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https://www.readbyqxmd.com/read/28911360/evaluation-of-the-tb-lamp-assay-for-the-rapid-diagnosis-of-pulmonary-tuberculosis-in-northern-india
#1
R Yadav, N Sharma, R Khaneja, P Agarwal, A Kanga, D Behera, S Sethi
SETTING: A tertiary care hospital in North India. OBJECTIVE: To evaluate a commercial kit-based loop-mediated isothermal amplification (TB-LAMP) assay for the diagnosis of pulmonary tuberculosis (PTB). DESIGN: A total of 530 patients presenting with PTB symptoms were enrolled and one sputum sample was collected from each patient. The TB-LAMP assay (Loopamp™ MTBC Detection kit) was performed on the raw sputum sample. The remaining sample was used for smear microscopy and mycobacterial culture...
October 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28911358/performance-of-nested-rt-pcr-on-csf-for-tuberculous-meningitis-diagnosis-in-hiv-infected-patients
#2
F A S Gualberto, M G Gonçalves, L O Fukasawa, A M Ramos Dos Santos, C T Sacchi, L H Harrison, D R Boulware, J E Vidal
SETTING: Timely diagnosis of tuberculous meningitis (TBM) in patients with human immunodeficiency virus (HIV) infection remains a challenge. Despite the current scale-up of the Xpert® MTB/RIF assay, other molecular diagnostic tools are necessary, particularly in referral centres in low- and middle-income countries without Xpert testing. OBJECTIVE: To determine the diagnostic performance of nested real-time polymerase chain reaction (nRT-PCR) in HIV-infected TBM patients categorised according to standardised clinical case definitions...
October 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28911354/drug-resistance-patterns-among-extra-pulmonary-tuberculosis-cases-in-a-tertiary-care-centre-in-north-india
#3
S K Sharma, J Chaubey, B K Singh, R Sharma, A Mittal, A Sharma
BACKGROUND: xtra-pulmonary tuberculosis (EPTB) is a growing public health concern, and data on drug resistance are limited. MATERIAL AND METHODS: Specimens from 2468 clinically diagnosed EPTB patients received at the Intermediate Reference Laboratory (IRL) of a tertiary centre in India were subjected to Ziehl-Neelsen staining, Xpert® MTB/RIF testing, liquid culture and drug susceptibility testing (DST) using automated BACTEC MGIT™ 960™. Line-probe assay (LPA) was performed on all culture-positive isolates...
October 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28911352/missed-opportunities-for-earlier-diagnosis-of-rifampicin-resistant-tuberculosis-despite-access-to-xpert-%C3%A2-mtb-rif
#4
E Mohr, J Daniels, O Muller, J Furin, B Chabalala, S J Steele, V Cox, T Dolby, G Ferlazzo, A Shroufi, L T Duran, H Cox
OBJECTIVE: To assess the proportion of rifampicin-resistant tuberculosis (RR-TB) patients with potential earlier RR-TB diagnoses in Khayelitsha, South Africa. DESIGN: We conducted a retrospective analysis among RR-TB patients diagnosed from 2012 to 2014. Patients were considered to have missed opportunities for earlier diagnosis if 1) they were incorrectly screened according to the Western Cape diagnostic algorithm; 2) the first specimen was not tested using Xpert® MTB/RIF; 3) no specimen was ever tested; or 4) the initial Xpert test showed a negative result, but no subsequent specimen was sent for follow-up testing in human immunodeficiency virus-positive patients...
October 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28904186/stool-culture-for-the-diagnosis-of-pulmonary-tuberculosis-in-children
#5
Elisabetta Walters, Anne-Marie Demers, Marieke M van der Zalm, Andrew Whitelaw, Megan Palmer, Corné Bosch, Heather R Draper, Robert P Gie, Anneke C Hesseling
Bacteriological confirmation of Mycobacterium tuberculosis is achieved in the minority of young children with tuberculosis (TB), as specimen collection is resource-intensive and respiratory secretions are mostly paucibacillary, leading to limited sensitivity of available diagnostic tests. Although molecular tests are increasingly available globally, mycobacterial culture remains the gold standard for diagnosis and determination of drug susceptibility and is more sensitive than molecular methods for paucibacillary TB...
