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Evaluation of Xpert MTB/RIF Ultra performance for pulmonary tuberculosis diagnosis on smear-negative respiratory samples in a French centre.
Eur J Clin Microbiol Infect Dis. 2019 Mar; 38(3):601-605.EJ

Abstract

Tuberculosis (TB) is a worldwide public health concern, including in high-resource countries with a low prevalence of TB. Xpert MTB/RIF assay was developed to improve TB and rifampicin (RIF) resistance detection, but sensitivity remains poor on smear-negative sputum. Xpert MTB/RIF Ultra assay was designed to enhance the sensitivity of TB detection in clinical samples. Herein, we evaluated retrospectively the performance of this test on smear-negative respiratory samples. Respiratory specimens with smear-negative and a Mycobacterium tuberculosis (MTB) complex-positive culture were retrospectively selected from those taken from patients during routine care, and analysed in the Mycobacteria Laboratory of the Lyon University hospital, France. Specimens were stored at - 20 °C before testing by Xpert MTB/RIF Ultra. For each sample, growth delay and date of anti-TB treatment initiation were recorded. Forty-six samples-29 sputum, 8 bronchial aspirates, 6 broncho-alveolar lavages, and 3 gastric aspirates-were selected. Among samples collected before treatment initiation (n = 33), sensitivity was 81.8% (95% CI [64.5; 93.0]) and there was a significant correlation between the quantitative measurements (Ct) of Xpert MTB/RIF Ultra assay and the time to growth detection in culture. Among samples collected after treatment initiation (n = 12), sensitivity was 100%, without correlation with time to growth detection due to presence of afterglow DNA in samples. In high-resource settings, the Xpert MTB/RIF Ultra test represents a useful tool for pulmonary TB diagnosis, notably for the paucibacillary forms. Moreover, quantitative measurement of Xpert MTB/RIF Ultra could help to predict time to MTB culture positivity and be used as a quality indicator of MTB culture process.

Authors+Show Affiliations

Hospices Civils de Lyon, Hôpital de la Croix Rousse-Centre de Biologie Nord, Institut des Agents Infectieux, Laboratoire de Bactériologie, Grande Rue de la Croix Rousse, 69004, Lyon, France. elisabeth.hodille@chu-lyon.fr. Centre International de Recherche en Infectiologie, INSERM U1111, Université de Lyon, Lyon, France. elisabeth.hodille@chu-lyon.fr.Hospices Civils de Lyon, Hôpital de la Croix Rousse-Centre de Biologie Nord, Institut des Agents Infectieux, Laboratoire de Bactériologie, Grande Rue de la Croix Rousse, 69004, Lyon, France.Hospices Civils de Lyon, Hôpital de la Croix Rousse-Centre de Biologie Nord, Institut des Agents Infectieux, Laboratoire de Bactériologie, Grande Rue de la Croix Rousse, 69004, Lyon, France.Hospices Civils de Lyon, Hôpital de la Croix Rousse-Centre de Biologie Nord, Institut des Agents Infectieux, Laboratoire de Bactériologie, Grande Rue de la Croix Rousse, 69004, Lyon, France.Centre International de Recherche en Infectiologie, INSERM U1111, Université de Lyon, Lyon, France.Hospices Civils de Lyon, Hôpital de la Croix Rousse-Centre de Biologie Nord, Institut des Agents Infectieux, Laboratoire de Bactériologie, Grande Rue de la Croix Rousse, 69004, Lyon, France.Hospices Civils de Lyon, Hôpital de la Croix Rousse-Centre de Biologie Nord, Institut des Agents Infectieux, Laboratoire de Bactériologie, Grande Rue de la Croix Rousse, 69004, Lyon, France. Centre International de Recherche en Infectiologie, INSERM U1111, Université de Lyon, Lyon, France.Hospices Civils de Lyon, Hôpital de la Croix Rousse-Centre de Biologie Nord, Institut des Agents Infectieux, Laboratoire de Bactériologie, Grande Rue de la Croix Rousse, 69004, Lyon, France. Centre International de Recherche en Infectiologie, INSERM U1111, Université de Lyon, Lyon, France.Hospices Civils de Lyon, Hôpital de la Croix Rousse-Centre de Biologie Nord, Institut des Agents Infectieux, Laboratoire de Bactériologie, Grande Rue de la Croix Rousse, 69004, Lyon, France. Centre International de Recherche en Infectiologie, INSERM U1111, Université de Lyon, Lyon, France.

