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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
#1
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
https://www.readbyqxmd.com/read/29126226/optimizing-tuberculosis-diagnosis-in-hiv-infected-inpatients-meeting-the-criteria-of-seriously-ill-in-the-who-algorithm
#2
Rulan Griesel, Annemie Stewart, Helen van der Plas, Welile Sikhondze, Molebogeng X Rangaka, Mark P Nicol, Andre P Kengne, Marc Mendelson, Gary Maartens
BACKGROUND: The WHO algorithm for the diagnosis of tuberculosis in seriously ill HIV-infected patients lacks a firm evidence base. We aimed to develop a clinical prediction rule for the diagnosis of tuberculosis and to determine the diagnostic utility of the Xpert MTB/RIF assay in seriously ill HIV-infected patients. METHODS: We conducted a prospective study among HIV-infected inpatients with any cough duration and WHO-defined danger signs. Culture-positive tuberculosis from any site was the reference standard...
November 6, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29116638/evolution-of-phenotypic-and-molecular-drug-susceptibility-testing
#3
Daniela M Cirillo, Paolo Miotto, Enrico Tortoli
Drug Resistant Tuberculosis (DRTB) is an emerging problem world-wide. In order to control the disease and decrease the number of cases overtime a prompt diagnosis followed by an appropriate treatment should be provided to patients. Phenotypic DST based on liquid automated culture has greatly reduced the time needed to generate reliable data but has the drawback to be expensive and prone to contamination in the absence of appropriate infrastructures. In the past 10 years molecular biology tools have been developed...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29109010/a-novel-isothermal-amplification-based-method-to-detect-mycobacterium-tuberculosis-complex
#4
Dongxin Liu, Bing Zhao, Xichao Ou, Huiwen Zheng, Aijing Ma, Wencong He, Shengfen Wang, Yang Zhou, Hui Xia, Yang Zheng, Ping Hou, Guangxue He, Yanlin Zhao
Mycobacterium tuberculosis (MTB) is the causative agent of pulmonary tuberculosis. Rapid and accurate diagnosis is crucial to tuberculosis control and prevention. A series of diagnostic methods has been available for MTB detection; however, new rapid, simple and affordable methods are needed. In this study, a multiple cross displacement amplification (MCDA)-based assay was developed to detect the IS6110 gene of the M. tuberculosis complex. Hydroxy naphthol blue (HNB), a colorimetric indicator, was used to detect amplification products...
November 3, 2017: Journal of Microbiological Methods
https://www.readbyqxmd.com/read/29093504/mycobacterial-genomic-dna-from-used-xpert-mtb-rif-cartridges-can-be-utilised-for-accurate-second-line-genotypic-drug-susceptibility-testing-and-spoligotyping
#5
Rouxjeane Venter, Brigitta Derendinger, Margaretha de Vos, Samantha Pillay, Tanya Dolby, John Simpson, Natasha Kitchin, Ashley Ruiters, Paul D van Helden, Robin M Warren, Grant Theron
Xpert MTB/RIF (Xpert) is a widely-used test for tuberculosis (TB) and rifampicin-resistance. Second-line drug susceptibility testing (DST), which is recommended by policymakers, typically requires additional specimen collection that delays effective treatment initiation. We examined whether cartridge extract (CE) from used Xpert TB-positive cartridges was, without downstream DNA extraction or purification, suitable for both genotypic DST (MTBDRplus, MTBDRsl), which may permit patients to rapidly receive a XDR-TB diagnosis from a single specimen, and spoligotyping, which could facilitate routine genotyping...
November 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29091135/an-evaluation-of-false-positive-rifampicin-resistance-on-the-xpert-mtb-rif
#6
Yeliz Tanriverdi Cayci, Kemal Bilgin, Ahmet Yilmaz Coban, Asuman Birinci, Belma Durupınar
BACKGROUND: Mycobacterium tuberculosis (MTB) is one of the most significant causes of mortality and morbidity. Early diagnose is important especially in multiple drug resistant tuberculosis to avoid transmission. Traditional techniques requires at least one to three weeks for diagnosis of tuberculosis. Diagnostic delays with multiple drug resistant tuberculosis are associated with worse clinical outcomes and increased transmission The Xpert MTB/RIF assay is one of the new diagnostic device for the diagnosis of tuberculosis and rapid detection of rifampicin resistance...