September 13, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28902596/evaluation-of-a-rapid-molecular-drug-susceptibility-test-for-tuberculosis
#6
Yingda L Xie, Soumitesh Chakravorty, Derek T Armstrong, Sandra L Hall, Laura E Via, Taeksun Song, Xing Yuan, Xiaoying Mo, Hong Zhu, Peng Xu, Qian Gao, Myungsun Lee, Jongseok Lee, Laura E Smith, Ray Y Chen, Joon Sung Joh, YoungSoo Cho, Xin Liu, Xianglin Ruan, Lili Liang, Nila Dharan, Sang-Nae Cho, Clifton E Barry, Jerrold J Ellner, Susan E Dorman, David Alland
Background Fluoroquinolones and second-line injectable drugs are the backbone of treatment regimens for multidrug-resistant tuberculosis, and resistance to these drugs defines extensively drug-resistant tuberculosis. We assessed the accuracy of an automated, cartridge-based molecular assay for the detection, directly from sputum specimens, of Mycobacterium tuberculosis with resistance to fluoroquinolones, aminoglycosides, and isoniazid. Methods We conducted a prospective diagnostic accuracy study to compare the investigational assay against phenotypic drug-susceptibility testing and DNA sequencing among adults in China and South Korea who had symptoms of tuberculosis...
September 14, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28893193/light-emitting-diode-fluorescent-microscopy-and-xpert-mtb-rif%C3%A2-assay-for-diagnosis-of-pulmonary-tuberculosis-among-patients-attending-ambo-hospital-west-central-ethiopia
#7
Alemu Gadissa Gelalcha, Abebaw Kebede, Hassen Mamo
BACKGROUND: The relatively simple and cheaper light-emitting diode fluorescent microscopy (LED-FM) was recommended by the World Health Organization (WHO) to replace the conventional tuberculosis (TB) microscopy in both high- and low-volume laboratories. More recently the WHO also endorsed one more technique, Xpert MTB/RIF® assay (Xpert), for improved TB diagnosis particularly among human immunodeficiency virus (HIV)-infected cases. However, the relative performance of both of these tools differs from setting to setting in reference to the conventional TB diagnostics...
September 11, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28886729/evaluation-of-xpert-mtb-rif-testing-for-rapid-diagnosis-of-childhood-pulmonary-tuberculosis-in-children-by-xpert-mtb-rif-testing-of-stool-samples-in-a-low-resource-setting
#8
Zahra Hasan, Sadia Shakoor, Fehmina Arif, Aisha Mehnaz, Alnoor Akber, Marium Haider, Akbar Kanji, Rumina Hasan
OBJECTIVE: Children with tuberculosis (TB) remain underdiagnosed due to difficulty in testing for Mycobacterium tuberculosis (MTB) infection. We evaluated the Xpert MTB/RIF assay for respiratory and stool testing in children for pulmonary TB through a cross-sectional study at tertiary care facilities in Karachi, Pakistan. Fifty children aged 0-15 years screened by a modified Kenneth-Jones (KJ) score were included. Mycobacterial culture of respiratory samples was the microbiological standard against stool Xpert TB results...
