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

Author:

Guillouzouic Aurélie1,Gaudart Alice2,Tessier Eve1,Risso Karine3ORCID,Hamdad Farida4,Alauzet Corentine4,Vaillant Pierre5,Koebel Christelle6,Kassegne Loïc7,Chenouard Rachel8,Abgueguen Pierre9,Le Brun Cécile10ORCID,Jamard Simon11,Lecomte Raphaël12,Lefebvre Maeva12,Bémer Pascale1ORCID

Affiliation:

1. Department of Microbiology, Nantes University Hospital, 44093 Nantes, France

2. Department of Microbiology, Nice University Hospital, 06000 Nice, France

3. Department of Infectious Diseases, Nice University Hospital, 06000 Nice, France

4. Department of Microbiology, Nancy University Hospital, 54035 Nancy, France

5. Pulmonary Department, Nancy University Hospital, 54035 Nancy, France

6. Department of Microbiology, Strasbourg University Hospital, 67091 Strasbourg, France

7. Pulmonary Department, Strasbourg University Hospital, 67091 Strasbourg, France

8. Department of Microbiology, Angers University Hospital, 49000 Angers, France

9. Department of Infectious Diseases, Angers University Hospital, 49000 Angers, France

10. Department of Microbiology, Tours University Hospital, 37081 Tours, France

11. Department of Infectious Diseases, Tours University Hospital, 37081 Tours, France

12. Department of Infectious Diseases, Nantes University Hospital, 44095 Nantes, France

Abstract

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.

Publisher

MDPI AG

Subject

General Medicine

Reference14 articles.

1. World Health Organization Global Tuberculosis Report 2020, Executive Summary, WHO. Available online: https://www.who.int/tb/publications/global_report/en/.

2. Disseminated Tuberculosis A 10-Year Experience in a Medical Center;Wang;Medicine,2007

3. Miliary tuberculosis: New insights into an old disease;Sharma;Lancet Infect. Dis.,2005

4. Huang, Y., Ai, L., Wang, X., Sun, Z., and Wang, F. (2022). Review and Updates on the Diagnosis of Tuberculosis. J. Clin. Med., 11.

5. World Health Organization (2021). WHO Operational Handbook on Tuberculosis. Module 3: Diagnosis—Rapid Diagnostics for Tuberculosis Detection, 2021 Update, World Health Organization.

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3