November 2017: Memórias do Instituto Oswaldo Cruz
https://www.readbyqxmd.com/read/29053085/rifampicin-resistance-and-multidrug-resistant-tuberculosis-detection-using-xpert-mtb-rif-in-wuhan-china-a-retrospective-study
#7
Hai Huang, Yanlin Zhang, Sheng Li, Jun Wang, Jun Chen, Zhiyun Pan, Hui Gan
BACKGROUND: The Xpert MTB/RIF test (Cepheid, Sunnyvale, CA) can simultaneously detect the Mycobacterium tuberculosis (MTB) complex DNA and rifampicin (RFP) resistance and can rapidly determine RFP resistance and predict multidrug-resistant tuberculosis (MDR-TB). In this study, we analyzed clinical examination results of a hospital specializing in TB treatment in Wuhan, Hubei, China, and examined the use of traditional culture and drug-sensitive test (DST) results as a gold standard to assess the diagnosis value of the Xpert MTB/RIF test in RFP resistance and MDR-TB...
October 20, 2017: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
https://www.readbyqxmd.com/read/29050773/detection-of-mycobacterial-infection-in-non-human-primates-using-the-xpert-mtb-rif-molecular-assay
#8
Duanne Alves da Silva, Amanda M Rêgo, Nicole V Ferreira, Manoela A S de Andrade, Aline R Campelo, Paulo César S Caldas, Márcia Aparecida S Pereira, Paulo Redner, Lucindo C de Pina, Felipe C Resende, Thalita A Pissinatti, Claudia A A Lopes, Tatiana Kugelmeier, Javier A S Perea, Igo V de Souza, Fábio A da Silva, Carla F Campos, Fátima C O Fandinho Montes, L Caetano M Antunes
Tuberculosis is a major public health concern, and diagnostic strategies applied to animal populations are scarce. As part of ongoing efforts to control tuberculosis dissemination at our animal facility, two non-human primates (NHP, Saimiri sciureus) presenting cutaneous lesions were examined for mycobacterial infection. Both animals tested positive for acid-fast bacilli and Mycobacterium tuberculosis using a molecular assay (IS6110 PCR). Animals were euthanized and several samples were tested for M. tuberculosis using the Xpert MTB/RIF assay...
December 2017: Tuberculosis
https://www.readbyqxmd.com/read/29037293/community-based-active-case-finding-for-tuberculosis-in-rural-western-china-a-cross-sectional-study
#9
C Chen, C-G Yang, X Gao, Z-Z Lu, F-X Tang, J Cheng, Q Gao, V Cárdenas
SETTING: Current passive case finding strategies are not effective at identifying tuberculosis (TB) patients in rural China. OBJECTIVE: To evaluate a community-based, active case finding (ACF) scheme in identifying symptomatic individuals with TB. DESIGN: We conducted door-to-door household visits of all residents aged 15 years at two rural sites to screen for TB symptoms. Individuals with symptoms were enrolled and asked to provide three sputum samples...
November 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/29037292/accuracy-of-giant-african-pouched-rats-for-diagnosing-tuberculosis-comparison-with-culture-and-xpert-%C3%A2-mtb-rif
#10
C Mulder, G F Mgode, H Ellis, E Valverde, N Beyene, C Cox, S E Reid, A H Van't Hoog, T L Edwards
SETTING: Enhanced tuberculosis (TB) case finding using detection rats in Tanzania. OBJECTIVES: To assess the diagnostic accuracy of detection rats compared with culture and Xpert® MTB/RIF, and to compare enhanced case-finding algorithms using rats in smear-negative presumptive TB patients. DESIGN: A fully paired diagnostic accuracy study in which sputum of new adult presumptive TB patients in Tanzania was tested using smear microscopy, 11 detection rats, culture and Xpert...
November 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/29028662/stool-xpert-mtb-rif-and-urine-lipoarabinomannan-lam-for-diagnosing-tuberculosis-in-hospitalized-hiv-infected-children
#11
Sylvia M LaCourse, Patricia B Pavlinac, Lisa M Cranmer, Irene N Njuguna, Cyrus Mugo, John Gatimu, Joshua Stern, Judd L Walson, Elizabeth Maleche-Obimbo, Julius Oyugi, Dalton Wamalwa, Grace John-Stewart
BACKGROUND: Tuberculosis (TB) causes substantial morbidity and mortality in HIV-infected children. Sample collection and paucibacillary nature of TB in children makes diagnosis challenging. Rapid diagnostic tools using easily obtained specimens are urgently needed. METHODS: Hospitalized, HIV-infected children ≤12 years enrolled in a randomized controlled trial (NCT02063880) comparing urgent to poststabilization ART initiation in Kenya underwent TB evaluation. At enrollment, sputum or gastric aspirates (GA) were collected for TB culture and Xpert, stool for Xpert, and urine for lateral flow lipoarabinomannan (LAM )...
