Molecular detection of Mycobacterium tuberculosis in blood stained sputum samples using GeneXpert PCR assay

Aninagyei, Enoch; Ayivor-Djanie, Reuben; Attoh, Juliana; Dakorah, Mavis Puopelle; Ginko, Muniru Nuhu; Acheampong, Desmond Omane

doi:10.1016/j.diagmicrobio.2021.115363

Cited by 7 publications

(5 citation statements)

References 42 publications

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“…There are over 130 GeneXpert devices in facilities across the country,(12) often used for Mycobacterium tuberculos is testing. (13) This study found the availability of the rRT-PCR model equipment in only 9 of the 16 regions. There were none in the Ahafo, Brong Ahafo, Bono East, Central, North-East, Upper West, and Western North regions of the country.…”

Section: Discussionmentioning

confidence: 89%

CoViD-19 rRT-PCR Testing Capacity in Ghana; Indications of Preparedness for Marburg virus Outbreak?

Nyarko

Kumi

Ofori

et al. 2022

Preprint

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Introduction: Ghana, as of July 2022, has had 168,350 Real-Time Reverse Transcription-Polymerase Chain Reaction (rRT-PCR)-confirmed cases of CoViD-19 infections and 1,458 deaths. Besides, 2 cases of Marburg virus diseases (MVD) were confirmed in the country within the same month. Both CoViD-19 and MVD require rRT-PCR for diagnosis, however, rRT-PCR facilities are scarce in Ghana, especially, hitherto, the CoViD-19 pandemic. The objectives of this study were to assess the current testing capacity of CoViD-19 rRT-PCR in Ghana, and to make some recommendations in case of an MVD outbreak, or recurrence of the CoViD-19 pandemic. Methods: The study was cross-sectional. Questionnaires were administered to 100 health professionals actively involved in the testing cycle of CoViD-19 across rRT-PCR testing institutions. Responses with regards to CoViD-19 rRT-PCR testing, biosafety, and relationship with Surveillance Outbreak Response Management and Analysis System (SORMAS), PanaBios and Zipline, were obtained for 2020-through-2022. The responses were analyzed with Microsoft Excel office-365 and SPSS v.23. Results: Thirty-five (35) of the 53 testing institutions were in the Greater Accra Region, but none in seven (7) regions of the country. Many (49%) were privately owned. Nine (9) different professionals were involved in rRT-PCR testing. The testing institutions increased from 2 (in March 2020) to 53 by June-ending 2022, and most (90%) had Biosafety Cabinet class II (BSCII). PPEs were inadequate between march and June, 2020 (25%), but enough (100%) by June 2022. Zipline, SORMAS, and PanaBios, respectively, saw transactions from 28%, 81%, and 77% of the institutions. Conclusion: Ghana is adequately resourced for recurrence of CoViD-19, or any MVD outbreak, in terms of diagnosis with rRT-PCR. However, the country needs redistribution of these testing resources, expand the services of Zipline and SORMAS, satisfy additional biosafety requirements for MVD testing and equip over 180 GeneXpert facilities to help in accessible and affordable testing. KEYWORDS: CoViD-19, rRT-PCR, Testing, BSC, SORMAS, Zipline, Marburg virus, Ghana

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Section: Discussionmentioning

confidence: 89%

CoViD-19 rRT-PCR Testing Capacity in Ghana; Indications of Preparedness for Marburg virus Outbreak?

Nyarko

Kumi

Ofori

et al. 2022

Preprint

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“… 27 A study conducted by Aninagyei et al showed that the GeneXpert result was unreliable at more than 5% blood contamination of the sample, and absolute PCR inhibition occurred at 20% blood contamination. 28 Local bleeding is an inevitable complication during needle puncture, which can interfere with GeneXpert detection.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of Chest Wall Tuberculosis Using Fine Needle Aspiration: A Single-Center Experience

