GeneXpert® MTB/RIF assay with transbronchial lung cryobiopsy for Mycobacterium tuberculosis diagnosis

Sánchez-Cabral, Olivia; Santillán-Díaz, Cira; Flores-Bello, Ángel Paul; Herrera-Ortega, Mildred Ivannia; Sandoval-Gutiérrez, José Luis; Santillán-Doherty, Patricio; Martínez-Mendoza, Dina

doi:10.21037/atm.2020.02.100

Cited by 9 publications

(9 citation statements)

References 29 publications

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“…UU.) (15). Hence, we might diagnose M. tuberculosis by a tissue culture; however, the final diagnosis was made on the basis of sputum culture results.…”

Section: Discussionmentioning

confidence: 99%

“…Since M. tuberculosis is not easily killed by cryopreservation ( 14 ), freezing with a cryoprobe is not expected to hinder tissue culturing. Additionally, it has been reported that the diagnostic rate of transbronchial cryobiopsy was 100% (16/16) by culture, while the rate was 81.3% (14/16) by GeneXpert Ⓡ MTB/RIF (Cepheid, Sunnyvale, USA) ( 15 ). Hence, we might diagnose M. tuberculosis by a tissue culture; however, the final diagnosis was made on the basis of sputum culture results.…”

Section: Discussionmentioning

confidence: 99%

“…In terms of safety, the major complications after transbronchial cryobiopsy are pneumothorax and bleeding ( 16 ); the bleeding risk due to transbronchial cryobiopsy is reportedly higher than that due to transbronchial forceps biopsy ( 17 ). Although transbronchial cryobiopsy due to infection, including M. tuberculosis infection, is reportedly relatively safe and the complications are controllable ( 15 , 18 ), it should nevertheless be carefully performed.…”

Section: Discussionmentioning

confidence: 99%

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Transbronchial Cryobiopsy for Miliary Tuberculosis Mimicking Hypersensitivity Pneumonitis

Nasu¹,

Kawahara

Han³

et al. 2021

Intern. Med.

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Miliary tuberculosis is a potentially lethal type of tuberculosis that results from the hematogenous dissemination of Mycobacterium tuberculosis bacilli. We herein describe the case of a 34-year-old man that presented with a one-month history of cough and fever, while his sputum smear results were negative. Chest computed tomography revealed bilateral centrilobular ground-glass opacification (GGO), suggestive of hypersensitivity pneumonitis; thus, bronchoscopy was performed. Cryobiopsy specimens revealed necrotic granulomas. A re-examination of sputum after bronchoscopy identified Mycobacterium tuberculosis, and miliary tuberculosis was diagnosed. A cryobiopsy might be useful for diagnosing miliary tuberculosis pathologically, particularly when miliary nodules may be masked by GGO.

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“…UU.) (15). Hence, we might diagnose M. tuberculosis by a tissue culture; however, the final diagnosis was made on the basis of sputum culture results.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Transbronchial Cryobiopsy for Miliary Tuberculosis Mimicking Hypersensitivity Pneumonitis

Nasu¹,

Kawahara

Han³

et al. 2021

Intern. Med.

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“…In 1999, Head et al technology has been widely adopted by clinical laboratories thereafter (16)(17)(18)(19)(20). A meta-analysis (including 15 studies) in 2014 showed that the overall sensitivity of DNA microarray for detecting RFP resistance was 0.91 (95% CI: 0.89-0.92), the overall specificity was 0.96 (95% CI: 0.96-0.97), and the AUC was 0.97 (21).…”

Section: Detection Of Rfp-resistant M Tuberculosis With Dna Microarraymentioning

confidence: 99%

Diagnostic performance of DNA microarray for detecting rifampicin and isoniazid resistance in Mycobacterium tuberculosis