October 12, 2017: AIDS
https://www.readbyqxmd.com/read/29026323/diagnostic-accuracy-of-xpert-mtb-rif-assay-for-musculoskeletal-tuberculosis-a-meta-analysis
#12
REVIEW
Hai Wen, Pengzhi Li, Hong Ma, Guohua Lv
OBJECTIVES: Xpert MTB/RIF assay, a rapid and automated real-time nucleic acid amplification test, has been reported for the diagnosis of musculoskeletal tuberculosis (TB) in current years. This meta-analysis aims to determine the diagnostic accuracy of Xpert for the detection of musculoskeletal TB and rifampicin (RIF) resistance. METHODS: We searched PubMed, Embase, China National Knowledge Infrastructure, and Wanfang for original articles published up to 1st June 2017 to identify studies in which the Xpert assay was applied to diagnose musculoskeletal TB...
2017: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29020319/tuberculosis-case-finding-with-combined-rapid-point-of-care-assays-xpert-mtb-rif-and-determine-tb-lam-in-hiv-positive-individuals-starting-antiretroviral-therapy-in-mozambique
#13
Marco Floridia, Fausto Ciccacci, Mauro Andreotti, Archa Hassane, Zita Sidumo, Nurja A Magid, Horacio Sotomane, Muhlavasse David, Elsa Mutemba, Junia Cebola, Remigio Josè Mugunhe, Fabio Riccardi, Maria Cristina Marazzi, Marina Giuliano, Leonardo Palombi, Sandro Mancinelli
Background: Tuberculosis is a major health concern in several countries, and effective diagnostic algorithms for use in human immunodeficiency virus (HIV)-positive patients are urgently needed. Methods: At prescription of antiretroviral therapy, all patients in 3 Mozambican health centers were screened for tuberculosis, with a combined approach: World Health Organization (WHO) 4-symptom screening (fever, cough, night sweats, and weight loss), a rapid test detecting mycobacterial lipoarabinomannan in urine (Determine TB LAM), and a molecular assay performed on a sputum sample (Xpert MTB/RIF; repeated if first result was negative)...
November 13, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29016684/performance-of-the-xpert-mtb-rif-assay-for-the-diagnosis-of-pulmonary-tuberculosis-and-rifampin-resistance-in-a-low-incidence-high-resource-setting
#14
Jason P Rice, Marva Seifert, Kathleen S Moser, Timothy C Rodwell
Performance of the Xpert MTB/RIF assay, designed to simultaneously detect Mycobacterium tuberculosis complex (MTBC) and rifampin (RIF) resistance, has been well documented in low-resource settings with high TB-incidence. However, few studies have assessed its accuracy in low TB incidence settings. We evaluated the performance of Xpert MTB/RIF using clinical sputum specimens routinely collected from suspect pulmonary TB patients over a 4-year time period in San Diego County, California. Xpert MTB/RIF results were compared to acid-fast bacilli (AFB) smear microscopy, mycobacterial culture, and phenotypic drug susceptibility testing (DST)...
2017: PloS One
https://www.readbyqxmd.com/read/29016303/undiagnosed-active-pulmonary-tuberculosis-among-pilgrims-during-the-2015-hajj-mass-gathering-a-prospective-cross-sectional-study
#15
Saber Yezli, Alimuddin Zumla, Yara Yassin, Ali M Al-Shangiti, Gamal Mohamed, Abdulhafiz M Turkistani, Badriah Alotaibi
Mass gatherings pose a risk for tuberculosis (TB) transmission and reactivation of latent TB infection. The annual Hajj pilgrimage attracts 2 million pilgrims from high TB-endemic countries. We evaluated the burden of undiagnosed active pulmonary TB in pilgrims attending the 2015 Hajj mass gathering. We conducted a prospective cross-sectional study in Mecca, Kingdom of Saudi Arabia, for nonhospitalized adult pilgrims from five high TB-endemic countries. Enrollment criteria were the presence of a cough and the ability to produce a sputum sample...
