Parallel Tests Using Culture, Xpert MTB/RIF, and SAT-TB in Sputum Plus Bronchial Alveolar Lavage Fluid Significantly Increase Diagnostic Performance of Smear-Negative Pulmonary Tuberculosis

Abstract

At present, tuberculosis remains a serious threat to human health. The diagnosis of pulmonary tuberculosis (PTB) is still difficult, and the prominent challenge for diagnosis is the lack of a highly sensitive and specific method. In order to explore the diagnostic value of parallel tests, this study prospectively enrolled 258 patients with smear-negative PTB from May 2, 2015 to December 31, 2016. The sputum specimens and bronchial alveolar lavage fluid (BALF) samples from all patients were assessed for MTB detection by culture, Xpert MTB/RIF, and simultaneous amplification and testing method for TB (SAT-TB). Overall, the sensitivity of any single test using culture, Xpert MTB/RIF, or SAT-TB was lower than that for parallel tests (p < 0.05), and the sensitivity rates for MTB detection in BALF were significantly higher than those in sputum samples. There were lower agreements in the detection results between sputum samples and BALF for all tests (p < 0.05). The parallel tests models of using culture plus Xpert MTB/RIF plus SAT-TB, culture plus Xpert, or culture plus SAT-TB achieved higher sensitivities compared with all three single test models (p < 0.05). Additionally, joint detection using sputum and BALF samples achieved a high sensitivity (0.8566, 95% CI: 0.8086–0.8941). In conclusion, the parallel tests model using culture, Xpert MTB/RIF, and SAT-TB in sputum plus BALF significantly increases the diagnostic performance of smear-negative PTB; thus, this method should be applied clinically when PTB is suspected but smear results are negative.

[Retracted] Application Value of SAT‐TB Combined with Acid‐Fast Staining in the Diagnosis and Treatment of Pulmonary Tuberculosis

“…Though the application of TB DNA detection considerably raises the detection rate of PTB, DNA as an amplified product can easily spark laboratory cross-contamination and cause false-positive results, thereby leading to errors of clinical diagnosis. Another one uses RNA as a template, with the target RNA amplified by PCR to detect RNA products of M. tuberculosis in specimens [ 8 ]. During this approach, RNA is the initial target, and gene contamination can be effectively avoided owing to the fact that RNA is extremely easily degradable, which supports that RNA only exists in live bacteria.…”

“…Previous research indicated that the specificity of SAT-TB for the diagnosis of PTB is almost 100%, with the sensitivity and accuracy reaching 75.8% and 80.2%, respectively [ 7 ], suggesting that SAT-TB as a new detecting method has potential clinical value in PTB diagnosis. Another advantage of SAT-TB is that it targets RNA rather than DNA, and hence, it is capable of detecting live bacteria [ 8 ]. This paper was designed to compare the SAT-TB detection technique combined with acid-fast staining with the MGIT 960 culture test and analyze the sensitivity as well as the specificity of SAT-TB or SAT-TB combined with acid-fast staining for PTB diagnosis so as to evaluate their application value in the diagnosis and treatment of PTB.…”

Screening and identification of serum biomarkers of osteoarticular tuberculosis based on mass spectrometry

“…Tuberculosis has become the world's second leading cause of death due to infectious disease after AIDS. 14,15 However, in most parts of Asia, Africa, and Russia, the situation of prevention and control of tuberculosis is not very satisfactory due to the eco- Human heterogeneous nuclear ribonucleoproteins A2/B1 (3.94%). 17 In addition to common tuberculosis, the incidence of extrapulmonary tuberculosis is also increasing.…”

Simultaneous amplification and testing method forMycobacterium tuberculosisrRNA to differentiate sputum-negative tuberculosis from sarcoidosis

“…The sensitivity and specificity of SAT to diagnose TB were 96 and 88%, respectively (20). SAT of sputum and bronchial alveolar lavage fluid significantly increases the diagnostic performance of smearnegative and sputum-scare pulmonary TB in our hospital (10,21). Thus, in this study, we aimed to use EBUS-TBNA biopsy specimens to validate and test the performance of the SAT-TB to differentially diagnose sputum-negative TB from sarcoidosis.…”