Prospective evaluation of host biomarkers other than interferon gamma in QuantiFERON Plus supernatants as candidates for the diagnosis of tuberculosis in symptomatic individuals
An estimated 10.4 million people were reported to have fallen ill with tuberculosis (TB), and another 1.6 million died of the disease in 2017.1 The currently existing diagnostic tests have several widely publicised limitations2,3 including poor sensitivity (smear microscopy),4 long turnaround times and high costs (culture).5 The GeneXpert MTB/RIF test (Cepheid, Sunnyvale, CA, USA), is relatively rapid and detects resistance to rifampicin, but is also expensive, with low specificity in recurrent TB.
Authors: Mathabire Rucker SC, Cossa L, Harrison RE, Mpunga J, Lobo S, Kisaka Kimupelenge P, Mandar Kol'Ampwe F, Amoros Quiles I, Molfino L, Szumilin E, Telnov O, Ndlovu Z, Huerga H Abstract Background: Determine TB-LAM is a urine-based point-of-care assay for diagnosis of tuberculosis (TB). Objective: To assess the feasibility of using LAM to diagnose TB in adult HIV-positive patients in resource-limited settings. Methods: We performed a multi-centric mixed-methods cross-sectional descriptive study in the Democratic Republic of Congo, Malawi, and Mozambique. We used the study and program monitoring tools to estimat...
Conclusion: A single Xpert MTB/resistance to rifampicin test detected all smear-positive patients, whereas the third smear did not significantly contribute to MTB isolation. PMID: 31588479 [PubMed - in process]
In this study, we report a new method for detecting cell-free Mycobacterium tuberculosis DNA (cf-TB) in CSF and evaluate its clinical value for TBM diagnosis. METHODS: Of 68 patients prospectively recruited, 46 were diagnosed as having TBM and 22 as non-TBM. We compared the cf-TB method with CSF smear microscopy, mycobacterial culture, and the Xpert MTB/RIF assay (Xpert) using the consensus case definition for TBM proposed in 2009 as a reference standard. RESULTS: The sensitivity of the cf-TB test was 56.5% (26/46) in patients with TBM, and it was significantly higher than other methods: microscopy (2.2%, 1/46; P
This study compared results of interferon-gamma release assays (IGRA) between contacts of pulmonary TB patients with AFB smear positivity and those with smear negativity using QuantiFERON®-TB Gold In-Tube (QFT) assays. Close contacts of TB patients with culture-confirmed infections between April 2010 and December 2012 in Ibaraki, Japan, were enrolled, and 439 Japanese contacts of 129 index TB patients were examined. Adjusted odds ratios of QFT in contacts were 0.68 (95% confidence interval: 0.17–2.8) for AFB scanty patients, 1.12 (0.45–2.8) for AFB 1+, 1.20 (0.48–3.0) for AFB 2+, and 4...
Diagnostic tests for tuberculosis (TB) have undergone an era of unprecedented innovation . Over the past century, the bacteriological diagnosis of TB was primarily based on sputum smear microscopy and culture (solid and subsequently liquid culture). Rapid new molecular tests have been introduced, including the automated nucleic acid amplification test Xpert MTB/RIF (Xpert) and its recent successor Xpert MTB/RIF Ultra (Ultra) [2–4]. Diagnostic algorithms have been developed that combine these new tests with established tools [5–7]; however, such algorithms are often country- or setting-specific, depending on ...
Conclusion: To conclude, though GeneXpert detects tuberculosis within the shortest possible time, it still suffers from intermediate level sensitivity, which makes culture facilities relevant even in settings that offer an Xpert/Rif assay. PMID: 31562713 [PubMed - in process]
Authors: Mthiyane T, Peter J, Allen J, Connolly C, Davids M, Rustomjee R, Holtz TH, Malinga L, Dheda K Abstract Background: Based on current WHO guidelines, hospitalized tuberculosis (TB) and HIV co-infected patients with CD4 count
ConclusionThe current study highlights the potential of LAMP test for the specific diagnosis of tubercular lymphadenitis in FNAC samples from HIV-infected patients, especially when cytology is either non-conclusive or non-available. Though MPCR had a higher sensitivity than LAMP assay, the added advantages of low cost, minimal technical expertise and simplicity of procedure make LAMP assay a suitable diagnostic test in resource-limited settings.
We report the case of a 10-year-old child treated for latent tuberculosis infection (LTBI) with pyrazinamide (PZA) and levofloxacin after contact with a smear-positive multidrug-resistant tuberculosis adult. Over the course of the treatment, the patient developed a drug-induced fulminant hepatitis attributed to the combination of PZA and levofloxacin. This case highlights the hepatotoxicity of the association of second-line anti-TB treatment in children.
Conclusion: The highest burden of the disease was recorded among the male population in productive ages. The identification test for species of the complex showed all were M. tuberculosis. However, it is not possible to discard the presence of M. bovis in humans in Colombia. The differential identification of species should be done in risk groups and in areas where the circulation of this mycobacterium in cattle is known. PMID: 31529854 [PubMed - in process]