Cargando…
Diagnosis of extrapulmonary tuberculosis using the MPT64 antigen detection test in a high-income low tuberculosis prevalence setting
BACKGROUND: Extrapulmonary tuberculosis (EPTB) poses diagnostic challenges due to the paucibacillary nature of the disease. The immunochemistry-based MPT64 antigen detection test (MPT64 test) has shown promising results for diagnosing EPTB in previous studies performed in low-resource settings, with...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7014701/ https://www.ncbi.nlm.nih.gov/pubmed/32050915 http://dx.doi.org/10.1186/s12879-020-4852-z |
_version_ | 1783496689773969408 |
---|---|
author | Hoel, Ida Marie Sviland, Lisbet Syre, Heidi Dyrhol-Riise, Anne Ma Skarstein, Ingerid Jebsen, Peter Jørstad, Melissa Davidsen Wiker, Harald Mustafa, Tehmina |
author_facet | Hoel, Ida Marie Sviland, Lisbet Syre, Heidi Dyrhol-Riise, Anne Ma Skarstein, Ingerid Jebsen, Peter Jørstad, Melissa Davidsen Wiker, Harald Mustafa, Tehmina |
author_sort | Hoel, Ida Marie |
collection | PubMed |
description | BACKGROUND: Extrapulmonary tuberculosis (EPTB) poses diagnostic challenges due to the paucibacillary nature of the disease. The immunochemistry-based MPT64 antigen detection test (MPT64 test) has shown promising results for diagnosing EPTB in previous studies performed in low-resource settings, with higher sensitivity than microscopy and culture. The aim of this study was to investigate the performance of the MPT64 test in a routine clinical setting in a high-income low TB prevalence country. METHODS: Extrapulmonary samples sent for TB diagnostics to microbiology and pathology laboratories at three regional tertiary care hospitals in Norway in a one-year period were included and subjected to the MPT64 test in parallel to the routine TB diagnostic tests. RESULTS: Samples from 288 patients were included and categorised as confirmed TB cases (n = 26), clinically diagnosed TB cases (n = 5), non-TB cases (n = 243) and uncategorised (n = 14), using a composite reference standard (CRS). In formalin-fixed biopsies, the sensitivity (95% CI) of the MPT64 test, microscopy, PCR-based tests pooled, and culture was 37% (16–62), 20% (4–48), 37% (16–62) and 50% (23–77), respectively, against the CRS. The MPT64 test showed a good positive predictive value (88%) and an excellent specificity (99, 95% CI 92–100) in formalin-fixed biopsies. In fine-needle aspirates, pus and fluid samples, the test performance was lower. CONCLUSIONS: The MPT64 test was implementable in pathology laboratories as part of routine diagnostics, and although the sensitivity of the MPT64 test was not better than culture in this setting, the test supplements other rapid diagnostic methods, including microscopy and PCR-based tests, and can contribute to strengthen the diagnosis of EPTB in formalin-fixed biopsies in the absence of culture confirmation. |
format | Online Article Text |
id | pubmed-7014701 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-70147012020-02-18 Diagnosis of extrapulmonary tuberculosis using the MPT64 antigen detection test in a high-income low tuberculosis prevalence setting Hoel, Ida Marie Sviland, Lisbet Syre, Heidi Dyrhol-Riise, Anne Ma Skarstein, Ingerid Jebsen, Peter Jørstad, Melissa Davidsen Wiker, Harald Mustafa, Tehmina BMC Infect Dis Research Article BACKGROUND: Extrapulmonary tuberculosis (EPTB) poses diagnostic challenges due to the paucibacillary nature of the disease. The immunochemistry-based MPT64 antigen detection test (MPT64 test) has shown promising results for diagnosing EPTB in previous studies performed in low-resource settings, with higher sensitivity than microscopy and culture. The aim of this study was to investigate the performance of the MPT64 test in a routine clinical setting in a high-income low TB prevalence country. METHODS: Extrapulmonary samples sent for TB diagnostics to microbiology and pathology laboratories at three regional