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https://www.readbyqxmd.com/read/28746344/treatment-initiation-among-persons-diagnosed-with-drug-resistant-tuberculosis-in-johannesburg-south-africa
#1
Denise Evans, Kathryn Schnippel, Caroline Govathson, Tembeka Sineke, Andrew Black, Lawrence Long, Rebecca Berhanu, Sydney Rosen
BACKGROUND: In South Africa, roughly half of the drug-resistant TB cases diagnosed are reported to have been started on treatment. We determined the proportion of persons diagnosed with rifampicin resistant (RR-) TB who initiated treatment in Johannesburg after the introduction of decentralized RR-TB care in 2011. METHODS: We retrospectively matched adult patients diagnosed with laboratory-confirmed RR-TB in Johannesburg from 07/2011-06/2012 with records of patients initiating RR-TB treatment at one of the city's four public sector treatment sites (one centralized, three decentralized)...
2017: PloS One
https://www.readbyqxmd.com/read/28745310/a-two-step-algorithm-for-rapid-diagnosis-of-active-pulmonary-tuberculosis-in-entry-applicants-using-the-t-spot-tb-and-xpert-mtb-rif-assays-in-shanghai-china
#2
Chengyan Meng, Yaojie Shen, Jian Wang, Sen Wang, Xinchang Chen, Shenglei Yu, Wei Ye, Jing Wu
No abstract text is available yet for this article.
July 26, 2017: Emerging Microbes & Infections
https://www.readbyqxmd.com/read/28739268/xpert%C3%A2-mtb-rif-usefulness-for-the-diagnosis-of-tuberculosis-and-resistance-to-rifampicin
#3
REVIEW
Andrea Vergara Gómez, Julià González-Martín, Alberto L García-Basteiro
The advent of the Xpert® MTB/RIF technique was a revolution in the diagnosis of tuberculosis, especially in areas with high incidence and low resources. It allows the detection of Mycobacterium tuberculosis complex and simultaneously the most common resistance mutations to rifampicin in less than 2h. For respiratory samples the sensitivity is very high, but it decreases for extrapulmonary samples and children. Although it is faster and simpler than conventional methods, it presents some limitations and new and better techniques are needed to reduce the number of cases and deaths caused by tuberculosis...
July 21, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28736821/testing-for-high-risk-hpv-in-cervical-and-tonsillar-paraffin-embedded-tissue-using-a-cartridge-based-assay
#4
Elina Virtanen, Pekka Laurila, Jaana Hagström, Pekka Nieminen, Eeva Auvinen
This study evaluates the suitability of Xpert HPV (Cepheid, Sunnyvale, CA, USA) test for cervical and tonsillar formalin-fixed paraffin-embedded (FFPE) tissue samples as compared to the tests currently used in diagnostics. Cervical biopsies and liquid cytology (LC) samples were collected from 48 women attending colposcopy. Biopsies were processed for histology and tested for hrHPV using Xpert HPV. LC samples were tested using Xpert and Hybrid Capture 2 (HC2; Qiagen, Hilden, Germany) tests. Also 29 archived tonsillar carcinoma samples were tested using Xpert, and the results were compared with histology and immunohistochemical p16INK4a (p16) staining...
July 24, 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/28727491/impact-of-point-of-care-xpert-mtb-rif-on-tuberculosis-treatment-initiation-a-cluster-randomised-trial
#5
Richard J Lessells, Graham S Cooke, Nuala McGrath, Mark P Nicol, Marie-Louise Newell, Peter Godfrey-Faussett
RATIONALE: Point-of-care (POC) diagnostics have potential to reduce pre-treatment loss to follow-up and delays to initiation of appropriate TB treatment. OBJECTIVE: To evaluate the effect of a POC diagnostic strategy on initiation of appropriate TB treatment. METHODS: A cluster randomised trial of adults with cough who were HIV positive and/or at high risk of drug-resistant TB. Two-week time blocks were randomised to two strategies (i) Xpert performed at district hospital laboratory (ii) POC Xpert performed at primary health care clinic...