September 8, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28883510/disseminated-tuberculosis-among-hospitalised-hiv-patients-in-south-africa-a-common-condition-that-can-be-rapidly-diagnosed-using-urine-based-assays
#9
Andrew D Kerkhoff, David A Barr, Charlotte Schutz, Rosie Burton, Mark P Nicol, Stephen D Lawn, Graeme Meintjes
HIV-associated disseminated TB (tuberculosis) has been under-recognised and poorly characterised. Blood culture is the gold-standard diagnostic test, but is expensive, slow, and may under-diagnose TB dissemination. In a cohort of hospitalised HIV patients, we aimed to report the prevalence of TB-blood-culture positivity, performance of rapid diagnostics as diagnostic surrogates, and better characterise the clinical phenotype of disseminated TB. HIV-inpatients were systematically investigated using sputum, urine and blood testing...
September 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28880875/scaling-up-the-xpert-mtb-rif-assay-for-the-detection-of-tuberculosis-and-rifampicin-resistance-in-india-an-economic-analysis
#10
Sunil Khaparde, Neeraj Raizada, Sreenivas Achuthan Nair, Claudia Denkinger, Kuldeep Singh Sachdeva, Chinnambedu Nainarappan Paramasivan, Virender Singh Salhotra, Anna Vassall, Anja Van't Hoog
BACKGROUND: India is considering the scale-up of the Xpert MTB/RIF assay for detection of tuberculosis (TB) and rifampicin resistance. We conducted an economic analysis to estimate the costs of different strategies of Xpert implementation in India. METHODS: Using a decision analytical model, we compared four diagnostic strategies for TB patients: (i) sputum smear microscopy (SSM) only; (ii) Xpert as a replacement for the rapid diagnostic test currently used for SSM-positive patients at risk of drug resistance (i...
2017: PloS One
https://www.readbyqxmd.com/read/28879163/diagnostic-system-strengthening-for-drug-resistant-tuberculosis-in-nigeria-impact-and-challenges
#11
Gambo Aliyu, Nicholas Ezati, Mosunmola Iwakun, Sam Peters, Alash'le Abimiku
BACKGROUND: The increasing prevalence of drug-resistant tuberculosis and the threat of extensively-drug-resistant tuberculosis in HIV hotspots have made the detection and treatment of drug-resistant tuberculosis in the sub-Saharan Africa setting a global public health priority. OBJECTIVE: We sought to examine the impact and challenges of tuberculosis diagnostic capacity development for the detection of drug-resistant tuberculosis and bio-surveillance using a modular biosafety level 3 (BSL-3) laboratory in Nigeria...
2017: African Journal of Laboratory Medicine
https://www.readbyqxmd.com/read/28879160/performance-of-xpert-%C3%A2-mtb-rif-among-tuberculosis-outpatients-in-lilongwe-malawi
#12
Tarsizio Chikaonda, Nelson Nguluwe, Brian Barnett, Runa H Gokhale, Robert Krysiak, Isaac Thengolose, Nora E Rosenberg, Christopher Stanley, James Mpunga, Irving F Hoffman, Mina Hosseinipour, Lesley Scott, Wendy Stevens
BACKGROUND: Xpert(®) MTB/RIF is a molecular test for the detection of Mycobacterium tuberculosis and rifampicin resistance. It is considered to be a great advance over smear microscopy and culture. However, there is very little information regarding the performance characteristics of Xpert MTB/RIF in Malawi. OBJECTIVE: We aimed to evaluate the performance of Xpert MTB/RIF in a Malawian setting. METHODS: Stored sputum pellets were processed on Xpert MTB/RIF between June 2012 and May 2014...
2017: African Journal of Laboratory Medicine
https://www.readbyqxmd.com/read/28879159/molecular-characterisation-of-rifampicin-resistant-mycobacterium-tuberculosis-strains-from-malawi
#13
Tarsizio Chikaonda, Irene Ketseoglou, Nelson Nguluwe, Robert Krysiak, Isaac Thengolose, Felix Nyakwawa, Nora E Rosenberg, Christopher Stanley, James Mpunga, Irving F Hoffman, Maria A Papathanasopoulos, Mina Hosseinipour, Lesley Scott, Wendy Stevens
BACKGROUND: Availability and access to the detection of resistance to anti-tuberculosis drugs remains a significant challenge in Malawi due to limited diagnostic services. The Xpert(®) MTB/RIF can detect Mycobacterium tuberculosis and resistance to rifampicin in a single, rapid assay. Rifampicin-resistant M. tuberculosis has not been well studied in Malawi. OBJECTIVES: We aimed to determine mutations in the rifampicin resistance determining region (RRDR) of the rpoB gene of M...
