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Xpert MTB

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https://www.readbyqxmd.com/read/29305538/false-positive-xpert-mtb-rif-results-in-re-tested-patients-with-previous-tuberculosis-frequency-profile-and-prospective-clinical-outcomes
#1
Grant Theron, Rouxjeane Venter, Liezel Smith, Aliasgar Esmail, Philippa Randall, Vishesh Sood, Suzette Oelfese, Greg Calligaro, Robin Warren, Keertan Dheda
Introduction: Globally, Xpert MTB/RIF (Xpert) is the most widely-used PCR test for tuberculosis (TB). Positive results in previously-treated patients, which are due to old DNA or active disease, are a diagnostic dilemma.Materials and methods: We prospectively re-tested sputum from 238 patients, irrespective of current symptoms, who were previously-diagnosed as Xpert-positive and treated successfully. Patients who re-tested as Xpert-positive, culture-negative were exhaustively investigated (repeated culture, chest radiography, bronchoscopy with bronchoalveolar lavage, long-term clinical follow-up)...
January 5, 2018: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/29305460/delays-in-the-diagnosis-and-treatment-of-bone-and-joint-tuberculosis-in-the-united-kingdom
#2
C Broderick, S Hopkins, D J F Mack, W Aston, R Pollock, J A Skinner, S Warren
AIMS: Tuberculosis (TB) infection of bones and joints accounts for 6.7% of TB cases in England, and is associated with significant morbidity and disability. Public Health England reports that patients with TB experience delays in diagnosis and treatment. Our aims were to determine the demographics, presentation and investigation of patients with a TB infection of bones and joints, to help doctors assessing potential cases and to identify avoidable delays. PATIENTS AND METHODS: This was a retrospective observational study of all adults with positive TB cultures on specimens taken at a tertiary orthopaedic centre between June 2012 and May 2014...
January 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29284421/improved-performance-of-xpert-mtb-rif-assay-on-sputum-sediment-samples-obtained-from-presumptive-pulmonary-tuberculosis-cases-at-kibong-oto-infectious-diseases-hospital-in%C3%A2-tanzania
#3
Peter M Mbelele, Said Aboud, Stellah G Mpagama, Mecky I Matee
BACKGROUND: The introduction of Xpert MTB/RIF assay (Xpert) has significantly improved diagnosis of Tuberculosis (TB) in resource limited human immunodeficiency virus (HIV) endemic settings. We aimed to modify the Xpert protocol to improve the detection of Mycobacterium tuberculosis (MTB). METHODS: This cross sectional study was conducted among presumptive pulmonary tuberculosis (PTB) patients at Kibong'oto Infectious Diseases Hospital between August and November 2015...
December 29, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29246776/evaluation-of-loopamp%C3%A2-mtbc-detection-kit-for-diagnosis-of-pulmonary-tuberculosis-at-a-peripheral-laboratory-in-a-high-burden-setting
#4
Van Anh Thi Nguyen, Hung Van Nguyen, Thuong Van Dinh, Ha Hoang Du, Chinh Nhu Do, Guy B Marks, Nhung Viet Nguyen
The Loopamp™MTBC detection kit (TB-LAMP) was designed to replace the sputum smear microscopy for the diagnosis of pulmonary tuberculosis. We evaluated its performance at a peripheral laboratory in Vietnam. The sensitivity of TB-LAMP was 45.5% (28.1%-63.6%), which was equal to 3-sputum smear microscopy but lower than that of Xpert MTB/RIF (87.8% [71.8%-96.6%]). In patients with culture-confirmed TB, sensitivity was 80% (51.9%-95.7%) in smear-positive and 16.7% (3.5%-41.4%) in smear-negative cases. The specificity of TB-LAMP was 95...
November 21, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/29240766/estimated-clinical-impact-of-the-xpert-mtb-rif-ultra-cartridge-for-diagnosis-of-pulmonary-tuberculosis-a-modeling-study
#5
Emily A Kendall, Samuel G Schumacher, Claudia M Denkinger, David W Dowdy
BACKGROUND: The Xpert MTB/RIF (Xpert) assay offers rapid and accurate diagnosis of tuberculosis (TB) but still suffers from imperfect sensitivity. The newer Xpert MTB/RIF Ultra cartridge has shown improved sensitivity in recent field trials, but at the expense of reduced specificity. The clinical implications of switching from the existing Xpert cartridge to the Xpert Ultra cartridge in different populations remain uncertain. METHODS AND FINDINGS: We developed a Markov microsimulation model of hypothetical cohorts of 100,000 individuals undergoing diagnostic sputum evaluation with Xpert for suspected pulmonary TB, in each of 3 emblematic settings: an HIV clinic in South Africa, a public TB center in India, and an adult primary care setting in China...
