Association of Radiological Findings with the Xpert MTB/RIF Test in Patients with Suspected Pulmonary Tuberculosis

Purpose Tuberculosis (TB) treatment is often carried out empirically, based on clinical and radiological findings. Chest X-ray (CXR) has good sensitivity but poor specificity in TB diagnosis. Xpert MTB/RIF ( Mycobacterium tuberculosis /Rifampicin) is increasingly used in many countries as the initia...

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Bibliographic Details
Published in:Lung 2018-12, Vol.196 (6), p.755-760
Main Authors: Neto, Wilson Oliveira Ezequiel, Pereira, Giovana Rodrigues, Barbosa, Márcia Silva, Dias, Natan José Dutra, Silva, Denise Rossato
Format: Article
Language:English
Subjects:
Adult
Aged
Antibiotics, Antitubercular - pharmacology
Cross-Sectional Studies
Diagnosis
Diagnostic systems
DNA, Bacterial - analysis
Female
Humans
Male
Medical diagnosis
Medicine
Medicine & Public Health
Middle Aged
Mycobacterium tuberculosis - drug effects
Mycobacterium tuberculosis - genetics
Mycobacterium tuberculosis - isolation & purification
Patients
Pneumology/Respiratory System
Predictive Value of Tests
Radiography, Thoracic
Respiratory Infections
Rifampin
Rifampin - pharmacology
Smear
Sputum
Sputum - microbiology
Tuberculosis
Tuberculosis, Pulmonary - diagnostic imaging
Tuberculosis, Pulmonary - microbiology
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Summary:Purpose Tuberculosis (TB) treatment is often carried out empirically, based on clinical and radiological findings. Chest X-ray (CXR) has good sensitivity but poor specificity in TB diagnosis. Xpert MTB/RIF ( Mycobacterium tuberculosis /Rifampicin) is increasingly used in many countries as the initial diagnostic test for TB. The aim of the present study was to evaluate the association of radiological findings with the Xpert MTB/RIF test in patients with suspected pulmonary TB. Methods Cross-sectional study in an outpatient TB clinic. Sputum AFB smear, culture, Xpert MTB/RIF, and CXR were collected in patients with suspected pulmonary TB. Results During the study period, 312 patients met the inclusion criteria and were included in the analysis. Among Xpert MTB/RIF-positive cases, the radiographic patterns were classified as typical of TB, compatible of TB, and normal in 78 (70.3%), 31 (27.9%), and 2 (1.8%) patients, respectively. CXRs were classified as typical of TB, compatible of TB, and normal in 20 (10.0%), 25 (12.4%), and 152 (75.6%) patients, respectively, in Xpert MTB/RIF-negative cases. Conclusions We found an association between radiographic patterns and Xpert MTB/RIF results in patients with suspected pulmonary TB. These results confirm the current recommended diagnosis algorithm.
ISSN:0341-2040
1432-1750
DOI:10.1007/s00408-018-0157-z