tertiary care hospitals in Norway in a one-year period were included and subjected to the MPT64 test in parallel to the routine TB diagnostic tests. RESULTS: Samples from 288 patients were included and categorised as confirmed TB cases (n = 26), clinically diagnosed TB cases (n = 5), non-TB cases (n = 243) and uncategorised (n = 14), using a composite reference standard (CRS). In formalin-fixed biopsies, the sensitivity (95% CI) of the MPT64 test, microscopy, PCR-based tests pooled, and culture was 37% (16–62), 20% (4–48), 37% (16–62) and 50% (23–77), respectively, against the CRS. The MPT64 test showed a good positive predictive value (88%) and an excellent specificity (99, 95% CI 92–100) in formalin-fixed biopsies. In fine-needle aspirates, pus and fluid samples, the test performance was lower. CONCLUSIONS: The MPT64 test was implementable in pathology laboratories as part of routine diagnostics, and although the sensitivity of the MPT64 test was not better than culture in this setting, the test supplements other rapid diagnostic methods, including microscopy and PCR-based tests, and can contribute to strengthen the diagnosis of EPTB in formalin-fixed biopsies in the absence of culture confirmation. BioMed Central 2020-02-12 /pmc/articles/PMC7014701/ /pubmed/32050915 http://dx.doi.org/10.1186/s12879-020-4852-z Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Hoel, Ida Marie Sviland, Lisbet Syre, Heidi Dyrhol-Riise, Anne Ma Skarstein, Ingerid Jebsen, Peter Jørstad, Melissa Davidsen Wiker, Harald Mustafa, Tehmina Diagnosis of extrapulmonary tuberculosis using the MPT64 antigen detection test in a high-income low tuberculosis prevalence setting |
title | Diagnosis of extrapulmonary tuberculosis using the MPT64 antigen detection test in a high-income low tuberculosis prevalence setting |
title_full | Diagnosis of extrapulmonary tuberculosis using the MPT64 antigen detection test in a high-income low tuberculosis prevalence setting |
title_fullStr | Diagnosis of extrapulmonary tuberculosis using the MPT64 antigen detection test in a high-income low tuberculosis prevalence setting |
title_full_unstemmed | Diagnosis of extrapulmonary tuberculosis using the MPT64 antigen detection test in a high-income low tuberculosis prevalence setting |
title_short | Diagnosis of extrapulmonary tuberculosis using the MPT64 antigen detection test in a high-income low tuberculosis prevalence setting |
title_sort | diagnosis of extrapulmonary tuberculosis using the mpt64 antigen detection test in a high-income low tuberculosis prevalence setting |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7014701/ https://www.ncbi.nlm.nih.gov/pubmed/32050915 http://dx.doi.org/10.1186/s12879-020-4852-z |
work_keys_str_mv | AT hoelidamarie diagnosisofextrapulmonarytuberculosisusingthempt64antigendetectiontestinahighincomelowtuberculosisprevalencesetting AT svilandlisbet diagnosisofextrapulmonarytuberculosisusingthempt64antigendetectiontestinahighincomelowtuberculosisprevalencesetting AT syreheidi diagnosisofextrapulmonarytuberculosisusingthempt64antigendetectiontestinahighincomelowtuberculosisprevalencesetting AT dyrholriiseannema diagnosisofextrapulmonarytuberculosisusingthempt64antigendetectiontestinahighincomelowtuberculosisprevalencesetting AT skarsteiningerid diagnosisofextrapulmonarytuberculosisusingthempt64antigendetectiontestinahighincomelowtuberculosisprevalencesetting AT jebsenpeter diagnosisofextrapulmonarytuberculosisusingthempt64antigendetectiontestinahighincomelowtuberculosisprevalencesetting AT jørstadmelissadavidsen diagnosisofextrapulmonarytuberculosisusingthempt64antigendetectiontestinahighincomelowtuberculosisprevalencesetting AT wikerharald diagnosisofextrapulmonarytuberculosisusingthempt64antigendetectiontestinahighincomelowtuberculosisprevalencesetting AT mustafatehmina diagnosisofextrapulmonarytuberculosisusingthempt64antigendetectiontestinahighincomelowtuberculosisprevalencesetting |