Abstract
AbstractTimely diagnosis of paucibacillary tuberculosis (TB) which includes smear-negative pulmonary TB (PTB) and extra-pulmonary TB (EPTB) remains a challenge. This study was performed to assess the diagnostic utility of stool as a specimen of choice for detection of mycobacterial DNA in paucibacillary TB patients in a TB-endemic setting. Stool samples were collected from 246 subjects including 129 TB patients (62 PTB and 67 EPTB) recruited at TB hospital in Delhi, India. Diagnostic efficacy of stool IS6110 PCR (n = 228) was measured, using microbiologically/clinically confirmed TB as the reference standard. The clinical sensitivity of stool PCR was 97.22% (95% confidence interval (CI), 85.47-99.93) for detection of Mycobacterium tuberculosis in stool samples of smear-positive PTB patients and 76.92% (CI, 56.35–91.03) in samples from smear-negative PTB patients. Overall sensitivity of PCR for EPTB was 68.66% (CI, 56.16–79.44), with the highest sensitivity for stool samples from patients with lymph node TB (73.5%), followed by abdominal TB (66.7%) and pleural effusion (56.3%). Stool PCR presented a specificity of 95.12%. The receiver operating characteristic curve also indicated the diagnostic utility of stool PCR in TB detection (AUC: 0.882). The performance characteristic of the molecular assay suggests that stool DNA testing has clinical value in detection of TB.
Publisher
Springer Science and Business Media LLC
Reference27 articles.
1. Global Tuberculosis Report 2019. World Health Organization, Geneva, Switzerland.
2. Sharma, S. K. et al. Index-TB guidelines: Guidelines on extrapulmonary tuberculosis for India. Indian. J. Med. Res. 145, 448–463, https://doi.org/10.4103/ijmr.IJMR_1950_16 (2017).
3. India TB Report 2018. R. N. T. C. P., India. Available at: https://tbcindia.gov.in/index1.php?lang=1&level=1&sublinkid=4160&lid=2807 [Accessed on 11 July 2019].
4. Albert, H. et al. Development, roll-out and impact of Xpert MTB/RIF for tuberculosis: what lessons have we learnt and how can we do better? Eur. Respir. J. 48, 516–525, https://doi.org/10.1183/13993003.00543-2016 (2016).
5. Technical and Operational Guidelines for TB Control in India 2016. R. N. T. C. P., India. Available at: https://tbcindia.gov.in/index1.php?lang=1&level=2&sublinkid=4573&lid=3177 [Accessed on 11 July 2019].
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