July 20, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28717600/implementation-of-the-xpert-mtb-rif-assay-for-tuberculosis-in-mongolia-a-qualitative-exploration-of-barriers-and-enablers
#6
Nicole L Rendell, Solongo Bekhbat, Gantungalag Ganbaatar, Munkhjargal Dorjravdan, Madhukar Pai, Claudia C Dobler
OBJECTIVE: The aim of our study was to identify barriers and enablers to implementation of the Xpert MTB/RIF test within Mongolia's National Tuberculosis Program. METHODS: Twenty-foursemi-structured interviews were conducted between June and September 2015 with laboratory staff and tuberculosis physicians in Mongolia's capital Ulaanbaatar and regional towns where Xpert MTB/RIF testing had been implemented. Interviews were recorded, transcribed, translated and analysed thematically using NVIVO qualitative analysis software...
2017: PeerJ
https://www.readbyqxmd.com/read/28716809/determining-clinical-decision-thresholds-for-hiv-positive-patients-suspected-of-having-tuberculosis
#7
Tom Boyles, Isabella Locatelli, Nicolas Senn, Mark Ebell
Clinical decision thresholds may aid the evaluation of diagnostic tests but have rarely been determined for tuberculosis (TB). We presented clinicians with six web-based clinical scenarios, describing patients with HIV and possible TB at various sites and with a range of clinical stability. The probability of disease was varied randomly and clinicians asked to make treatment decisions; threshold curves and therapeutic thresholds were calculated. Test and treatment thresholds were calculated using Bayes theorem and the diagnostic accuracy of Xpert MTB/RIF...
July 17, 2017: Evidence-based Medicine
https://www.readbyqxmd.com/read/28716462/rapid-identification-of-a-mycobacterium-tuberculosis-full-genetic-drug-resistance-profile-through-whole-genome-sequencing-directly-from-sputum
#8
Camus Nimmo, Ronan Doyle, Carrie Burgess, Rachel Williams, Rebecca Gorton, Timothy D McHugh, Mike Brown, Stephen Morris-Jones, Helen Booth, Judith Breuer
INTRODUCTION: Resistance to second line tuberculosis drugs is common, but slow to diagnose with phenotypic drug sensitivity testing. Rapid molecular tests speed up diagnosis, but can only detect limited mutations. Whole genome sequencing (WGS) of culture isolates can generate a complete genetic drug resistance profile, but is delayed by the initial culture step. We previously successfully achieved WGS directly from sputum using targeted enrichment. CASE REPORT: A 29-year-old Nigerian lady was diagnosed with tuberculosis...
July 14, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28711526/xpert-hiv-1-point-of-care-test-for-neonatal-diagnosis-of-hiv-in-the-birth-testing-programme-of-a-maternity-hospital-a-field-evaluation-study
#9
Karl-Günter Technau, Louise Kuhn, Ashraf Coovadia, Pamela M Murnane, Gayle Sherman
BACKGROUND: Point-of-care testing (POCT) among HIV-exposed infants might improve linkage to care relative to laboratory-based testing (LABT). We evaluated HIV-1 POCT at birth in the context of universal LABT in a maternity hospital and describe our implementation experience. METHODS: We did a field evaluation study between Oct 1, 2014, and April 30, 2016, at the urban Rahima Moosa Mother and Child Hospital (RMMCH), Johannesburg, South Africa. We aimed to sample consecutive neonates at birth with POCT (Cepheid Xpert HIV-1 Qualitative test) and compared results with those of LABT (Roche COBAS TaqMan HIV-1 Qualitative test) with respect to performance in terms of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Cohen's κ coefficient, result return, antiretroviral treatment (ART) initiation, and coverage...
July 12, 2017: Lancet HIV
https://www.readbyqxmd.com/read/28709488/endobronchial-ultrasound-experience-in-a-high-tuberculosis-prevalence-setting
#10
Balamugesh Thangakunam, Barney Thomas Jesudason Isaac, Devasahayam Jesudas Christopher
BACKGROUND: Most of the published endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) data are from the western countries, establishing the role of EBUS-TBNA in the diagnosis and staging of lung cancer. The etiology of mediastinal lymphadenopathy may be different in an ethnic group with a high prevalence of tuberculosis (TB). OBJECTIVE: To assess the etiology of mediastinal adenopathy in a high TB prevalence setting and to determine the performance of various tests in the diagnosis of tuberculous mediastinal lymphadenitis...