September 5, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28972418/challenges-in-pleural-tuberculosis-diagnosis-existing-reference-standards-and-nucleic-acid-tests
#16
Shaifali Tyagi, Neera Sharma, Jaya Sivaswami Tyagi, Sagarika Haldar
Pleural tuberculosis (pTB) is a grave form of extrapulmonary tuberculosis. Microbiological tests are usually found to be inadequate for pTB diagnosis. The absence of a uniform 'composite reference standard' is challenging; therefore, diagnosis is usually performed using a combination of diversified criteria. Nucleic acid tests vary in diagnostic accuracy and have not yet been integrated into clinical decision making. This review assesses the varied criteria used for pTB classification and the challenges afflicting pleural fluid-based DNA diagnostic tests, namely, PCR and Xpert(®) MTB/RIF...
October 2017: Future Microbiology
https://www.readbyqxmd.com/read/28924924/predictors-of-microbiologically-confirmed-intrathoracic-tuberculosis
#17
Rakhi Jain, Aparna Mukherjee, Mohit Singla, Yogita Verma, Hitender Gautam, Rakesh Lodha, Urvashi B Singh, Sushil K Kabra
OBJECTIVE: To identify risk factors for microbiologically confirmed intrathoracic tuberculosis in children. METHODS: Children, 6 mo to 15 y of age, attending the out-patient department of a tertiary care centre in India, with probable intrathoracic tuberculosis were enrolled. Microbiological confirmation of tuberculosis was defined as positivity on smear (Ziehl-Neelsen staining) and/or Xpert MTB/RIF and/or MGIT-960 culture. Association of various factors with microbiological confirmation were assessed by univariate and multivariate analysis...
September 19, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28924198/bacteriological-diagnosis-of-childhood-tb-a-prospective-observational-study
#18
Andrew J Brent, Daisy Mugo, Robert Musyimi, Agnes Mutiso, Susan Morpeth, Michael Levin, J Anthony G Scott
Childhood TB diagnosis is challenging. Studies in adults suggest Microscopic Observation Drug Susceptibility (MODS) culture or the Xpert MTB/RIF assay might be used to expand bacteriological diagnosis. However data from children are more limited. We prospectively compared MODS and Xpert MTB/RIF with standard microscopy and culture using the BD MGIT 960 system among 1442 Kenyan children with suspected TB. 97 specimens from 54 children were TB culture-positive: 91 (94%) by MGIT and 74 (76%) by MODS (p = 0...
September 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28919549/the-predominance-of-ethiopian-specific-mycobacterium-tuberculosis-families-and-minimal-contribution-of-mycobacterium-bovis-in-tuberculous-lymphadenitis-patients-in-southwest-ethiopia
#19
Mulualem Tadesse, Gemeda Abebe, Alemayehu Bekele, Mesele Bezabih, Pim de Rijk, Conor J Meehan, Bouke C de Jong, Leen Rigouts
BACKGROUND: Ethiopia has an extremely high rate of extrapulmonary tuberculosis, dominated by tuberculous lymphadenitis (TBLN). However, little is known about Mycobacterium tuberculosis complex (MTBc) lineages responsible for TBLN in Southwest Ethiopia. METHODS: A total of 304 MTBc isolates from TBLN patients in Southwest Ethiopia were genotyped primarily by spoligotyping. Isolates of selected spoligotypes were further analyzed by 15-loci mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) (n=167) and qPCR-based single nucleotide polymorphism (n=38)...
September 15, 2017: Infection, Genetics and Evolution
https://www.readbyqxmd.com/read/28919338/diagnostic-accuracy-of-xpert-mtb-rif-ultra-for-tuberculous-meningitis-in-hiv-infected-adults-a-prospective-cohort-study
#20
Nathan C Bahr, Edwin Nuwagira, Emily E Evans, Fiona V Cresswell, Philip V Bystrom, Adolf Byamukama, Sarah C Bridge, Ananta S Bangdiwala, David B Meya, Claudia M Denkinger, Conrad Muzoora, David R Boulware
BACKGROUND: WHO recommends Xpert MTB/RIF as initial diagnostic testing for tuberculous meningitis. However, diagnosis remains difficult, with Xpert sensitivity of about 50-70% and culture sensitivity of about 60%. We evaluated the diagnostic performance of the new Xpert MTB/RIF Ultra (Xpert Ultra) for tuberculous meningitis. METHODS: We prospectively obtained diagnostic cerebrospinal fluid (CSF) specimens during screening for a trial on the treatment of HIV-associated cryptococcal meningitis in Mbarara, Uganda...
September 14, 2017: Lancet Infectious Diseases
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