction-assay-in-bronchial-washing-specimen-and-its-clinical-implications
#14
Yong Suk Jo, Ju-Hee Park, Jung Kyu Lee, Eun Young Heo, Hee Soon Chung, Deog Kyeom Kim
The prevalence and clinical implications of discordance between Xpert MTB/RIF assays and the AdvanSure TB/NTM real-time polymerase chain reaction (PCR) for bronchial washing specimens have not been studied in pulmonary TB (PTB) patients. The discordant proportion and its clinical impact were evaluated in 320 patients from the bronchoscopy registry whose bronchial washing specimens were tested simultaneously with Xpert MTB/RIF and the TB/NTM PCR assay for three years, and the accuracy of the assays, including the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), were studied...
2016: PloS One
https://www.readbyqxmd.com/read/27758992/role-of-xpert-mtb-rif-in-differentiating-tuberculosis-from-sarcoidosis-in-patients-with-mediastinal-lymphadenopathy-undergoing-ebus-tbna-a-study-of-147-patients
#15
Sahajal Dhooria, Nalini Gupta, Amanjit Bal, Inderpaul Singh Sehgal, Ashutosh Nath Aggarwal, Sunil Sethi, Digambar Behera, Ritesh Agarwal
BACKGROUND: In patients with intrathoracic lymphadenopathy, differentiating tuberculosis from sarcoidosis is often difficult. We hypothesized that Xpert MTB/RIF assay, a semi-automated hemi-nested PCR would help in this regard. OBJECTIVE: To evaluate the performance of Xpert MTB/RIF in the differential diagnosis of tuberculosis and sarcoidosis. METHODS: This was a retrospective analysis of patients with intrathoracic lymphadenopathy who underwent endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA), and were diagnosed as either tuberculosis or sarcoidosis...
October 7, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
https://www.readbyqxmd.com/read/27754539/trends-in-tuberculosis-notification-and-treatment-outcomes-in-prisons-a-country-wide-assessment-in-el-salvador-from-2009-2014
#16
Gilberto Ayala, Julio Garay, Miguel Aragon, Tom Decroo, Rony Zachariah
Objective To describe trends in tuberculosis (TB) notification and treatment outcomes in 25 prisons in El Salvador from 2009-2014 and to determine if a set of interventions introduced in 2011 affected TB case finding and management. Methods This was operational research that utilized a retrospective cohort study of program data from 2009-2014. The package of interventions introduced in 2011 provides staff training, engages inmates in TB case finding, and offers diagnosis through mobile X-ray and Xpert® MTB/RIF...
January 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/27749648/cost-effectiveness-of-diagnostic-algorithms-for-tuberculosis-in-children-less-than-5-years-of-age
#17
Amanda K Debes, Robert H Gilman, Carolyne Onyango-Makumbi, Andrea Ruff, Richard Oberhelman, David W Dowdy
BACKGROUND: The objective of this analysis was to assess the cost-effectiveness of TB diagnosis using Microscopic Observation Drug Susceptibility (MODS), Xpert MTB/RIF (Xpert), and empiric treatment for all patients, in addition to current clinical diagnostic practices in children less than 5 years of age in a national tuberculosis (TB) referral hospital in Uganda. METHODS: A decision analysis was conducted from the healthcare perspective, with a primary outcome of incremental cost effectiveness expressed as cost per year of life gained (YLG)...
October 3, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27737841/diagnostic-test-accuracy-in-childhood-pulmonary-tuberculosis-a-bayesian-latent-class-analysis
#18
Samuel G Schumacher, Maarten van Smeden, Nandini Dendukuri, Lawrence Joseph, Mark P Nicol, Madhukar Pai, Heather J Zar
Evaluation of tests for the diagnosis of childhood pulmonary tuberculosis (CPTB) is complicated by the absence of an accurate reference test. We present a Bayesian latent class analysis in which we evaluated the accuracy of 5 diagnostic tests for CPTB. We used data from a study of 749 hospitalized South African children suspected to have CPTB from 2009 to 2014. The following tests were used: mycobacterial culture, smear microscopy, Xpert MTB/RIF (Cepheid Inc.), tuberculin skin test (TST), and chest radiography...
November 1, 2016: American Journal of Epidemiology
https://www.readbyqxmd.com/read/27733634/xpert-mtb-rif-assay-shows-faster-clearance-of-m-tuberculosis-dna-with-higher-rifapentine-exposure
#19
A Jayakumar, R M Savic, C K Everett, D Benator, D Alland, C M Heilig, M Weiner, S O Friedrich, N A Martinson, A Kerrigan, C Zamudio, S V Goldberg, W C Whitworth, J L Davis, P Nahid
The Xpert® MTB/RIF assay is both sensitive and specific as a diagnostic test. Xpert also reports quantitative output in cycle thresholds (Ct), which may provide a dynamic measure of sputum bacillary burden when used longitudinally. We evaluated the relationship between Xpert Ct trajectory and drug exposure during TB treatment to evaluate the potential utility of Xpert Ct for treatment monitoring. We obtained serial sputum samples from patients with smear-positive pulmonary TB consecutively enrolled at ten international clinical trial sites participating in Study 29X, a CDC-sponsored TB Trials Consortium study evaluating the tolerability, safety, and antimicrobial activity of rifapentine at daily doses up to 20 mg/kg...
October 12, 2016: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/27725051/comparing-laboratory-costs-of-smear-culture-and-xpert-%C3%A2-mtb-rif-based-tuberculosis-diagnostic-algorithms
#20
P Naidoo, R Dunbar, E du Toit, M van Niekerk, S B Squire, N Beyers, J Madan
SETTING: Cape Town, South Africa, where Xpert(®) MTB/RIF was introduced as a screening test for all presumptive tuberculosis (TB) cases. OBJECTIVE: To compare laboratory costs of smear/culture- and Xpert-based tuberculosis (TB) diagnostic algorithms in routine operational conditions. METHODS: Economic costing was undertaken from a laboratory perspective, using an ingredients-based costing approach. Cost allocation was based on reviews of standard operating procedures and laboratory records, timing of test procedures, measurement of laboratory areas and manager interviews...
October 2016: International Journal of Tuberculosis and Lung Disease
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