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Xpert((R)) MTB/RIF for detection of Mycobacterium tuberculosis from frozen string and induced sputum sediments

  • 2016/08/01
Type de publication
  • Articles
Auteurs
  • Deen
  • J.; von
  • Seidlein L.; Luquero
  • F.J.; Troeger
  • C.; Reyburn
  • R.; Lopez
  • A.L.; Debes
  • A.; Sack
  • D.A.
Thèmes
  • Tuberculose
Abstract
SETTING
Although it is now widely used for tuberculosis (TB) diagnosis, Xpert(®) MTB/RIF availability remains inadequate in low-resource settings. Moreover, its accuracy in testing stored samples from non-expectorating patients has not been evaluated.
 
OBJECTIVE
To assess the performance of Xpert in frozen samples of induced sputum (IS) and sputum from string test (ST) from non-expectorating individuals with presumed TB.
 
DESIGN
This was a laboratory-based study of 377 ST and IS samples collected between March 2010 and March 2013 at a referral hospital in Uganda. Samples were decontaminated, centrifuged and cultured, and the resultant samples were frozen at -20°C before Xpert evaluation.
 
RESULTS
TB was detected in ST and IS samples from 19/163 (11.7%) children and 63/201 (29.4%) adults using culture. Xpert sensitivity in frozen sediments from children was 37.5% (95%CI 8.5-75.5) in ST and 41.7% (95%CI 15.2-72.3) in IS samples, with specificities of respectively 100% (95%CI 94.9-100) and 98.6% (95%CI 92.7-100). In adults, sensitivity was respectively 50% (95%CI 31.3-68.7) and 48.5% (95%CI 30.8-66.4) in ST and IS samples, with specificities of respectively 100% (95%CI 95.5-100) and 98.6% (95%CI 92.4-100).
 
CONCLUSION
Given these results, and particularly the high specificity, the use of Xpert on frozen ST and IS sediment samples from both children and adults is promising.