Evaluation of rapid diagnostic tests and assessment of risk factors in drug-resistant pulmonary tuberculosis.
GeneXpert
line probe assay
liquid culture
multidrug resistant tuberculosis
Journal
Journal of family medicine and primary care
ISSN: 2249-4863
Titre abrégé: J Family Med Prim Care
Pays: India
ID NLM: 101610082
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
10
12
2019
revised:
10
01
2020
accepted:
29
01
2020
entrez:
23
4
2020
pubmed:
23
4
2020
medline:
23
4
2020
Statut:
epublish
Résumé
Early diagnosis and treatment of drug-resistant tuberculosis (TB) is crucial to halt the spread of drug resistance in the community. The aim of the study was to compare rapid diagnostic tests (GeneXpert and line probe assay, LPA) with conventional liquid culture for the diagnosis of drug-resistant TB and to assess the risk factors for it. This cross-sectional study recruited 229 multidrug-resistant TB suspects who were sputum smear positive. They were evaluated by the rapid diagnostic tests and sensitivity, specificity, positive predictive value and negative predictive value were calculated for drug resistance detection as compared to liquid culture drug susceptibility testing. The risk factors for the development of drug resistance were also assessed and the In the final comparison, 193 samples were included. The sensitivity and specificity of GeneXpert for detection of drug resistance (rifampicin) was 100% (95% confidence interval, CI: 88.8-100%) and 99.4% (95% CI: 96.6-99.9%), respectively. Whereas sensitivity and specificity of LPA was 94.3% (95% CI: 80.8-99.3%) and 100% (95% CI: 97.7-100%), respectively. Only three discordant samples were observed. Defaulting to antitubercular therapy, contact with resistant TB, and disseminated disease were found to be significant risk factors for the development of drug-resistant TB with high statistical significance ( Both rapid diagnostic tests have very high sensitivity and specificity for detection of drug resistance in sputum smear positive with the advantage of short turn-around time. Defaulting to antitubercular therapy, contact with resistant TB, and disseminated disease are significant risk factors for drug resistance.
Sections du résumé
BACKGROUND
BACKGROUND
Early diagnosis and treatment of drug-resistant tuberculosis (TB) is crucial to halt the spread of drug resistance in the community.
AIM
OBJECTIVE
The aim of the study was to compare rapid diagnostic tests (GeneXpert and line probe assay, LPA) with conventional liquid culture for the diagnosis of drug-resistant TB and to assess the risk factors for it.
METHOD
METHODS
This cross-sectional study recruited 229 multidrug-resistant TB suspects who were sputum smear positive. They were evaluated by the rapid diagnostic tests and sensitivity, specificity, positive predictive value and negative predictive value were calculated for drug resistance detection as compared to liquid culture drug susceptibility testing. The risk factors for the development of drug resistance were also assessed and the
RESULTS
RESULTS
In the final comparison, 193 samples were included. The sensitivity and specificity of GeneXpert for detection of drug resistance (rifampicin) was 100% (95% confidence interval, CI: 88.8-100%) and 99.4% (95% CI: 96.6-99.9%), respectively. Whereas sensitivity and specificity of LPA was 94.3% (95% CI: 80.8-99.3%) and 100% (95% CI: 97.7-100%), respectively. Only three discordant samples were observed. Defaulting to antitubercular therapy, contact with resistant TB, and disseminated disease were found to be significant risk factors for the development of drug-resistant TB with high statistical significance (
CONCLUSION
CONCLUSIONS
Both rapid diagnostic tests have very high sensitivity and specificity for detection of drug resistance in sputum smear positive with the advantage of short turn-around time. Defaulting to antitubercular therapy, contact with resistant TB, and disseminated disease are significant risk factors for drug resistance.
Identifiants
pubmed: 32318462
doi: 10.4103/jfmpc.jfmpc_883_19
pii: JFMPC-9-1028
pmc: PMC7113933
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1028-1034Informations de copyright
Copyright: © Journal of Family Medicine and Primary Care.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
Références
N Engl J Med. 2010 Sep 9;363(11):1005-15
pubmed: 20825313
PLoS One. 2016 Apr 07;11(4):e0152694
pubmed: 27054344
PLoS One. 2014 Jun 16;9(6):e99810
pubmed: 24932706
PLoS Med. 2016 Oct 4;13(10):e1002137
pubmed: 27701423
Infect Genet Evol. 2016 Jun;40:8-16
pubmed: 26917365
Thorax. 2012 Apr;67(4):361-7
pubmed: 22213739
PLoS One. 2013 Nov 06;8(11):e78364
pubmed: 24223148
BMC Infect Dis. 2017 Apr 24;17(1):300
pubmed: 28438132
PLoS One. 2013 Sep 05;8(9):e72036
pubmed: 24039735
BMC Infect Dis. 2019 Oct 15;19(1):852
pubmed: 31615537
PLoS One. 2015 Aug 31;10(8):e0136861
pubmed: 26322781
Trop Med Int Health. 2011 Jan;16(1):74-8
pubmed: 21091857
J Clin Microbiol. 2011 Dec;49(12):4138-41
pubmed: 21956978
Eur Respir J. 2008 Nov;32(5):1165-74
pubmed: 18614561
Clin Infect Dis. 2008 Jun 15;46(12):1844-51
pubmed: 18462099
J Clin Microbiol. 2007 Aug;45(8):2635-40
pubmed: 17537937
Soc Sci Med. 2009 Jun;68(12):2240-6
pubmed: 19394122