Sun¹,

Sun²

2021

J Thorac Dis

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Background: While rifampicin (RFP) and isoniazid (INH) are the most commonly used first-line antituberculosis drugs, multidrug resistance in Mycobacterium tuberculosis poses a threat to the success of tuberculosis (TB) control programs. Clinical practice guidelines and expert consensuses recommend drug susceptibility testing (DST) before the initiation of antituberculosis treatment. However, traditional DST is time-consuming and has high requirements for laboratory conditions. The recently developed molecular diagnostic techniques, such as DNA microarray, offer new options. We thus investigated the diagnostic value of DNA microarray in detecting RFP + INH-resistant TB, with an attempt to identify simple, efficient, and accurate drug-resistant TB testing methods. Methods: The clinical features and DST results of patients diagnosed with pulmonary tuberculosis by Bactec MGIT 960 liquid culture system (Becton, Dickinson and Company, Franklin Lakes, NJ, USA) who received DNA microarray analysis in our center from July 2019 to July 2020 were retrospectively analyzed.Level of agreement between liquid culture and DNA microarray technology was assessed by using the Cohen kappa coefficient. With the results of liquid culture as the gold standard, the sensitivity and specificity of the DNA microarray were calculated, and the receiver operating characteristic (ROC) curves were used to assess the diagnostic values of the DNA microarray in detecting RFP + INH-resistant TB. Results: A total of 825 patients were enrolled. The sensitivity and specificity of DNA microarray were 0.84 and 0.94, respectively, in the detection of RFP resistance, with an area under the curve (AUC) of 0.89 [95% confidence interval (CI): 0.87-0.91)] and a Cohen kappa coefficient of 0.78 (95% CI: 0.72-0.83). For INH resistance, the sensitivity and specificity of the DNA microarray were 0.73 and 0.97, respectively, with an AUC of 0.85 (95% CI: 0.82-0.87) and a Cohen kappa coefficient of 0.75 (95% CI: 0.70-0.80). Conclusions:The DNA microarray had high specificity and sensitivity in detecting RFP + INH-resistant TB. As a rapid, accurate, and practical technique, it can be routinely performed in clinical laboratories.

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“…We identified 50 articles: 17 [7,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] in the adult BAL group, 14 [35,[40][41][42][43][44][45][46][47][48][49][50][51][52] in the adult ES group, 7 [35,45,50,[53][54][55][56] in the adult IS group, 2 [57,58] in the pediatric ES group, 6 [57,[59][60][61][62][63] in the pediatric GA group, and 9 [59,[64][65][66][67]…”

Section: Studies' Characteristicsmentioning

confidence: 99%

Which sample type is better for Xpert MTB/RIF to diagnose adult and pediatric pulmonary tuberculosis?

et al. 2020

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Objective: This review aimed to identify proper respiratory-related sample types for adult and pediatric pulmonary tuberculosis (PTB), respectively, by comparing performance of Xpert MTB/RIF when using bronchoalveolar lavage (BAL), induced sputum (IS), expectorated sputum (ES), nasopharyngeal aspirates (NPA) and gastric aspiration (GA) as sample. Methods: Articles were searched in Web of Science, PubMed, and Ovid from inception up to June 29, 2020. Pooled sensitivity and specificity were calculated, each with a 95% confidence interval (CI). Quality assessment and heterogeneity evaluation across included studies were performed. Results: Fifteen articles were included. The respective sensitivity and specificity were 87% (95% CI: 0.84–0.89), 91% (95% CI: 0.90–0.92) and 95% (95% CI: 0.93–0.97) in the adult BAL group, 90% (95% CI: 0.88–0.91), 98% (95% CI: 0.97–0.98) and 97% (95% CI: 0.95–0.99) in the adult ES group, 86% (95% CI: 0.84–0.89) and 97% (95% CI: 0.96–0.98) in the adult IS group, 14% (95% CI: 0.10–0.19) and 99% (95% CI: 0.97–1.00) in the pediatric ES group, 80% (95% CI: 0.72–0.87) and 94% (95% CI: 0.92–0.95) in the pediatric GA group, 67% (95% CI: 0.62–0.72) and 99% (95% CI: 0.98–0.99) in the pediatric IS group, and 54% (95% CI: 0.43–0.64) and 99% (95% CI: 0.97–0.99) in the pediatric NPA group. The heterogeneity across included studies was deemed acceptable. Conclusion: Considering diagnostic accuracy, cost and sampling process, ES was a proper choice for adult PTB. GA might be more suitable than others for pediatric PTB. The actual choice of sample types should consider the needs of specific situations.

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GeneXpert® MTB/RIF assay with transbronchial lung cryobiopsy for Mycobacterium tuberculosis diagnosis

Cited by 9 publications

References 29 publications

Transbronchial Cryobiopsy for Miliary Tuberculosis Mimicking Hypersensitivity Pneumonitis

Transbronchial Cryobiopsy for Miliary Tuberculosis Mimicking Hypersensitivity Pneumonitis

Diagnostic performance of DNA microarray for detecting rifampicin and isoniazid resistance in Mycobacterium tuberculosis

Which sample type is better for Xpert MTB/RIF to diagnose adult and pediatric pulmonary tuberculosis?

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