Comparison between the diagnostic accuracy of Xpert MTB/Rif assay and culture for pleural tuberculosis using tissue biopsy.
Journal
ERJ open research
ISSN: 2312-0541
Titre abrégé: ERJ Open Res
Pays: England
ID NLM: 101671641
Informations de publication
Date de publication:
Jul 2019
Jul 2019
Historique:
received:
08
03
2019
accepted:
20
07
2019
entrez:
4
10
2019
pubmed:
4
10
2019
medline:
4
10
2019
Statut:
epublish
Résumé
Early diagnosis of pleural tuberculosis is difficult as it is a paucibacillary disease and a combination of tests is required to diagnose it, which have varied diagnostic accuracy and increase the cost. The aim of this study was to evaluate the diagnostic performance of the Xpert MTB/Rif assay on thoracoscopic pleural biopsy specimens. A total of 201 patients with exudative pleural effusion and normal lung parenchyma were included in the study. All patients underwent thoracoscopic pleural biopsy under local anaesthesia. Biopsy samples were sent for Xpert MTB/Rif assay and culture, along with histopathology. Chronic granulomatous inflammation on histopathology and response to antituberculous treatment was taken as the reference standard for diagnosis of tuberculous pleurisy. Of the 198 patients included in the final analysis, 134 had pleural tuberculosis. The sensitivity of the Xpert assay was 52.2% and specificity was 100%, and that of pleural biopsy cultures were 41% and 100% respectively. The sensitivity and specificity of Xpert MTB/Rif assay scores were high, hence escalating the speed of diagnosis and imparting marked impact on patient outcomes. The Xpert MTB/Rif assay is a potential game changer in diagnosing pleural tuberculosis.
Sections du résumé
BACKGROUND
BACKGROUND
Early diagnosis of pleural tuberculosis is difficult as it is a paucibacillary disease and a combination of tests is required to diagnose it, which have varied diagnostic accuracy and increase the cost. The aim of this study was to evaluate the diagnostic performance of the Xpert MTB/Rif assay on thoracoscopic pleural biopsy specimens.
METHODS
METHODS
A total of 201 patients with exudative pleural effusion and normal lung parenchyma were included in the study. All patients underwent thoracoscopic pleural biopsy under local anaesthesia. Biopsy samples were sent for Xpert MTB/Rif assay and culture, along with histopathology. Chronic granulomatous inflammation on histopathology and response to antituberculous treatment was taken as the reference standard for diagnosis of tuberculous pleurisy.
RESULTS
RESULTS
Of the 198 patients included in the final analysis, 134 had pleural tuberculosis. The sensitivity of the Xpert assay was 52.2% and specificity was 100%, and that of pleural biopsy cultures were 41% and 100% respectively.
CONCLUSION
CONCLUSIONS
The sensitivity and specificity of Xpert MTB/Rif assay scores were high, hence escalating the speed of diagnosis and imparting marked impact on patient outcomes. The Xpert MTB/Rif assay is a potential game changer in diagnosing pleural tuberculosis.
Identifiants
pubmed: 31579677
doi: 10.1183/23120541.00065-2019
pii: 00065-2019
pmc: PMC6759584
pii:
doi:
Types de publication
Journal Article
Langues
eng
Informations de copyright
Copyright ©ERS 2019.
Déclaration de conflit d'intérêts
Conflict of interest: N. Akhter has nothing to disclose. Conflict of interest: K.K. Sumalani has nothing to disclose. Conflict of interest: D. Chawla has nothing to disclose. Conflict of interest: N.A. Rizvi has nothing to disclose.
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