Examination of respiratory specimens improves microbiological diagnosis of patients with presumptive extrapulmonary tuberculosis.
Examination of respiratory specimens improves microbiological diagnosis of patients with presumptive extrapulmonary tuberculosis.
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DOI：
10.1016/j.ijid.2021.03.022
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发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
Cordeiro-Santos M
中科院分区：
文献类型：
--
作者：
Spener-Gomes R;Costa AG;Melo HF;Souza AB;Beraldi-Magalhães F;Jesus JS;Arriaga MB;Kritski A;Safe I;Andrade BB;Trajman A;Cordeiro-Santos M
肺外结核（EPTB）的细菌学确认具有挑战性，原因有几个：样本的少菌性;资源稀缺，主要是在中低收入国家;需要住院治疗;以及不利的结果。我们前瞻性地评估了呼吸道标本检查在一组推定EPTB患者中的诊断作用。从2018年7月至2019年1月，在结核病（TB）/艾滋病参考医院，对157例推定EPTB患者的队列进行了评价。Xpert® MTB/RIF Ultra或培养阳性结果被视为细菌学确诊的TB。在157例疑似EPTB患者中，97例（62%）提供了肺外和呼吸道标本，60例（38%）仅提供了肺外标本。在60例肺外样本中，5例（8%）阳性。在呼吸道和肺外样本中，27例（28%）为阳性：10例呼吸道和肺外样本，6例仅肺外样本，11例仅呼吸道样本。呼吸道标本检查使结核菌学确诊的机会增加6倍（比值比= 5.97 [1.11-47.17]）。我们的结论是呼吸道标本应检查患者推定EPTB。
Bacteriological confirmation of extrapulmonary tuberculosis (EPTB) is challenging for several reasons: the paucibacillary nature of the sample; scarce resources, mainly in middle and low-income countries; the need for hospitalization; and unfavorable outcomes. We evaluated the diagnostic role of respiratory specimen examination prospectively in a cohort of patients with presumptive EPTB. From July 2018 to January 2019, in a tuberculosis (TB)/HIV reference hospital, a cohort of 157 patients with presumed EPTB was evaluated. Xpert® MTB/RIF Ultra or a culture-positive result was considered for bacteriologically confirmed TB. Out of 157 patients with presumptive EPTB, 97 (62%) provided extrapulmonary and respiratory specimens and 60 (38%) extrapulmonary specimens only. Of the 60 patients with extrapulmonary samples, 5 (8%) were positive. Of those with respiratory and extrapulmonary samples, 27 (28%) were positive: 10 in both the respiratory and extrapulmonary samples, 6 in the extrapulmonary sample only, and 11 in the respiratory sample only. A respiratory specimen examination increased by 6-fold the chance of bacteriological confirmation of TB (odds ratio = 5.97 [1.11–47.17]). We conclude that respiratory samples should be examined in patients with presumptive EPTB.
影响因子：
10
作者：
Hernández-Garduño, E;Cook, V;FitzGerald, JM
通讯作者：
FitzGerald, JM
影响因子：
6
作者：
Zurcher, Kathrin;Ballif, Marie;de Waal, Renee
通讯作者：
de Waal, Renee
影响因子：
7.5
作者：
Palmieri, F;Girardi, E;Ippolito, G
通讯作者：
Ippolito, G