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

30680567

Citation

Hodille, Elisabeth, et al. "Evaluation of Xpert MTB/RIF Ultra Performance for Pulmonary Tuberculosis Diagnosis On Smear-negative Respiratory Samples in a French Centre." European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology, vol. 38, no. 3, 2019, pp. 601-605.
Hodille E, Maisson A, Charlet L, et al. Evaluation of Xpert MTB/RIF Ultra performance for pulmonary tuberculosis diagnosis on smear-negative respiratory samples in a French centre. Eur J Clin Microbiol Infect Dis. 2019;38(3):601-605.
Hodille, E., Maisson, A., Charlet, L., Bauduin, C., Genestet, C., Fredenucci, I., Rasigade, J. P., Lina, G., & Dumitrescu, O. (2019). Evaluation of Xpert MTB/RIF Ultra performance for pulmonary tuberculosis diagnosis on smear-negative respiratory samples in a French centre. European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology, 38(3), 601-605. https://doi.org/10.1007/s10096-018-03463-1
Hodille E, et al. Evaluation of Xpert MTB/RIF Ultra Performance for Pulmonary Tuberculosis Diagnosis On Smear-negative Respiratory Samples in a French Centre. Eur J Clin Microbiol Infect Dis. 2019;38(3):601-605. PubMed PMID: 30680567.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of Xpert MTB/RIF Ultra performance for pulmonary tuberculosis diagnosis on smear-negative respiratory samples in a French centre. AU - Hodille,Elisabeth, AU - Maisson,Audey, AU - Charlet,Laurine, AU - Bauduin,Clyde, AU - Genestet,Charlotte, AU - Fredenucci,Isabelle, AU - Rasigade,Jean-Philippe, AU - Lina,Gérard, AU - Dumitrescu,Oana, Y1 - 2019/01/24/ PY - 2018/11/21/received PY - 2018/12/26/accepted PY - 2019/1/27/pubmed PY - 2019/9/13/medline PY - 2019/1/26/entrez KW - Diagnosis KW - High-resource setting KW - Pulmonary tuberculosis KW - Smear-negative KW - Xpert MTB/RIF Ultra SP - 601 EP - 605 JF - European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology JO - Eur J Clin Microbiol Infect Dis VL - 38 IS - 3 N2 - Tuberculosis (TB) is a worldwide public health concern, including in high-resource countries with a low prevalence of TB. Xpert MTB/RIF assay was developed to improve TB and rifampicin (RIF) resistance detection, but sensitivity remains poor on smear-negative sputum. Xpert MTB/RIF Ultra assay was designed to enhance the sensitivity of TB detection in clinical samples. Herein, we evaluated retrospectively the performance of this test on smear-negative respiratory samples. Respiratory specimens with smear-negative and a Mycobacterium tuberculosis (MTB) complex-positive culture were retrospectively selected from those taken from patients during routine care, and analysed in the Mycobacteria Laboratory of the Lyon University hospital, France. Specimens were stored at - 20 °C before testing by Xpert MTB/RIF Ultra. For each sample, growth delay and date of anti-TB treatment initiation were recorded. Forty-six samples-29 sputum, 8 bronchial aspirates, 6 broncho-alveolar lavages, and 3 gastric aspirates-were selected. Among samples collected before treatment initiation (n = 33), sensitivity was 81.8% (95% CI [64.5; 93.0]) and there was a significant correlation between the quantitative measurements (Ct) of Xpert MTB/RIF Ultra assay and the time to growth detection in culture. Among samples collected after treatment initiation (n = 12), sensitivity was 100%, without correlation with time to growth detection due to presence of afterglow DNA in samples. In high-resource settings, the Xpert MTB/RIF Ultra test represents a useful tool for pulmonary TB diagnosis, notably for the paucibacillary forms. Moreover, quantitative measurement of Xpert MTB/RIF Ultra could help to predict time to MTB culture positivity and be used as a quality indicator of MTB culture process. SN - 1435-4373 UR - https://www.unboundmedicine.com/medline/citation/30680567/Evaluation_of_Xpert_MTB/RIF_Ultra_performance_for_pulmonary_tuberculosis_diagnosis_on_smear_negative_respiratory_samples_in_a_French_centre_ DB - PRIME DP - Unbound Medicine ER -