July 2017: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/28708844/diagnostic-accuracy-of-xpert-mtb-rif-for-tuberculosis-detection-in-different-regions-with-different-endemic-burden-a-systematic-review-and-meta-analysis
#11
Shiying Li, Bin Liu, Mingli Peng, Min Chen, Wenwei Yin, Hui Tang, Yuxuan Luo, Peng Hu, Hong Ren
PURPOSE: To estimate the diagnostic accuracy of Xpert MTB/RIF, a systematic review and meta-analysis were carried out. METHODS: Up to June 20, 2015, multiple databases were screened for relevant studies. RESULTS: Accordingly, 106 studies included 52,410 samples were selected. Diagnostic accuracy of Xpert MTB/RIF for TB detection was validated against either culture or a composite reference standard (CRS). Additionally, selected studies were further subgrouped in four groups based on sample's type, subject's age, status of HIV co-infection and smear-positivity...
2017: PloS One
https://www.readbyqxmd.com/read/28708053/rapid-diagnosis-of-extrapulmonary-tuberculosis-with-xpert-mycobacterium-tuberculosis-rifampicin-assay
#12
Yan Li, Yu Pang, Tianhua Zhang, Xiaoping Xian, Xidi Wang, Jian Yang, Rui Wang, Meiling Chen, Wei Chen
PURPOSE: XpertMycobacterium tuberculosis/rifampicin (Xpert MTB/RIF) assay has been endorsed by the World Health Organization (WHO) for diagnosis of extrapulmonary tuberculosis (EPTB), while the sensitivity and specificity have not been fully evaluated. We aimed to evaluate the performance of Xpert MTB/RIF assay in the detection of different extrapulmonary specimens. METHODS: A total of 420 nonrespiratory specimens were detected with acid-fast bacilli (AFB) smear microscopy, solid culture, conventional drug susceptibility testing (DST) and Xpert MTB/RIF assay...
July 15, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28705388/the-good-the-bad-and-the-ugly-of-the-next-generation-xpert-mtb-rif-%C3%A2-ultra-test-for-tuberculosis-diagnosis
#13
Alberto L García-Basteiro, Belén Saavedra, Frank Cobelens
No abstract text is available yet for this article.
July 10, 2017: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/28705265/comparison-of-histological-microbiological-and-molecular-methods-in-diagnosis-of-patients-with-tbln-having-different-anti-tb-treatment-background
#14
Nan Ying Che, Shao Jun Huang, Yan Ma, Yi Han, Zi Chen Liu, Chen Zhang, Jing Mu, Dan Zhao, Yang Qu, Hai Qing Zhang, Zhi Dong Liu, Shao Fa Xu
OBJECTIVE: The influence of anti-tuberculosis (TB) treatment history on tuberculous lymphadenitis (TBLN) diagnosis is unclear. Therefore, this study aims to evaluate the diagnostic methods, including histology, microbiology, and molecular tests, used for TBLN. METHODS: In this study, suspected patients with TBLN and having different anti-TB treatment background were enrolled. All the samples were tested simultaneously by histology, Ziehl-Neelsen (ZN) staining, mycobacterial culture (culture), Xpert MTB/RIF (xpert), real-time PCR, and high-resolution melting curve PCR (HRM)...
June 2017: Biomedical and Environmental Sciences: BES
https://www.readbyqxmd.com/read/28705215/feasibility-of-district-wide-screening-of-health-care-workers-for-tuberculosis-in-zambia
#15
Suzanne Verver, Nathan Kapata, Mathildah Kakungu Simpungwe, Seraphine Kaminsa, Mavis Mwale, Chitambeya Mukwangole, Bernard Sichinga, Sevim Ahmedov, Max Meis
BACKGROUND: Many health care workers (HCWs) are at increased risk for tuberculosis (TB). The World Health Organization (WHO) recommends screening HCWs for TB in high burden settings but this is often not implemented in countries with a high TB incidence. We assessed the feasibility of TB screening among HCWs, including participation rate and yield, as part of a project introducing facility specific TB interventions. METHODS: This study had a cross-sectional design...
