Loading…

A Comprehensive Evaluation of Xpert MTB/RIF Assay With Bronchoalveolar Lavage Fluid as a Single Test or Combined With Conventional Assays for Diagnosis of Pulmonary Tuberculosis in China: A Two-Center Prospective Study

The Xpert MTB/RIF is recommended by the World Health Organization as a first line rapid test for the diagnosis of pulmonary tuberculosis (TB); however, China does not routinely use this test, partially due to the lack of a sufficient number of systematic evaluations of this assay in local patients....

Full description

Saved in:
Bibliographic Details
Published in:Frontiers in microbiology 2018-03, Vol.9, p.444-444
Main Authors: Pan, Xiaofu, Yang, Shoufeng, Deighton, Margaret A, Qu, Yue, Hong, Liang, Su, Feifei
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c462t-e13347afe263b5b9e3b595f371c932bb395a25983e020a3e2a6ec743ba405a53
cites cdi_FETCH-LOGICAL-c462t-e13347afe263b5b9e3b595f371c932bb395a25983e020a3e2a6ec743ba405a53
container_end_page 444
container_issue
container_start_page 444
container_title Frontiers in microbiology
container_volume 9
creator Pan, Xiaofu
Yang, Shoufeng
Deighton, Margaret A
Qu, Yue
Hong, Liang
Su, Feifei
description The Xpert MTB/RIF is recommended by the World Health Organization as a first line rapid test for the diagnosis of pulmonary tuberculosis (TB); however, China does not routinely use this test, partially due to the lack of a sufficient number of systematic evaluations of this assay in local patients. The aims of this study were to comprehensively assess the diagnostic performance of Xpert MTB/RIF, either alone or in combination with conventional assays for the diagnosis of pulmonary TB in adult Chinese patients. Xpert MTB/RIF tests were performed in 190 adult patients with suspected pulmonary TB, using bronchoalveolar lavage fluid (BALF) as test specimens. In parallel, conventional tests were carried out using the same BALF samples. Using two different reference standards, the performance of Xpert MTB/RIF, conventional assays and their combinations were evaluated. Using mycobacterial culture as the reference comparator, Xpert MTB/RIF was found to be superior to smear-microscopy in detecting . When final diagnosis, based on clinical criteria, was employed as the reference standard, Xpert MTB/RIF showed an even higher accuracy of 72.1%, supported by a sensitivity of 61.1% and specificity of 96.6%. Xpert MTB/RIF also demonstrated a powerful capability to identify pulmonary TB cases undetected by culture or smear-microscopy. Combining smear-microscopy and Xpert MTB/RIF was found to be the most accurate early predictor for pulmonary TB. Rifampicin resistance reported by Xpert MTB/RIF slightly deviated from that by phenotypic antibiotic susceptibility testing and requires further study with a larger sample size. This two-center prospective study highlights the value of Xpert MTB/RIF with BALF in diagnosing pulmonary TB in adult Chinese patients. These findings might contribute to the optimization of current diagnostic algorithms for pulmonary TB in China.
doi_str_mv 10.3389/fmicb.2018.00444
format article
fullrecord <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_f273ef1e41f44f98aa4865ab9c4ea2a9</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_f273ef1e41f44f98aa4865ab9c4ea2a9</doaj_id><sourcerecordid>2019811088</sourcerecordid><originalsourceid>FETCH-LOGICAL-c462t-e13347afe263b5b9e3b595f371c932bb395a25983e020a3e2a6ec743ba405a53</originalsourceid><addsrcrecordid>eNpVUkFv0zAUjhCITWN3TshHLu2S2EltDkhdWKFSEROLxG7Wi_vSenLtYidB_av8Gpx2TJsPz5b9vu977_lLkvdZOqWUi6t2p1UzzdOMT9OUMfYqOc_Kkk1omt-_fnY-Sy5DeEjjYmke49vkLBeFoCXn58nfOancbu9xizboAcnNAKaHTjtLXEvu9-g78r2-vvq5XJB5CHAgv3S3JdfeWbV1YAZ0BjxZwQAbJAvT6zWBQIDcabsxSGoMHXF-VGm0xfUJXjk7oB1VwJxoA2lj1hcNG-uCDqP4bW92McEfSN036FVvji_akmqrLXwic1L_cZMqEqEnt96FPapubOKu69eHd8mbFkzAy8f9IqkXN3X1bbL68XVZzVcTxcq8m2BGKZtBi3lJm6IRGKMoWjrLlKB501BRQF4ITjFODyjmUKKaMdoASwso6EWyPNGuHTzIvde7WLF0oOXxwvmNBN9pZVC2-YximyHLWsZawQEYLwtohGIIOYjI9fnEte-bHa5V7MyDeUH68sXqrdy4QRY8fmhBI8HHRwLvfvdx9HKng0JjwKLrg4xuETzLUs5janpKVXFwwWP7JJOlcjSYPBpshHB5NFiEfHhe3hPgv53oPytp0Tg</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2019811088</pqid></control><display><type>article</type><title>A