Exploring alternative biomaterials for diagnosis of pulmonary tuberculosis in HIV-negative patients by use of the geneXpert MTB/RIF assay

Shenai, Shubhada, Amisano, Danielle, Ronacher, Katharina, Kriel, Magdalena, Banada, Padmapriya P., Song, Taeksun, Lee, Myungsun, Joh, Joon Sung, Winter, Jill, Thayer, Rich, Via, Laura E., Kim, Soyeon, Barry III, Clifton E., Walzl, Gerhard and Alland, David (2013) Exploring alternative biomaterials for diagnosis of pulmonary tuberculosis in HIV-negative patients by use of the geneXpert MTB/RIF assay. Journal of Clinical Microbiology, 51 12: 4161-4166. doi:10.1128/JCM.01743-13

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Author Shenai, Shubhada
Amisano, Danielle
Ronacher, Katharina
Kriel, Magdalena
Banada, Padmapriya P.
Song, Taeksun
Lee, Myungsun
Joh, Joon Sung
Winter, Jill
Thayer, Rich
Via, Laura E.
Kim, Soyeon
Barry III, Clifton E.
Walzl, Gerhard
Alland, David
Title Exploring alternative biomaterials for diagnosis of pulmonary tuberculosis in HIV-negative patients by use of the geneXpert MTB/RIF assay
Journal name Journal of Clinical Microbiology   Check publisher's open access policy
ISSN 0095-1137
1070-633X
1098-660X
Publication date 2013-12-01
Sub-type Article (original research)
DOI 10.1128/JCM.01743-13
Open Access Status File (Publisher version)
Volume 51
Issue 12
Start page 4161
End page 4166
Total pages 6
Place of publication Washington, DC United States
Publisher American Society for Microbiology
Language eng
Formatted abstract
The utility of the GeneXpert MTB/RIF (Xpert) assay for detection of Mycobacterium tuberculosis in sputum samples has been extensively studied. However, the performance of the Xpert assay as applied to other readily accessible body fluids such as exhaled breath condensate (EBC), saliva, urine, and blood has not been established. We used the Xpert assay to test EBC, saliva, urine, and blood samples from HIV-negative, smear- and culture-positive pulmonary tuberculosis (TB) patients for the presence of M. tuberculosis. To compare the ability of the assay to perform bacterial load measurements on sputum samples with versus without sample processing, the assay was also performed on paired direct and processed sputum samples from each patient. The Xpert assay detected M. tuberculosis in none of the 26 EBC samples (sensitivity, 0.0%; 95% confidence interval [95% CI], 0.0%, 12.9%), 10 of the 26 saliva samples (sensitivity, 38.5%; 95% CI, 22.4%, 57.5%), 1 of 26 urine samples (sensitivity, 3.8%; 95% CI, 0.7%, 18.9%), and 2 of 24 blood samples (sensitivity, 8.3%; 95% CI, 2.3%, 25.8%). For bacterial load measurements in the different types of sputum samples, the cycle thresholds of the two M. tuberculosis-positive sputum types were well correlated (Spearman correlation of 0.834). This study demonstrates that the Xpert assay should not be routinely used to detect M. tuberculosis in EBC, saliva, urine, or blood samples from HIV-negative patients suspected of having pulmonary tuberculosis. As a test of bacterial load, the assay produced similar results when used to test direct versus processed sputum samples. Sputum remains the optimal sample type for diagnosing pulmonary tuberculosis in HIV-negative patients with the Xpert assay.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: Mater Research Institute-UQ (MRI-UQ)
 
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Created: Thu, 16 Feb 2017, 11:28:19 EST by Johanna Barclay on behalf of Mater Research Institute-UQ