2017: African Journal of Laboratory Medicine
https://www.readbyqxmd.com/read/28862176/index-tb-guidelines-guidelines-on-extrapulmonary-tuberculosis-for-india
#14
Surendra K Sharma, H Ryan, Sunil Khaparde, K S Sachdeva, Achintya D Singh, Alladi Mohan, Rohit Sarin, C N Paramasivan, Prahlad Kumar, Neeraj Nischal, Saurav Khatiwada, Paul Garner, Prathap Tharyan
Extrapulmonary tuberculosis (EPTB) is frequently a diagnostic and therapeutic challenge. It is a common opportunistic infection in people living with HIV/AIDS and other immunocompromised states such as diabetes mellitus and malnutrition. There is a paucity of data from clinical trials in EPTB and most of the information regarding diagnosis and management is extrapolated from pulmonary TB. Further, there are no formal national or international guidelines on EPTB. To address these concerns, Indian EPTB guidelines were developed under the auspices of Central TB Division and Directorate of Health Services, Ministry of Health and Family Welfare, Government of India...
April 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28852676/the-burden-and-clinical-presentation-of-pulmonary-tuberculosis-in-adults-with-severe-respiratory-illness-in-a-high-human-immunodeficiency-virus-prevalence-setting-2012-2014
#15
Sibongile Walaza, Stefano Tempia, Andries Dreyer, Halima Dawood, Ebrahim Variava, Neil A Martinson, Jocelyn Moyes, Adam L Cohen, Nicole Wolter, Claire von Mollendorf, Anne von Gottberg, Sumayya Haffejee, Florette Treurnicht, Orienka Hellferscee, Nazir Ismail, Cheryl Cohen
BACKGROUND: Understanding the burden and clinical presentation of tuberculosis in patients with severe respiratory illness (SRI) has important implications for anticipating treatment requirements. METHODS: Hospitalized patients aged ≥15 years with SRI at 2 public teaching hospitals in periurban areas in 2 provinces (Edendale Hospital in Pietermaritzburg, KwaZulu-Natal Province and Tshepong Hospital in Klerksdorp, North West Province) were enrolled prospectively from 2012 to 2014...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28851844/the-new-xpert-mtb-rif-ultra-improving-detection-of-mycobacterium-tuberculosis-and-resistance-to-rifampin-in-an-assay-suitable-for-point-of-care-testing
#16
Soumitesh Chakravorty, Ann Marie Simmons, Mazhgan Rowneki, Heta Parmar, Yuan Cao, Jamie Ryan, Padmapriya P Banada, Srinidhi Deshpande, Shubhada Shenai, Alexander Gall, Jennifer Glass, Barry Krieswirth, Samuel G Schumacher, Pamela Nabeta, Nestani Tukvadze, Camilla Rodrigues, Alena Skrahina, Elisa Tagliani, Daniela M Cirillo, Amy Davidow, Claudia M Denkinger, David Persing, Robert Kwiatkowski, Martin Jones, David Alland
The Xpert MTB/RIF assay (Xpert) is a rapid test for tuberculosis (TB) and rifampin resistance (RIF-R) suitable for point-of-care testing. However, it has decreased sensitivity in smear-negative sputum, and false identification of RIF-R occasionally occurs. We developed the Xpert MTB/RIF Ultra assay (Ultra) to improve performance. Ultra and Xpert limits of detection (LOD), dynamic ranges, and RIF-R rpoB mutation detection were tested on Mycobacterium tuberculosis DNA or sputum samples spiked with known numbers of M...
