[Rapid diagnosis of pleural tuberculosis by Xpert MTB/RIF assay].

Abstract

OBJECTIVE:

Early diagnosis of pleural tuberculosis (TB) is particularly difficult. The aim of this study was to investigate the diagnostic accuracy of the Xpert MTB/RIF (Xpert) assay using pleural biopsy and pleural fluid specimens in patients with suspected pleural TB negative for sputum acid-fast bacilli (AFB) smear.

METHODS:

In this study, 134 sputum smear-negative suspected pleural TB patients were selected. Paired pleural fluid and pleural biopsy specimens were tested for Mycobacterium tuberculosis by standard smear-microscopy, Lowenstein-Jensen and mycobacterial growth indicator tube (MGIT) culture, and the Xpert assay. Mycobacterial culture from pleural biopsy specimens were used as a reference standard for sensitivity and specificity calculations. Detection of rifampicin resistance was compared to the MGIT method.

RESULTS:

The sensitivity of the Xpert assay using pleural biopsy specimens for the diagnosis of pleural TB was 85.5% (47/55), and the specificity was 97.2% (69/71). The sensitivity and specificity of the Xpert assay in pleural fluid were 43.6% (24/55) and 98.6% (70/71), respectively. The Xpert assay correctly identified 90.0% (10/11) of phenotypic rifampicin-resistant cases and 93.9% (31/33) of phenotypic rifampicin-susceptible cases.

CONCLUSION:

The Xpert assay on pleural biopsy specimens may provide an accurate diagnosis of pleural TB in patients who had a negative AFB smear.

• Authors: Xu Liu, Zikun Huang, Jinghui Du
• Journal: Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases (Zhonghua Jie He He Hu Xi Za Zhi) Vol. 38 Issue 10 Pg. 741-5 (Oct 2015) ISSN: 1001-0939 [Print] China
• PMID: 26703940 (Publication Type: Journal Article)

Chemical References

• Rifampin

Topics

• Humans
• Microbiological Techniques
• Rifampin
• Sputum
• Tuberculosis, Pleural