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Evaluation of Xpert MTB/RIF Assay on Stool Samples for the Diagnosis of Pulmonary Tuberculosis among the Pediatric Population

Objective  Microbiological confirmation of tuberculosis (TB) in pediatric cases is challenging due to its paucibacillary nature and difficulty in specimen collection. This study aimed to validate stool as an alternative sample for the diagnosis of pediatric pulmonary TB via Xpert MTB/RIF (Xpert) ass...

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Autores principales: Jayagandan, Sangitha, Singh, Jitendra, Mudliar, Shivkumar Rashmi, Shankar, Prem, Maurya, Anand Kumar, Malhotra, Anvita Gupta, Malik, Shikha, Purwar, Shashank, Singh, Sarman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Medical and Scientific Publishers Pvt. Ltd. 2022
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10411201/
https://www.ncbi.nlm.nih.gov/pubmed/37564227
http://dx.doi.org/10.1055/s-0042-1757721
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author Jayagandan, Sangitha
Singh, Jitendra
Mudliar, Shivkumar Rashmi
Shankar, Prem
Maurya, Anand Kumar
Malhotra, Anvita Gupta
Malik, Shikha
Purwar, Shashank
Singh, Sarman
author_facet Jayagandan, Sangitha
Singh, Jitendra
Mudliar, Shivkumar Rashmi
Shankar, Prem
Maurya, Anand Kumar
Malhotra, Anvita Gupta
Malik, Shikha
Purwar, Shashank
Singh, Sarman
author_sort Jayagandan, Sangitha
collection PubMed
description Objective  Microbiological confirmation of tuberculosis (TB) in pediatric cases is challenging due to its paucibacillary nature and difficulty in specimen collection. This study aimed to validate stool as an alternative sample for the diagnosis of pediatric pulmonary TB via Xpert MTB/RIF (Xpert) assay. Materials and Methods  This cross-sectional study included 75 pediatric patients up to 10 years of age with signs and symptoms suggestive of TB. From each recruited patient, pulmonary and stool samples were collected in a sterile container. The collected samples were subjected to Ziehl-Neelsen staining, BACTEC MGIT 960 culture (MGIT), Xpert, and in-house multiplex polymerase chain reaction for TB diagnosis. Results  About 13.33% (10/75) of the pulmonary samples and, of them, 50% (5/75) of the stool samples were positive by Xpert assay. The sensitivity and specificity of Xpert assay with stool and pulmonary samples were 50 (95% confidence interval [CI]: 18.71–81.29%) and 100% (95% CI: 94.48–100%), respectively. Conclusion  The Xpert assay on stool samples showed limited sensitivity and good specificity in the diagnosis of pulmonary TB. Therefore, it can be proposed as an alternative screening sample to diagnose TB in pediatric cases for which getting a respiratory sample is extremely difficult. However, further studies with greater number of samples and multiple baseline variables are required to support our findings. Strategies to optimize stool Xpert assay should be performed to enhance the sensitivity of this method to detect Mycobacterium tuberculosis in children.
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spelling pubmed-104112012023-08-10 Evaluation of Xpert MTB/RIF Assay on Stool Samples for the Diagnosis of Pulmonary Tuberculosis among the Pediatric Population Jayagandan, Sangitha Singh, Jitendra Mudliar, Shivkumar Rashmi Shankar, Prem Maurya, Anand Kumar Malhotra, Anvita Gupta Malik, Shikha Purwar, Shashank Singh, Sarman J Lab Physicians Objective  Microbiological confirmation of tuberculosis (TB) in pediatric cases is challenging due to its paucibacillary nature and difficulty in specimen collection. This study aimed to validate stool as an alternative sample for the diagnosis of pediatric pulmonary TB via Xpert MTB/RIF (Xpert) assay. Materials and Methods  This cross-sectional study included 75 pediatric patients up to 10 years of age with signs and symptoms suggestive of TB. From each recruited patient, pulmonary and stool samples were collected in a sterile container. The collected samples were subjected to Ziehl-Neelsen staining, BACTEC MGIT 960 culture (MGIT), Xpert, and in-house multiplex polymerase chain reaction for TB diagnosis. Results  About 13.33% (10/75) of the pulmonary samples and, of them, 50% (5/75) of the stool samples were positive by Xpert assay. The sensitivity and specificity of Xpert assay with stool and pulmonary samples were 50 (95% confidence interval [CI]: 18.71–81.29%) and 100% (95% CI: 94.48–100%), respectively. Conclusion  The Xpert assay on stool samples showed limited sensitivity and good specificity in the diagnosis of pulmonary TB. Therefore, it can be proposed as an alternative screening sample to diagnose TB in pediatric cases for which getting a respiratory sample is extremely difficult. However, further studies with greater number of samples and multiple baseline variables are required to support our findings. Strategies to optimize stool Xpert assay should be performed to enhance the sensitivity of this method to detect Mycobacterium tuberculosis in children. Thieme Medical and Scientific Publishers Pvt. Ltd. 2022-10-20 /pmc/articles/PMC10411201/ /pubmed/37564227 http://dx.doi.org/10.1055/s-0042-1757721 Text en The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Jayagandan, Sangitha
Singh, Jitendra
Mudliar, Shivkumar Rashmi
Shankar, Prem
Maurya, Anand Kumar
Malhotra, Anvita Gupta
Malik, Shikha
Purwar, Shashank
Singh, Sarman
Evaluation of Xpert MTB/RIF Assay on Stool Samples for the Diagnosis of Pulmonary Tuberculosis among the Pediatric Population
title Evaluation of Xpert MTB/RIF Assay on Stool Samples for the Diagnosis of Pulmonary Tuberculosis among the Pediatric Population
title_full Evaluation of Xpert MTB/RIF Assay on Stool Samples for the Diagnosis of Pulmonary Tuberculosis among the Pediatric Population
title_fullStr Evaluation of Xpert MTB/RIF Assay on Stool Samples for the Diagnosis of Pulmonary Tuberculosis among the Pediatric Population
title_full_unstemmed Evaluation of Xpert MTB/RIF Assay on Stool Samples for the Diagnosis of Pulmonary Tuberculosis among the Pediatric Population
title_short Evaluation of Xpert MTB/RIF Assay on Stool Samples for the Diagnosis of Pulmonary Tuberculosis among the Pediatric Population
title_sort evaluation of xpert mtb/rif assay on stool samples for the diagnosis of pulmonary tuberculosis among the pediatric population
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10411201/
https://www.ncbi.nlm.nih.gov/pubmed/37564227
http://dx.doi.org/10.1055/s-0042-1757721
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