Comprehensive Evaluation of Xpert MTB/RIF Assay With Bronchoalveolar Lavage Fluid as a Single Test or Combined With Conventional Assays for Diagnosis of Pulmonary Tuberculosis in China: A Two-Center Prospective Study</title><source>PubMed Central(OpenAccess)</source><creator>Pan, Xiaofu ; Yang, Shoufeng ; Deighton, Margaret A ; Qu, Yue ; Hong, Liang ; Su, Feifei</creator><creatorcontrib>Pan, Xiaofu ; Yang, Shoufeng ; Deighton, Margaret A ; Qu, Yue ; Hong, Liang ; Su, Feifei</creatorcontrib><description>The Xpert MTB/RIF is recommended by the World Health Organization as a first line rapid test for the diagnosis of pulmonary tuberculosis (TB); however, China does not routinely use this test, partially due to the lack of a sufficient number of systematic evaluations of this assay in local patients. The aims of this study were to comprehensively assess the diagnostic performance of Xpert MTB/RIF, either alone or in combination with conventional assays for the diagnosis of pulmonary TB in adult Chinese patients. Xpert MTB/RIF tests were performed in 190 adult patients with suspected pulmonary TB, using bronchoalveolar lavage fluid (BALF) as test specimens. In parallel, conventional tests were carried out using the same BALF samples. Using two different reference standards, the performance of Xpert MTB/RIF, conventional assays and their combinations were evaluated. Using mycobacterial culture as the reference comparator, Xpert MTB/RIF was found to be superior to smear-microscopy in detecting . When final diagnosis, based on clinical criteria, was employed as the reference standard, Xpert MTB/RIF showed an even higher accuracy of 72.1%, supported by a sensitivity of 61.1% and specificity of 96.6%. Xpert MTB/RIF also demonstrated a powerful capability to identify pulmonary TB cases undetected by culture or smear-microscopy. Combining smear-microscopy and Xpert MTB/RIF was found to be the most accurate early predictor for pulmonary TB. Rifampicin resistance reported by Xpert MTB/RIF slightly deviated from that by phenotypic antibiotic susceptibility testing and requires further study with a larger sample size. This two-center prospective study highlights the value of Xpert MTB/RIF with BALF in diagnosing pulmonary TB in adult Chinese patients. These findings might contribute to the optimization of current diagnostic algorithms for pulmonary TB in China.</description><identifier>ISSN: 1664-302X</identifier><identifier>EISSN: 1664-302X</identifier><identifier>DOI: 10.3389/fmicb.2018.00444</identifier><identifier>PMID: 29593688</identifier><language>eng</language><publisher>Switzerland: Frontiers Media S.A</publisher><subject>bronchoalveolar lavage fluid (BALF) ; culture ; diagnosis ; Microbiology ; pulmonary tuberculosis (TB) ; smear-microscopy ; Xpert MTB/RIF</subject><ispartof>Frontiers in microbiology, 2018-03, Vol.9, p.444-444</ispartof><rights>Copyright © 2018 Pan, Yang, Deighton, Qu, Hong and Su. 2018 Pan, Yang, Deighton, Qu, Hong and Su</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c462t-e13347afe263b5b9e3b595f371c932bb395a25983e020a3e2a6ec743ba405a53</citedby><cites>FETCH-LOGICAL-c462t-e13347afe263b5b9e3b595f371c932bb395a25983e020a3e2a6ec743ba405a53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5859353/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5859353/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29593688$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pan, Xiaofu</creatorcontrib><creatorcontrib>Yang, Shoufeng</creatorcontrib><creatorcontrib>Deighton, Margaret A</creatorcontrib><creatorcontrib>Qu, Yue</creatorcontrib><creatorcontrib>Hong, Liang</creatorcontrib><creatorcontrib>Su, Feifei</creatorcontrib><title>A Comprehensive Evaluation of Xpert MTB/RIF Assay With Bronchoalveolar Lavage Fluid as a Single Test or Combined With Conventional Assays for Diagnosis of Pulmonary Tuberculosis in China: A Two-Center Prospective Study</title><title>Frontiers in microbiology</title><addtitle>Front Microbiol</addtitle><description>The Xpert MTB/RIF is recommended by the World Health Organization as a first line rapid test for the diagnosis of pulmonary tuberculosis (TB); however, China does not routinely use this test, partially due to the lack of a sufficient number of systematic evaluations of this assay in local patients. The aims of this study were to comprehensively assess the diagnostic performance of Xpert MTB/RIF, either alone or in combination with conventional assays for the diagnosis of pulmonary TB in adult Chinese patients. Xpert MTB/RIF tests were performed in 190 adult patients with suspected pulmonary TB, using bronchoalveolar lavage fluid (BALF) as test specimens. In parallel, conventional tests were carried out using the same BALF samples. Using two different reference standards, the performance of Xpert MTB/RIF, conventional assays and their combinations were evaluated. Using mycobacterial culture as the reference comparator, Xpert MTB/RIF was found to be superior to smear-microscopy in detecting . When final diagnosis, based on clinical criteria, was employed as the reference standard, Xpert MTB/RIF showed an even higher accuracy of 72.1%, supported by a sensitivity of 61.1% and specificity of 96.6%. Xpert MTB/RIF also demonstrated a powerful capability to identify pulmonary TB cases undetected by culture or smear-microscopy. Combining smear-microscopy and Xpert MTB/RIF was found to be the most accurate early predictor for pulmonary TB. Rifampicin resistance reported by Xpert MTB/RIF slightly deviated from that by phenotypic antibiotic susceptibility testing and requires further study with a larger sample size. This two-center prospective study highlights the value of Xpert MTB/RIF with BALF in diagnosing pulmonary TB in adult Chinese patients. These findings might contribute to the optimization of current diagnostic algorithms for pulmonary TB in China.</description><subject>bronchoalveolar lavage fluid (BALF)</subject><subject>culture</subject><subject>diagnosis</subject><subject>Microbiology</subject><subject>pulmonary tuberculosis (TB)</subject><subject>smear-microscopy</subject><subject>Xpert MTB/RIF</subject><issn>1664-302X</issn><issn>1664-302X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNpVUkFv0zAUjhCITWN3TshHLu2S2EltDkhdWKFSEROLxG7Wi_vSenLtYidB_av8Gpx2TJsPz5b9vu977_lLkvdZOqWUi6t2p1UzzdOMT9OUMfYqOc_Kkk1omt-_fnY-Sy5DeEjjYmke49vkLBeFoCXn58nfOancbu9xizboAcnNAKaHTjtLXEvu9-g78r2-vvq5XJB5CHAgv3S3JdfeWbV1YAZ0BjxZwQAbJAvT6zWBQIDcabsxSGoMHXF-VGm0xfUJXjk7oB1VwJxoA2lj1hcNG-uCDqP4bW92McEfSN036FVvji_akmqrLXwic1L_cZMqEqEnt96FPapubOKu69eHd8mbFkzAy8f9IqkXN3X1bbL68XVZzVcTxcq8m2BGKZtBi3lJm6IRGKMoWjrLlKB501BRQF4ITjFODyjmUKKaMdoASwso6EWyPNGuHTzIvde7WLF0oOXxwvmNBN9pZVC2-YximyHLWsZawQEYLwtohGIIOYjI9fnEte-bHa5V7MyDeUH68sXqrdy4QRY8fmhBI8HHRwLvfvdx9HKng0JjwKLrg4xuETzLUs5janpKVXFwwWP7JJOlcjSYPBpshHB5NFiEfHhe3hPgv53oPytp0Tg</recordid><startdate>20180313</startdate><enddate>20180313</enddate><creator>Pan, Xiaofu</creator><creator>Yang, Shoufeng</creator><creator>Deighton, Margaret A</creator><creator>Qu, Yue</creator><creator>Hong, Liang</creator><creator>Su, Feifei</creator><general>Frontiers Media S.A</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20180313</creationdate><title>A Comprehensive Evaluation of Xpert MTB/RIF Assay With Bronchoalveolar Lavage Fluid as a Single Test or Combined With Conventional Assays for Diagnosis of Pulmonary Tuberculosis in China: A Two-Center Prospective Study</title><author>Pan, Xiaofu ; Yang, Shoufeng ; Deighton, Margaret A ; Qu, Yue ; Hong, Liang ; Su, Feifei</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c462t-e13347afe263b5b9e3b595f371c932bb395a25983e020a3e2a6ec743ba405a53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>bronchoalveolar lavage fluid (BALF)</topic><topic>culture</topic><topic>diagnosis</topic><topic>Microbiology</topic><topic>pulmonary tuberculosis (TB)</topic><topic>smear-microscopy</topic><topic>Xpert MTB/RIF</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pan, Xiaofu</creatorcontrib><creatorcontrib>Yang, Shoufeng</creatorcontrib><creatorcontrib>Deighton, Margaret A</creatorcontrib><creatorcontrib>Qu, Yue</creatorcontrib><creatorcontrib>Hong, Liang</creatorcontrib><creatorcontrib>Su, Feifei</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Frontiers in microbiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pan, Xiaofu</au><au>Yang, Shoufeng</au><au>Deighton, Margaret A</au><au>Qu, Yue</au><au>Hong, Liang</au><au>Su, Feifei</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Comprehensive Evaluation of Xpert MTB/RIF Assay With Bronchoalveolar Lavage Fluid as a Single Test or Combined With Conventional Assays for Diagnosis of Pulmonary Tuberculosis in China: A Two-Center Prospective Study</atitle><jtitle>Frontiers in microbiology</jtitle><addtitle>Front Microbiol</addtitle><date>2018-03-13</date><risdate>2018</risdate><volume>9</volume><spage>444</spage><epage>444</epage><pages>444-444</pages><issn>1664-302X</issn><eissn>1664-302X</eissn><abstract>The Xpert MTB/RIF is recommended by the World Health Organization as a first line rapid test for the diagnosis of pulmonary tuberculosis (TB); however, China does not routinely use this test, partially due to the lack of a sufficient number of systematic evaluations of this assay in local patients. The aims of this study were to comprehensively assess the diagnostic performance of Xpert MTB/RIF, either alone or in combination with conventional assays for the diagnosis of pulmonary TB in adult Chinese patients. Xpert MTB/RIF tests were performed in 190 adult patients with suspected pulmonary TB, using bronchoalveolar lavage fluid (BALF) as test specimens. In parallel, conventional tests were carried out using the same BALF samples. Using two different reference standards, the performance of Xpert MTB/RIF, conventional assays and their combinations were evaluated. Using mycobacterial culture as the reference comparator, Xpert MTB/RIF was found to be superior to smear-microscopy in detecting . When final diagnosis, based on clinical criteria, was employed as the reference standard, Xpert MTB/RIF showed an even higher accuracy of 72.1%, supported by a sensitivity of 61.1% and specificity of 96.6%. Xpert MTB/RIF also demonstrated a powerful capability to identify pulmonary TB cases undetected by culture or smear-microscopy. Combining smear-microscopy and Xpert MTB/RIF was found to be the most accurate early predictor for pulmonary TB. Rifampicin resistance reported by Xpert MTB/RIF slightly deviated from that by phenotypic antibiotic susceptibility testing and requires further study with a larger sample size. This two-center prospective study highlights the value of Xpert MTB/RIF with BALF in diagnosing pulmonary TB in adult Chinese patients. These findings might contribute to the optimization of current diagnostic algorithms for pulmonary TB in China.</abstract><cop>Switzerland</cop><pub>Frontiers Media S.A</pub><pmid>29593688</pmid><doi>10.3389/fmicb.2018.00444</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1664-302X
ispartof Frontiers in microbiology, 2018-03, Vol.9, p.444-444
issn 1664-302X
1664-302X
language eng
recordid cdi_doaj_primary_oai_doaj_org_article_f273ef1e41f44f98aa4865ab9c4ea2a9
source PubMed Central(OpenAccess)
subjects bronchoalveolar lavage fluid (BALF)
culture
diagnosis
Microbiology
pulmonary tuberculosis (TB)
smear-microscopy
Xpert MTB/RIF
title A Comprehensive Evaluation of Xpert MTB/RIF Assay With Bronchoalveolar Lavage Fluid as a Single Test or Combined With Conventional Assays for Diagnosis of Pulmonary Tuberculosis in China: A Two-Center Prospective Study
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T01%3A11%3A22IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20Comprehensive%20Evaluation%20of%20Xpert%20MTB/RIF%20Assay%20With%20Bronchoalveolar%20Lavage%20Fluid%20as%20a%20Single%20Test%20or%20Combined%20With%20Conventional%20Assays%20for%20Diagnosis%20of%20Pulmonary%20Tuberculosis%20in%20China:%20A%20Two-Center%20Prospective%20Study&rft.jtitle=Frontiers%20in%20microbiology&rft.au=Pan,%20Xiaofu&rft.date=2018-03-13&rft.volume=9&rft.spage=444&rft.epage=444&rft.pages=444-444&rft.issn=1664-302X&rft.eissn=1664-302X&rft_id=info:doi/10.3389/fmicb.2018.00444&rft_dat=%3Cproquest_doaj_%3E2019811088%3C/proquest_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c462t-e13347afe263b5b9e3b595f371c932bb395a25983e020a3e2a6ec743ba405a53%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2019811088&rft_id=info:pmid/29593688&rfr_iscdi=true