Evaluation of Xpert MTB/RIF assay for detection of Mycobacterium tuberculosis in stool samples of adults with pulmonary tuberculosis.
Evaluation of Xpert MTB/RIF assay for detection of Mycobacterium tuberculosis in stool samples of adults with pulmonary tuberculosis.
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DOI：
10.1371/journal.pone.0203063
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Banu S
中科院分区：
文献类型：
--
作者：
Rahman SMM;Maliha UT;Ahmed S;Kabir S;Khatun R;Shah JA;Banu S
Xpert MTB/RIF （Xpert）检测技术可以从痰标本中快速、灵敏地诊断肺结核（PTB）。然而，对于不能咳痰的患者，诊断肺结核是困难的。本研究的目的是探讨使用Xpert法成功检测PTB使用成人受试者粪便样本。从达卡的一家结核病医院收集了已知涂片和Xpert阳性肺结核患者的粪便和痰样本。从达卡贫民窟地区无结核症状的健康个体收集粪便样本。粪便和痰标本用nalc - naoh - na -柠檬酸盐溶液净化和浓缩，所得沉淀物用于Xpert，抗酸杆菌（AFB）显微镜和培养。共收集了102份肺结核患者的粪便样本和另外50份未患肺结核的健康人的粪便样本。Xpert法检测PTB患者粪便标本中结核分枝杆菌的灵敏度为90.2% （95% CI, 82.9 ~ 95.0）。所有50份健康个体的粪便样本均为阴性（特异性100%；95% CI, 92.9-100）。与痰培养阳性结果相比，粪便Xpert法敏感性为94.8% （95% CI, 88.5-97.8）。此外，粪便专家显示完全一致的结果与痰培养检测利福平敏感性。Xpert法测定的rpoB探针的循环阈值与显微镜下粪便（Spearman相关= -0.40,P < 0.01）和痰（Spearman相关= -0.77,P < 0.01）样品中的杆菌载量显著相关。粪便Xpert可作为痰液检测的潜在替代方法，用于检测结核分枝杆菌和准确测定成人肺结核患者的RIF易感性。该方法对不能咳痰的成人肺结核患者的快速诊断具有重要意义。
The Xpert MTB/RIF (Xpert) assay technology allows rapid and sensitive diagnosis of pulmonary tuberculosis (PTB) from sputum specimens. However, diagnosis of PTB is difficult for patients who cannot produce sputum. The objective of this study was to investigate the use of Xpert assay for successful detection of PTB using stool samples from adult subjects. Both stool and sputum samples from known smear and Xpert positive PTB patients were collected from a TB hospital in Dhaka. Stool samples were collected from healthy individuals without TB symptoms from a slum area of Dhaka. Stool and sputum samples were decontaminated and concentrated using NALC-NaOH-Na-citrate solution and the resultant sediment was used for Xpert, acid-fast bacilli (AFB) microscopy and culture. A total of 102 stool samples were collected from PTB patients and another 50 stool samples from healthy individuals without TB. The sensitivity of the Xpert assay for detection of M. tuberculosis in stool samples of PTB patients was 90.2% (95% CI, 82.9–95.0). All 50 stool samples from healthy individuals were negative by the assay (Specificity 100%; 95% CI, 92.9–100). Compared with the sputum culture positive results the sensitivity of the stool Xpert assay was 94.8% (95% CI, 88.5–97.8). Moreover, stool Xpert demonstrated full concordant results with the sputum culture for detection of rifampicin susceptibility. The cycle threshold values of rpoB probes obtained from Xpert assay correlated significantly with the bacilli load in the corresponding stool (Spearman correlation = -0.40, P < 0.01) and sputum (Spearman correlation = -0.77, P < 0.01) samples as determined by microscopy. Stool Xpert can be applied as a potential alternative of sputum testing for detection of M. tuberculosis and accurate determination of RIF susceptibility in adult PTB patients. The assay would be beneficial for rapid diagnosis of PTB for those adult patients who cannot expectorate sputum.
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影响因子：
9.4
作者：
Walters E;Demers AM;van der Zalm MM;Whitelaw A;Palmer M;Bosch C;Draper HR;Gie RP;Hesseling AC
通讯作者：
Hesseling AC
影响因子：
3.7
作者：
Banada, Padmapriya P.;Naidoo, Uvistra;Alland, David
通讯作者：
Alland, David
影响因子：
56.3
作者：
Newton, Sandra M.;Brent, Andrew J.;Anderson, Suzanne;Whittaker, Elizabeth;Kampmann, Beate
通讯作者：
Kampmann, Beate
DOI：
10.1164/rccm.2111019
发表时间：
2003-03-01
影响因子：
24.7
作者：
Conde, MB;Loivos, AC;Kritski, AL
通讯作者：
Kritski, AL
影响因子：
9.4
作者：
Blakemore, Robert;Story, Elizabeth;Alland, David
通讯作者：
Alland, David