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https://www.readbyqxmd.com/read/28928173/cohort-profile-of-a-study-on-outcomes-related-to-tuberculosis-and-antiretroviral-drug-concentrations-in-uganda-design-methods-and-patient-characteristics-of-the-south-study
#1
Christine Sekaggya-Wiltshire, Barbara Castelnuovo, Amrei von Braun, Joseph Musaazi, Daniel Muller, Allan Buzibye, Ursula Gutteck, Lars Henning, Bruno Ledergerber, Natascia Corti, Mohammed Lamorde, Jan Fehr, Andrew Kambugu
PURPOSE: Tuberculosis (TB) is a leading cause of death among people living with HIV in sub-Saharan Africa. Several factors influence the efficacy of TB treatment by leading to suboptimal drug concentrations and subsequently affecting treatment outcome. The aim of this cohort is to determine the association between anti-TB drug concentrations and TB treatment outcomes. PARTICIPANTS: Patients diagnosed with new pulmonary TB at the integrated TB-HIV outpatient clinic in Kampala, Uganda, were enrolled into the study and started on first-line anti-TB treatment...
September 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28924924/predictors-of-microbiologically-confirmed-intrathoracic-tuberculosis
#2
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
#3
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/28920845/modified-use-of-real-time-pcr-detection-of-group-b-streptococcus-in-pregnancy
#4
Ali A Rabaan, Justin V Saunar, Ali M Bazzi, Joan L Soriano
The CDC recommends antenatal screening of vaginal/rectal samples for Streptococcus agalactiae at 35-37 weeks' gestation, with intra-partum antibiotic prophylaxis for positive cases. We tested a modified use of the Cepheid Xpert GBS real-time PCR kit on enrichment cultures from 554 vaginal/rectal swabs compared to the current subculturing gold standard method. Swabs were inoculated on polymyxin nalidixic acid agar plates, and Todd-Hewitt enrichment broth cultures were examined daily for growth. Todd-Hewitt broth culture was also used for Xpert GBS...
September 18, 2017: Journal of Medical Microbiology
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28919337/xpert-mtb-rif-ultra-a-gamechanger-for-tuberculous-meningitis
#7
Margaret Khonga, Mark Patrick Nicol
No abstract text is available yet for this article.
September 14, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28911361/detecting-mycobacterium-tuberculosis-using-the-loop-mediated-isothermal-amplification-test-in-south-africa
#8
S Reddy, S Ntoyanto, Y Sakadavan, T Reddy, S Mahomed, M Dlamini, B Spooner, G Ramjee, A Coutsoudis, N Ngomane, K Naidoo, K Mlisana, P Kiepiela
SETTING: In South Africa, KwaZulu-Natal is the epicentre of the human immunodeficiency virus (HIV) epidemic, where approximately 70% of people with tuberculosis (TB) are co-infected with HIV. Undiagnosed TB contributes to high mortality in HIV-infected patients. Delays in diagnosing TB and treatment initiation result in prolonged transmission and increased infectiousness. OBJECTIVE: To evaluate the LoopampTM MTBC Detection kit (TB-LAMP; based on the loop-mediated isothermal amplification assay), smear microscopy and Xpert test with the gold standard of mycobacterial culture...
October 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28911360/evaluation-of-the-tb-lamp-assay-for-the-rapid-diagnosis-of-pulmonary-tuberculosis-in-northern-india
#9
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
#10
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
#11
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
#12
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/28911347/post-implementation-blues-the-unfulfilled-potential-of-xpert
#13
Simon Tiberi, Emanuele Pontali, Giovanni Battista Migliori
No abstract text is available yet for this article.
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
#14
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
#15
MULTICENTER STUDY
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/28901908/performance-of-point-of-care-xpert-hiv-1-plasma-viral-load-assay-at-a-tertiary-hiv-care-centre-in-southern-india
#16
Chinnambedu Ravichandran Swathirajan, Ramachandran Vignesh, Jayaseelan Boobalan, Sunil Suhas Solomon, Shanmugam Saravanan, Pachamuthu Balakrishnan
BACKGROUND: Sustainable suppression of HIV replication forms the basis of anti-retroviral therapy (ART) medication. Thus, reliable quantification of HIV viral load has become an essential factor to monitor the effectiveness of the ART. Longer turnaround-time (TAT), batch testing and technical skills are major drawbacks of standard real-time PCR assays. METHODS: The performance of the point-of-care Xpert HIV-1 viral load assay was evaluated against the Abbott RealTime PCR m2000rt system...
September 13, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28898982/prevalence-of-anal-human-papillomavirus-hpv-and-performance-of-cepheid-xpert-and-hybrid-capture-2-hc2-hpv-assays-in-south-african-hiv-infected-women
#17
Zizipho Z A Mbulawa, Timothy Wilkin, Bridgette J Goeieman, Eefje Jong, Pamela Michelow, Avril Swarts, Jennifer S Smith, Patricia Kegorilwe, Cynthia S Firnhaber, Anna-Lise Williamson
Objectives: This study investigated anal high-risk HPV (HR-HPV) prevalence in HIV-infected women using the Cepheid Xpert HPV assay and compares its performance with that of Hybrid Capture-2 (hc2). Methods: A total of 199 HIV-infected women were recruited from Helen Joseph Hospital, Johannesburg. Stored ThinPrep anal swabs that had previously been tested using hc2 were tested for HPV using Xpert. Results: The HR-HPV prevalence by Xpert was 40...
August 1, 2017: American Journal of Clinical Pathology
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
#18
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/28892765/the-performance-of-luminex-aries-%C3%A2-flu-a-b-rsv-and-cepheid-xpert-%C3%A2-flu-rsv-xc-for-the-detection-of-influenza-a-influenza-b-and-respiratory-syncytial-virus-in-prospective-patient-samples
#19
Phillip McMullen, Sue Boonlayangoor, Angella Charnot-Katsikas, Kathleen G Beavis, Vera Tesic
BACKGROUND: The demand for rapid, accurate viral testing has increased the number of assays available for the detection of viral pathogens. One of the newest FDA cleared platforms is the Luminex ARIES(®) Flu A/B & RSV, which is a fully automated, real-time PCR-based assay used for detection of influenza A, influenza B, and respiratory syncytial virus (RSV). OBJECTIVES: We sought to compare the performance of Luminex ARIES(®) Flu A/B & RSV assay to the Cepheid Xpert(®) Flu/RSV XC assay for rapid Flu and RSV testing...
September 5, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
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
#20
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
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