Diagnostic accuracy of an exhaled breath test for TB in hospitalized patients with cough or risk-Reference-Cited by-同舟云学术

Diagnostic accuracy of an exhaled breath test for TB in hospitalized patients with cough or risk

Published:2024-09-01 Issue:9 Volume:28 Page:446-453
ISSN:1027-3719
Container-title:The International Journal of Tuberculosis and Lung Disease
language:en
Short-container-title:int j tuberc lung dis

Author:

Biewer A.¹,Tintaya K.²,Roman B.²,Hurwitz S.³,Lecca L.²,Nardell E.⁴,Tierney D.B.⁵,Nathavitharana R.R.⁶

Affiliation:

1. Beth Israel Deaconess Medical Center, Boston, MA, USA;

2. Socios en Salud, Lima, Peru;

3. Harvard Medical School, Boston, MA, USA;

4. Harvard Medical School, Boston, MA, USA;, Brigham and Women’s Hospital, Boston, MA, USA;

5. Harvard Medical School, Boston, MA, USA;, Brigham and Women’s Hospital, Boston, MA, USA;, Massachusetts Department of Public Health, Boston, MA, USA.

6. Beth Israel Deaconess Medical Center, Boston, MA, USA;, Harvard Medical School, Boston, MA, USA;

Abstract

<sec><title>INTRODUCTION</title>Closing the TB diagnostic gap is an urgent priority, for which non-sputum-based tests are needed. We evaluated the diagnostic accuracy of Aeonose, an exhaled breath test (EBT), as a TB triage test.</sec><sec><title>METHODS</title>Patients with cough or TB risk factors admitted to a tertiary hospital in Lima, Peru, were prospectively enrolled and underwent EBT. We evaluated EBT sensitivity and specificity for diagnosing pulmonary TB using culture and Xpert as primary and secondary reference standards and conducted stratified analyses based on risk factors.</sec><sec><title>RESULTS</title>EBT sensitivity was 85% (95% CI 72.9–93.4), and specificity was 51% (95% CI 46.0–56.6) in the training cohort (n = 417). EBT sensitivity was 70% (95% CI 47.1–86.8), and specificity was 54% (95% CI 44.8–63.6) in the validation cohort (n = 139) using the culture reference standard, with higher sensitivity (78%) when using the Xpert reference standard (n = 156). Sensitivity (60%) and specificity (48%) were lower when patients with prior TB were included. In a subset of participants randomly selected for interviews, 94% (15/16) preferred EBT to sputum-based testing.</sec><sec><title>CONCLUSIONS</title>EBT had moderate sensitivity and low specificity as a TB triage test in this hospitalised cohort with cough or risk factors. Diagnostic accuracy was lower in people with prior TB.</sec>

Publisher

International Union Against Tuberculosis and Lung Disease