December 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29225973/molecular-epidemiology-of-rifampicin-resistance-in-mycobacterium-tuberculosis-using-the-genexpert-mtb-rif-assay-from-a-rural-setting-in-india
#6
Raghuprakash Reddy, Gerardo Alvarez-Uria
The Xpert MTB/RIF assay can detect mutations in rpoB gene that confer rifampicin resistance (RR) using five overlapping probes (A, B, C, D, and E). In this study, we described our experience with the Xpert assay in a rural setting in India. During the study period, 3250 samples were processed. The result was unsuccessful in 5.7% of cases. For extrapulmonary specimens, the risk of unsuccessful result was higher in tissue biopsy and stool samples. Among samples positive for Mycobacterium tuberculosis, rifampicin resistance was indeterminate in 1...
2017: Journal of Pathogens
https://www.readbyqxmd.com/read/29214755/comparative-evaluation-of-the-loop-mediated-isothermal-amplification-assay-for-detecting-pulmonary-tuberculosis
#7
Chang Ki Kim, Eun A Cho, Dong Mi Shin, Sung Won Choi, So Youn Shin
BACKGROUND: Early detection of tuberculosis (TB) is challenging in resource-poor settings because of limited accessibility to molecular diagnostics. The aim of this study was to evaluate the performance of the loop-mediated isothermal amplification kit (TB-LAMP) for TB diagnosis compared with conventional and molecular tests. METHODS: A total of 290 consecutive sputum samples were collected from May till September, 2015. All samples were processed using the N-Acetyl-L-cysteine (NALC) NaOH method and tested by smear microscopy, solid and liquid culture, real-time PCR, and TB-LAMP...
March 2018: Annals of Laboratory Medicine
https://www.readbyqxmd.com/read/29212699/rapid-microarray-based-detection-of-rifampicin-isoniazid-and-fluoroquinolone-resistance-in-mycobacterium-tuberculosis-using-a-single-cartridge
#8
Juliane Havlicek, Beatrice Dachsel, Peter Slickers, Sönke Andres, Patrick Beckert, Silke Feuerriegel, Stefan Niemann, Matthias Merker, Ines Labugger
Rapid and robust identification of mutations in Mycobacterium tuberculosis complex (MTBC) strains mediating multidrug and extensively drug-resistant (M/XDR) phenotypes is crucial to combat the MDR tuberculosis (TB) epidemic. Currently available molecular TB drug susceptibility tests are either restricted to single targets/drugs (i.e. Xpert MTB/RIF) or aid the risk of cross-contaminations due to the design limitations of the open platform (i.e. line probe assays).With a good understanding of the technical and commercial boundaries we designed a test cartridge with an introduction of dried reagents, based on an oligonucleotide array, which has the ability to identify MTBC strains resistant to isoniazid, rifampicin and the fluoroquinolones...
December 6, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/29211755/comparison-between-the-diagnostic-validities-of-xpert-mtb-rif-and-interferon-%C3%AE-release-assays-for-tuberculous-pericarditis-using-pericardial-tissue
#9
Guocan Yu, Bo Ye, Da Chen, Fangming Zhong, Gang Chen, Jun Yang, Liliang Xu, Xudong Xu
BACKGROUND: This study aimed to assess the diagnostic performance of Xpert MTB/RIF for tuberculous pericarditis (TBP) using pericardial tissues. METHODS: The study involved 30 patients admitted with suspected TBP from January-December 2016; three patients were later excluded. The interferon-γ release assay (T-SPOT.TB) and the Xpert MTB/RIF test were performed using peripheral blood and pericardial tissues, respectively. TBP was confirmed using pericardial histopathology and a composite reference standard (CRS)...
2017: PloS One
https://www.readbyqxmd.com/read/29208074/the-impact-of-implementing-a-xpert-mtb-rif-algorithm-on-drug-sensitive-pulmonary-tuberculosis-a-retrospective-analysis
#10
K Rees, N Muditambi, M Maswanganyi, J Railton, J A McIntyre, H E Struthers, P B Fourie, R P H Peters
Xpert MTB/RIF (Xpert) is the preferred first-line test for all persons with tuberculosis (TB) symptoms in South Africa in line with a diagnostic algorithm. This study evaluates pre- and post-implementation trends in diagnostic practices for drug-sensitive, pulmonary TB in adults in an operational setting, following the introduction of the Xpert-based algorithm. We retrospectively analysed data from the national TB database for Greater Tzaneen sub-district, Limpopo Province. Trends in a number of cases, diagnosis and outcome and characteristics associated with death are reported...