Li¹,

Sha²

2023

IDR

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Introduction Minimally invasive diagnosis of chest wall tuberculosis remains a challenge. Fine needle aspiration (FNA) is a simple and safe method of sampling. However, previous studies have shown that conventional tuberculosis tests had poor diagnostic performance in the needle aspirates. With the popularization of molecular detection application, the value of FNA in the diagnosis of chest wall tuberculosis needs to be reevaluated. Methods We retrospectively studied patients with suspected chest wall tuberculosis at admission who underwent FNA for diagnosis and reported the diagnostic efficacy of acid-fast bacilli smear, mycobacterial culture, cytology and Xpert MTB/RIF (GeneXpert) when testing FNA specimens. A composite reference standard (CRS) was used as the diagnostic gold standard for this study. Results Among 89 included FNA specimens, acid-fast bacilli smear, mycobacterial culture, and GeneXpert were positive in 15 (16.85%), 23 (25.8%), and 61 (68.5%), respectively. Thirty-nine (43.8%) had cytologic features suggestive of tuberculosis. According to CRS, 75 (84.3%) cases were categorized as chest wall tuberculosis, 14 (15.7%) were not diagnosed with tuberculosis. Using CRS as the gold standard, acid-fast bacilli smear, mycobacterial culture, cytology and GeneXpert exhibited sensitivity of 20%, 30.7%, 52% and 81.3%, respectively. Specificity in these four tests was found to be 100%. Sensitivity of GeneXpert was significantly higher than that of smear, culture and cytology, X 2 =66.3, p <0.001. Conclusion GeneXpert achieved higher sensitivity as compared to cytology and conventional TB tests in the chest wall FNA specimens. The implementation of GeneXpert may increase the diagnostic efficacy of FNA in the diagnosis of chest wall TB.

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“…If sputum contamination with blood is beyond 5.0%, the result will be unreliable and absolute inhibition occurs at 20.0% blood contamination. 18 However, studies found that patients who are MTB positive in a blood sample have a higher risk of death. 36 Therefore, we are missing the most important sputum quality.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, various factors impact the Xpert ® MTB/RIF’s performance, such as the type of specimen, 17 sputum quality, 18 , 19 , 20 sample collection and diagnosis strategy, 21 , 22 , 23 and clinical characteristics of patients. 17 , 24 , 25 Since 2012, more than 314 GeneXpert ® instruments have been installed in Ethiopia.…”

Section: Introductionmentioning

confidence: 99%

Effect of sputum quality and role of Xpert® MTB/RIF assay for detection of smear-negative pulmonary tuberculosis in same-day diagnosis strategy in Addis Ababa, Ethiopia

et al. 2022

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Background: There is limited information on the performance of the Xpert® MTB/RIF test for diagnosis of smear-negative pulmonary tuberculosis (SNPT) and rifampicin resistance (RR) in the same-day diagnosis approach. The effects of sputum quality and other factors affecting the Xpert performance are also under-investigated.Objective: This study aimed to determine the performance of the Xpert® MTB/RIF test for detection of SNPT and RR in the same-day diagnosis strategy and the effect of sputum quality and other factors on its performance.Methods: A cross-sectional study was conducted from August 2017 to January 2018 across 16 health facilities in Addis Ababa, Ethiopia. Two spot sputum samples were collected from 418 presumptive SNPT patients, tested with Xpert® MTB/RIF, then compared to tuberculosis culture. Additionally, culture isolates were tested for RR by BACTEC MGIT™ 960 drug susceptibility testing (DST) and MTBDRplus version 2.Results: The Xpert® MTB/RIF test detected 24 (5.7%) SNPT cases, with a sensitivity of 92.3% (75.9% – 97.9%) and specificity of 99.2% (97.8% – 99.7%) compared with tuberculosis culture. Xpert® MTB/RIF also detected three (11.58%) RR strains with 100.0% concordance with BACTEC MGIT™ 960 DST and MTBDRplus results. Three blood-stained SNPT samples were positive by Xpert (30.0%), which was 6.9 times higher compared to salivary sputum (odds ratio: 6.9, 95% confidence interval: 1.36–34.96, p = 0.020).Conclusion: The performance of the Xpert® MTB/RIF to detect SNPT and RR in same-day diagnosis is high. However, SNPT positivity varies among sputum qualities, and good sample collection is necessary for better test performance.

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Molecular detection of Mycobacterium tuberculosis in blood stained sputum samples using GeneXpert PCR assay

Cited by 7 publications

References 42 publications

CoViD-19 rRT-PCR Testing Capacity in Ghana; Indications of Preparedness for Marburg virus Outbreak?

CoViD-19 rRT-PCR Testing Capacity in Ghana; Indications of Preparedness for Marburg virus Outbreak?

Diagnosis of Chest Wall Tuberculosis Using Fine Needle Aspiration: A Single-Center Experience

Effect of sputum quality and role of Xpert® MTB/RIF assay for detection of smear-negative pulmonary tuberculosis in same-day diagnosis strategy in Addis Ababa, Ethiopia

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