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Limited value of whole blood Xpert(®) MTB/RIF for diagnosing tuberculosis in children

Pohl, Christian and Rutaihwa, Liliana K. and Haraka, Frederick and Nsubuga, Martin and Aloi, Francesco and Ntinginya, Nyanda E. and Mapamba, Daniel and Heinrich, Norbert and Hoelscher, Michael and Marais, Ben J. and Jugheli, Levan and Reither, Klaus. (2016) Limited value of whole blood Xpert(®) MTB/RIF for diagnosing tuberculosis in children. The journal of infection, 73 (4). pp. 326-335.

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Official URL: http://edoc.unibas.ch/44595/

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Abstract

We evaluated the ability of the Xpert(®) MTB/RIF assay to detect Mycobacterium tuberculosis in whole blood of children with tuberculosis in tuberculosis endemic settings with high rates of HIV infection.; From June 2011 to September 2012 we prospectively enrolled children with symptoms or signs suggestive of tuberculosis at three research centres in Tanzania and Uganda. After clinical assessment, respiratory specimens were collected for microscopy and culture, as well as whole blood for Xpert(®) MTB/RIF. Children were classified according to standardised case definitions.; A total of 232 children were evaluated; 14 (6.0%) had culture-confirmed tuberculosis. The Xpert(®) MTB/RIF assay detected M. tuberculosis in 5/232 (2.2%) blood samples with 1 (0.4%) error reading and presumably 1 (0.4%) false-positive result. The sensitivity of the assay in children with culture-confirmed (1/14) versus no tuberculosis (1/117) was 7.1% (95% CI, 1.3-31.5). Three of the five Xpert(®) MTB/RIF positive patients had negative cultures, but were classified as probable tuberculosis cases. Assay sensitivity against a composite reference standard (culture-confirmed, highly probable or probable tuberculosis) was 5.4% (95% CI, 2.1-13.1).; Whole blood Xpert(®) MTB/RIF demonstrated very poor sensitivity, although it may enhance the diagnostic yield in select cases, with culture-negative tuberculosis.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Medical Parasitology and Infection Biology (MPI) > Tuberculosis Research (Gagneux)
UniBasel Contributors:Jugheli, Levan
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Academic Press
ISSN:0163-4453
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:12 Dec 2016 14:35
Deposited On:12 Dec 2016 14:35

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