December 6, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/29201657/tuberculosis-among-migrants-in-bishkek-the-capital-of-the-kyrgyz-republic
#11
O Goncharova, O Denisiuk, R Zachariah, K Davtyan, D Nabirova, C Acosta, A Kadyrov
Setting: Twenty-two first-line, two second-line and one tertiary health facility in Bishkek, the capital of Kyrgyzstan. Objectives: Among migrants, a marginalised population at risk for acquiring and transmitting tuberculosis (TB), we determined the proportion with TB among all registered TB cases. For those registered at primary-level facilities, we then reported on their demographic and clinical profiles and TB treatment outcomes. Design: This was a retrospective cohort analysis of 2012-2013 programme data...
September 21, 2017: Public Health Action
https://www.readbyqxmd.com/read/29201656/age-stratified-tuberculosis-treatment-outcomes-in-zimbabwe-are-we-paying-attention-to-the-most-vulnerable
#12
R T Ncube, K C Takarinda, C Zishiri, W van den Boogaard, N Mlilo, C Chiteve, N Siziba, F Trinchán, C Sandy
Setting: A high tuberculosis (TB) incidence, resource-limited urban setting in Zimbabwe. Objectives: To compare treatment outcomes among people initiated on first-line anti-tuberculosis treatment in relation to age and other explanatory factors. Design: This was a retrospective record review of routine programme data. Results: Of 2209 patients included in the study, 133 (6%) were children (aged <10 years), 132 (6%) adolescents (10-19 years), 1782 (81%) adults (20-59 years) and 162 (7%) were aged ⩾60 years, defined as elderly...
September 21, 2017: Public Health Action
https://www.readbyqxmd.com/read/29201654/increasing-isoniazid-preventive-therapy-uptake-in-an-hiv-program-in-rural-papua-new-guinea
#13
A Carmone, C A Rodriguez, T D Frank, M Kiromat, P W Bongi, R G Kuno, T Palou, M F Franke
Setting: Tuberculosis (TB) is the leading cause of death among people living with the human immunodeficiency virus (PLHIV) in Papua New Guinea. Despite a policy for isoniazid preventive therapy (IPT) among PLHIV, implementation has been slow. Objective: We prospectively evaluated a standardized guided screening process, including TB diagnostic support, to increase IPT initiation in adult PLHIV on antiretro-viral treatment. Design: The guided process included a paper-based IPT screening tool that prompted review of patient history and TB symptoms and sputum analysis by smear microscopy and Xpert® MTB/RIF...
September 21, 2017: Public Health Action
https://www.readbyqxmd.com/read/29198911/xpert-mtb-rif-ultra-for-detection-of-mycobacterium-tuberculosis-and-rifampicin-resistance-a-prospective-multicentre-diagnostic-accuracy-study
#14
Susan E Dorman, Samuel G Schumacher, David Alland, Pamela Nabeta, Derek T Armstrong, Bonnie King, Sandra L Hall, Soumitesh Chakravorty, Daniela M Cirillo, Nestani Tukvadze, Nino Bablishvili, Wendy Stevens, Lesley Scott, Camilla Rodrigues, Mubin I Kazi, Moses Joloba, Lydia Nakiyingi, Mark P Nicol, Yonas Ghebrekristos, Irene Anyango, Wilfred Murithi, Reynaldo Dietze, Renata Lyrio Peres, Alena Skrahina, Vera Auchynka, Kamal Kishore Chopra, Mahmud Hanif, Xin Liu, Xing Yuan, Catharina C Boehme, Jerrold J Ellner, Claudia M Denkinger
BACKGROUND: The Xpert MTB/RIF assay is an automated molecular test that has improved the detection of tuberculosis and rifampicin resistance, but its sensitivity is inadequate in patients with paucibacillary disease or HIV. Xpert MTB/RIF Ultra (Xpert Ultra) was developed to overcome this limitation. We compared the diagnostic performance of Xpert Ultra with that of Xpert for detection of tuberculosis and rifampicin resistance. METHODS: In this prospective, multicentre, diagnostic accuracy study, we recruited adults with pulmonary tuberculosis symptoms presenting at primary health-care centres and hospitals in eight countries (South Africa, Uganda, Kenya, India, China, Georgia, Belarus, and Brazil)...
November 30, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29198910/performance-of-xpert-mtb-rif-ultra-a-matter-of-dead-or-alive
#15
Sandra M Arend, Dick van Soolingen
No abstract text is available yet for this article.
November 30, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29194073/update-on-trends-in-childhood-tuberculosis
#16
Samantha Fry, Shaun Barnabas, Mark F Cotton
PURPOSE OF REVIEW: Although tuberculosis (TB) causes much morbidity and mortality in children, diagnosis and treatment remain challenging. Recently, children have gained increasing attention in research and clinical trials driving improved contact management, case identification and treatment of both drug-susceptible and drug-resistant TB. This review highlights some recent advances. RECENT FINDINGS: The tuberculin skin test is the most widely used test to distinguish Mycobacterium tuberculosis (M...
