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Xpert MTB/RIF Ultra Trace Results: Decision Support for the Treatment of Extrapulmonary Tuberculosis in Low TB Burden Countries

Objectives. Extrapulmonary tuberculosis (EPTB) can be difficult to diagnose, especially in severe forms. The Xpert MTB/RIF Ultra test introduced an additional category called trace to reference very small amounts of Mycobacterium tuberculosis complex (MTBC) DNA. The objective of our multicenter stud...

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Autores principales: Guillouzouic, Aurélie, Gaudart, Alice, Tessier, Eve, Risso, Karine, Hamdad, Farida, Alauzet, Corentine, Vaillant, Pierre, Koebel, Christelle, Kassegne, Loïc, Chenouard, Rachel, Abgueguen, Pierre, Le Brun, Cécile, Jamard, Simon, Lecomte, Raphaël, Lefebvre, Maeva, Bémer, Pascale
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179111/
https://www.ncbi.nlm.nih.gov/pubmed/37176590
http://dx.doi.org/10.3390/jcm12093148
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author Guillouzouic, Aurélie
Gaudart, Alice
Tessier, Eve
Risso, Karine
Hamdad, Farida
Alauzet, Corentine
Vaillant, Pierre
Koebel, Christelle
Kassegne, Loïc
Chenouard, Rachel
Abgueguen, Pierre
Le Brun, Cécile
Jamard, Simon
Lecomte, Raphaël
Lefebvre, Maeva
Bémer, Pascale
author_facet Guillouzouic, Aurélie
Gaudart, Alice
Tessier, Eve
Risso, Karine
Hamdad, Farida
Alauzet, Corentine
Vaillant, Pierre
Koebel, Christelle
Kassegne, Loïc
Chenouard, Rachel
Abgueguen, Pierre
Le Brun, Cécile
Jamard, Simon
Lecomte, Raphaël
Lefebvre, Maeva
Bémer, Pascale
author_sort Guillouzouic, Aurélie
collection PubMed
description Objectives. Extrapulmonary tuberculosis (EPTB) can be difficult to diagnose, especially in severe forms. The Xpert MTB/RIF Ultra test introduced an additional category called trace to reference very small amounts of Mycobacterium tuberculosis complex (MTBC) DNA. The objective of our multicenter study was to evaluate whether the trace result on an extrapulmonary (EP) sample is a sufficient argument to consider diagnosing tuberculosis and starting treatment, even in severe cases. Methods. A retrospective, multicenter cohort study was conducted from 2018 to 2022. Patients strongly suspected of EPTB with a trace result on an EP specimen were included. Hospital records were reviewed for clinical, treatment, and paraclinical data. Results. A total of 52 patients were included, with a severe form in 22/52 (42.3%) cases. Culture was positive for MTBC in 33/46 (71.7%) cases. Histological analysis showed granulomas in 36/45 (80.0%) cases. An Ultra trace result with a presumptive diagnosis of TB led to the decision to treat 41/52 (78.8%) patients. All patients were started on first-line anti-TB therapy (median duration of 6.1 months), with a favorable outcome in 31/35 (88.6%) patients. The presence of a small amount of MTBC genome in EPTB is a sufficient argument to treat patients across a large region of France.
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spelling pubmed-101791112023-05-13 Xpert MTB/RIF Ultra Trace Results: Decision Support for the Treatment of Extrapulmonary Tuberculosis in Low TB Burden Countries Guillouzouic, Aurélie Gaudart, Alice Tessier, Eve Risso, Karine Hamdad, Farida Alauzet, Corentine Vaillant, Pierre Koebel, Christelle Kassegne, Loïc Chenouard, Rachel Abgueguen, Pierre Le Brun, Cécile Jamard, Simon Lecomte, Raphaël Lefebvre, Maeva Bémer, Pascale J Clin Med Article Objectives. Extrapulmonary tuberculosis (EPTB) can be difficult to diagnose, especially in severe forms. The Xpert MTB/RIF Ultra test introduced an additional category called trace to reference very small amounts of Mycobacterium tuberculosis complex (MTBC) DNA. The objective of our multicenter study was to evaluate whether the trace result on an extrapulmonary (EP) sample is a sufficient argument to consider diagnosing tuberculosis and starting treatment, even in severe cases. Methods. A retrospective, multicenter cohort study was conducted from 2018 to 2022. Patients strongly suspected of EPTB with a trace result on an EP specimen were included. Hospital records were reviewed for clinical, treatment, and paraclinical data. Results. A total of 52 patients were included, with a severe form in 22/52 (42.3%) cases. Culture was positive for MTBC in 33/46 (71.7%) cases. Histological analysis showed granulomas in 36/45 (80.0%) cases. An Ultra trace result with a presumptive diagnosis of TB led to the decision to treat 41/52 (78.8%) patients. All patients were started on first-line anti-TB therapy (median duration of 6.1 months), with a favorable outcome in 31/35 (88.6%) patients. The presence of a small amount of MTBC genome in EPTB is a sufficient argument to treat patients across a large region of France. MDPI 2023-04-27 /pmc/articles/PMC10179111/ /pubmed/37176590 http://dx.doi.org/10.3390/jcm12093148 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Guillouzouic, Aurélie
Gaudart, Alice
Tessier, Eve
Risso, Karine
Hamdad, Farida
Alauzet, Corentine
Vaillant, Pierre
Koebel, Christelle
Kassegne, Loïc
Chenouard, Rachel
Abgueguen, Pierre
Le Brun, Cécile
Jamard, Simon
Lecomte, Raphaël
Lefebvre, Maeva
Bémer, Pascale
Xpert MTB/RIF Ultra Trace Results: Decision Support for the Treatment of Extrapulmonary Tuberculosis in Low TB Burden Countries
title Xpert MTB/RIF Ultra Trace Results: Decision Support for the Treatment of Extrapulmonary Tuberculosis in Low TB Burden Countries
title_full Xpert MTB/RIF Ultra Trace Results: Decision Support for the Treatment of Extrapulmonary Tuberculosis in Low TB Burden Countries
title_fullStr Xpert MTB/RIF Ultra Trace Results: Decision Support for the Treatment of Extrapulmonary Tuberculosis in Low TB Burden Countries
title_full_unstemmed Xpert MTB/RIF Ultra Trace Results: Decision Support for the Treatment of Extrapulmonary Tuberculosis in Low TB Burden Countries
title_short Xpert MTB/RIF Ultra Trace Results: Decision Support for the Treatment of Extrapulmonary Tuberculosis in Low TB Burden Countries
title_sort xpert mtb/rif ultra trace results: decision support for the treatment of extrapulmonary tuberculosis in low tb burden countries
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179111/
https://www.ncbi.nlm.nih.gov/pubmed/37176590
http://dx.doi.org/10.3390/jcm12093148
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