July 14, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28704202/the-integration-of-the-molecular-methods-in-the-diagnosis-algorithm-for-the-poliovirus-detection-in-the-sewage-water-comparing-concentration-and-detection-methods-a-pilot-study
#16
Anda Bãicuş
Introduction Two cases of circulating vaccine-derived poliovirus type 1(cVDPV1), from southwestern Ukraine, bordering Romania, were confirmed in 2015 and the environmental enterovirus surveillance was enhanced in our country. The molecular detection of human enteroviruses as a screening test followed by isolation on cell culture lines or sequencing could be proposed as a new diagnosis algorithm. Material and Methods The sensitivity of two molecular methods for the detection of enterovirus strains in 10 ml of sewage water (15 samples) was studied with Film Array ME panel BioFire (Biomerieux, France) and Xpert EV assay (Cepheid, USA)...
July 8, 2017: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
https://www.readbyqxmd.com/read/28697621/undiagnosed-tuberculosis-in-patients-with-hiv-infection-who-present-with-severe-anaemia-at-a-district-hospital
#17
Mbulelo Mntonintshi, Don O'Mahony, Sikhumbuzo Mabunda, Kakia A F Namugenyi
BACKGROUND: Tuberculosis (TB) is a major cause of severe anaemia in patients with human immunodeficiency virus (HIV) infection in South Africa. However, TB can be difficult to diagnose as it may be extra pulmonary and paucibacillary. AIM: The aim of this study was to investigate undiagnosed TB in patients with HIV infection and severe anaemia and to identify the optimal investigations for diagnosing TB. SETTING: Mthatha General Hospital, a district hospital...
June 30, 2017: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/28689228/impact-of-a-rapid-molecular-test-for-positive-blood-cultures-from-neonatal-intensive-care-patients-on-clinical-management-a-retrospective-audit
#18
L L Koh, S O'Rourke, M Brennan, L Clooney, M Cafferkey, N McCallion, R J Drew
BACKGROUND: Both Staphylococcus aureus and coagulase negative Staphylococci are common causes of late-onset neonatal sepsis in the neonatal intensive care unit (NICU), usually relating to intravascular access device infections. AIMS: This project aimed to review the impact on antimicrobial treatment and clinical outcome in the NICU setting, of the introduction of the Xpert MRSA/SA BC test (Cepheid, USA) for the identification of staphylococci in blood cultures. METHODS: A retrospective audit was carried out of the pre- and post-intervention periods; the intervention was the introduction of the Xpert MRSA/SA BC test...
July 8, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28686705/sputum-quality-and-diagnostic-performance-of-genexpert-mtb-rif-among-smear-negative-adults-with-presumed-tuberculosis-in-uganda
#19
Amanda J Meyer, Collins Atuheire, William Worodria, Samuel Kizito, Achilles Katamba, Ingvar Sanyu, Alfred Andama, Irene Ayakaka, Adithya Cattamanchi, Freddie Bwanga, Laurence Huang, J Lucian Davis
BACKGROUND: Introduction of GeneXpert MTB/RIF (Xpert) assay has constituted a major breakthrough for tuberculosis (TB) diagnostics. Several patient factors may influence diagnostic performance of Xpert including sputum quality. OBJECTIVE: We carried out a prospective, observational, cross-sectional study to determine the effect of sputum quality on diagnostic performance of Xpert among presumed TB patients in Uganda. METHODS: We collected clinical and demographic information and two sputum samples from participants...
2017: PloS One
https://www.readbyqxmd.com/read/28681972/pneumonia-in-the-developing-world-characteristic-features-and-approach-to-management
#20
REVIEW
Stephen J Aston
Community-acquired pneumonia (CAP) is a common cause of morbidity and mortality in adults worldwide, but its epidemiology varies markedly by region. Whilst in high-income countries, the predominant burden of CAP is in the elderly and those with chronic cardiovascular and pulmonary co-morbidity, CAP patients in low-income settings are often of working age and, in sub-Saharan Africa, frequently HIV-positive. Although region-specific aetiological data are limited, they are sufficient to highlight major trends: in high-burden settings, tuberculosis (TB) is a common cause of acute CAP; Gram-negative pathogens such as Klebsiella pneumoniae are regionally important; and HIV-associated opportunistic infections are common but difficult to diagnose...
July 6, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
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