November 30, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29174612/mortality-and-its-determinants-in-antiretroviral-treatment-naive-hiv-infected-children-with-suspected-tuberculosis-an-observational-cohort-study
#17
Olivier Marcy, Mathurin Tejiokem, Philippe Msellati, Khanh Truong Huu, Viet Do Chau, Duong Tran Ngoc, Boubacar Nacro, Francis Ateba-Ndongo, Suzie Tetang-Ndiang, Vibol Ung, Bunnet Dim, Leakhena Neou, Laureline Berteloot, Laurence Borand, Christophe Delacourt, Stéphane Blanche
BACKGROUND: Tuberculosis is a major cause of morbidity and mortality in HIV-infected children, but is difficult to diagnose. We studied mortality and its determinants in antiretroviral treatment (ART)-naive HIV-infected children presenting with suspected tuberculosis. METHODS: In this observational cohort study, HIV-infected children aged 13 years or younger with suspected tuberculosis were followed up for 6 months as part of the ANRS 12229 PAANTHER 01 cohort in eight hospitals in four countries (Burkina Faso, Cambodia, Cameroon, and Vietnam)...
November 23, 2017: Lancet HIV
https://www.readbyqxmd.com/read/29172708/a-comparative-study-on-the-role-of-xpert-mtb-rif-in-testing-different-types-of-spinal-tuberculosis-tissue-specimens
#18
Liang Tang, Shiqing Feng, Ruixiao Gao, Chenfu Han, Xiaochen Sun, Yucheng Bao, Wenlong Zhang
AIMS: The aim of the present study was to compare the role of the commercial Xpert Mycobacterium tuberculosis/rifampin (MTB/RIF) test in testing different types of spinal tuberculosis (TB) tissue specimens. METHODS: Pus, granulation tissue, and caseous necrotic tissue specimens from 223 patients who were diagnosed with spinal TB and who underwent curettage were collected for bacterial culture and the Xpert MTB/RIF assay to calculate the positive rate. Bacterial culture and phenotypic drug sensitivity testing (pDST) were adopted as the gold standards to calculate the sensitivity and specificity of the Xpert bacterial detection and drug resistance (DR) test...
November 27, 2017: Genetic Testing and Molecular Biomarkers
https://www.readbyqxmd.com/read/29165509/-evaluation-of-xpert%C3%A2-mtb-rif-technique-for-mycobacterium-tuberculosis-complex-detection-in-extra-respiratory-specimens
#19
Patricia García, M Elvira Balcells, Claudia Castillo, Carolina Miranda, Enrique Geoffroy, Juan C Román, Aniela Wozniak
Extra-pulmonary tuberculosis (TB) represents the 26.2% of total TB cases in Chile. Culture is the gold standard method, but the process is extremely slow. Xpert®MTB/RIF technique detects Mycobacterium tuberculosis complex (MTBc) through real time PCR in less than 3 h. However, it has been validated only for respiratory specimens. We aimed to determine the performance of Xpert®MTB/RIF test in detecting MTBc in extra-respiratory specimens compared with a combined gold standard consisting in a positive (liquid and solid) mycobacterial culture and/or a positive validated molecular method (q-RPC, Cobas®TaqMan®-MTB)...
August 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/29133554/what-is-resistance-impact-of-phenotypic-versus-molecular-drug-resistance-testing-on-multi-and-extensively-drug-resistant-tuberculosis-therapy
#20
Jan Heyckendorf, Sönke Andres, Claudio U Köser, Ioana D Olaru, Thomas Schön, Erik Sturegård, Patrick Beckert, Viola Schleusener, Thomas A Kohl, Doris Hillemann, Danesh Moradigaravand, Julian Parkhill, Sharon J Peacock, Stefan Niemann, Christoph Lange, Matthias Merker
Rapid and accurate drug-susceptibility testing (DST) is essential for the treatment of multi- and extensively drug-resistant tuberculosis (M/XDR-TB). We compared the utility of genotypic DST assays with phenotypic DST (pDST) using BACTEC 960 MGIT or Löwenstein-Jensen to construct M/XDR-TB treatment regimens for a cohort of 25 consecutive M/XDR-TB patients and 15 possible anti-TB drugs.Genotypic DST results from Cepheid GeneXpert MTB/RIF (Xpert) and line probe assays (LPAs: Hain GenoType MTBDRplus 2.0 and MTBDRsl 2...
November 13, 2017: Antimicrobial Agents and Chemotherapy
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