August 29, 2017: MBio
https://www.readbyqxmd.com/read/28826452/fast-implementation-in-bangladesh-high-frequency-of-unsuspected-tuberculosis-justifies-challenges-of-scale-up
#17
R R Nathavitharana, P Daru, A E Barrera, S M Mostofa Kamal, S Islam, M Ul-Alam, R Sultana, M Rahman, Md S Hossain, P Lederer, S Hurwitz, K Chakraborty, N Kak, D B Tierney, E Nardell
SETTING: National Institute of Diseases of the Chest and Hospital, Dhaka; Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders, Dhaka; and Chittagong Chest Disease Hospital, Chittagong, Bangladesh. OBJECTIVE: To present operational data and discuss the challenges of implementing FAST (Find cases Actively, Separate safely and Treat effectively) as a tuberculosis (TB) transmission control strategy. DESIGN: FAST was implemented sequentially at three hospitals...
September 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28823010/the-reliability-of-rifampicin-resistance-as-a-proxy-for-multidrug-resistant-tuberculosis-a-systematic-review-of-studies-from-iran
#18
REVIEW
M J Nasiri, S Zamani, A Pormohammad, M M Feizabadi, H R Aslani, M Amin, R Halabian, A A Imani Fooladi
In Iran, patients showing rifampicin (RIF) resistance detected by the Xpert® MTB/RIF assay are considered as candidates for multidrug-resistant tuberculosis (MDR-TB) treatment. Despite the fact that RIF resistance has been used as a proxy for MDR-TB, little is known about the proportion of isoniazid (INH) resistance patterns in RIF-resistant TB. We systematically searched MEDLINE, Embase, and other databases up to March 2017 for studies addressing the proportion of INH resistance patterns in RIF-resistant TB in Iran...
August 19, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28817643/peripheral-clinic-versus-centralized-laboratory-based-xpert-mtb-rif-performance-experience-gained-from-a-pragmatic-stepped-wedge-trial-in-botswana
#19
Tefera Agizew, Rosanna Boyd, Ndwapi Ndwapi, Andrew Auld, Joyce Basotli, Sambayawo Nyirenda, Zegabriel Tedla, Anikie Mathoma, Unami Mathebula, Chawangwa Lesedi, Sherri Pals, Anand Date, Heather Alexander, Thomas Kuebrich, Alyssa Finlay
BACKGROUND: In 2011, the Botswana National Tuberculosis Program adopted World Health Organization guidelines and introduced Xpert MTB/RIF (Xpert) assay to support intensified case finding among people living with HIV enrolling in care. An evaluation was designed to assess performance under operational conditions to inform the national Xpert scale-up. METHODS: Xpert was implemented from August 2012 through November 2014 with 13 GeneXpert instruments (GeneXpert) deployed in a phased approach over nine months: nine centralized laboratory and four point-of-care (POC) peripheral clinics...
2017: PloS One
https://www.readbyqxmd.com/read/28804167/the-impact-of-the-roll-out-of-rapid-molecular-diagnostic-testing-for-tuberculosis-on-empirical-treatment-in-cape-town-south-africa
#20
Sabine Hermans, Judy Caldwell, Richard Kaplan, Frank Cobelens, Robin Wood
OBJECTIVE: To investigate the impact of introducing a rapid test as the first-line diagnostic test for drug-sensitive tuberculosis in Cape Town, South Africa. METHODS: Xpert® MTB/RIF (Xpert®), an automated polymerase-chain-reaction-based assay, was rolled out between 2011 and 2013. Data were available on 102 007 adults treated for pulmonary tuberculosis between 2010 and 2014. Tuberculosis notification rates per 100 000 population were calculated for each calendar year and for each year relative to the test roll-out locally, overall and by bacteriological confirmation...
August 1, 2017: Bulletin of the World Health Organization
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