Value of real-time polymerase chain reaction in bronchoalveolar lavage fluid for diagnosis of pediatric pulmonary tuberculosis

Wang, Xinfeng; Wu, Yanhua; Zhang, Kaihui; Guan, Cuiping; Gao, Xusheng; Wang, Mao‐Shui

doi:10.1016/j.bjid.2013.06.002

Cited by 5 publications

(5 citation statements)

References 5 publications

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“…1 ). Twenty-one [ 10 , 24 , 25 , 27 , 29 , 31 , 32 , 39 , 44 , 45 , 47 , 49 , 51 , 52 , 54 , 57 , 60 , 61 , 64 , 66 , 67 ] reported detection of pulmonary TB (PTB), fifteen [ 23 , 30 , 33 , 35 , 37 , 38 , 40 – 42 , 50 , 53 , 55 , 56 , 59 , 62 ] reported detection of extra-pulmonary TB (EPTB) and ten [ 26 , 28 , 34 , 36 , 43 , 46 , 48 , 58 , 63 , 65 ] reported on both types of pathological sample. Table 1 summarises the main characteristics of the included studies.…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of real-time polymerase chain reaction assay for the detection of Mycobacterium tuberculosis in pathological samples: a systematic review and meta-analysis

et al. 2017

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BackgroundRapid and accurate diagnosis of tuberculosis (TB) is key to manage the disease and to control and prevent its transmission. Many established diagnostic methods suffer from low sensitivity or delay of timely results and are inadequate for rapid detection of Mycobacterium tuberculosis (MTB) in pulmonary and extra-pulmonary clinical samples. This study examined whether a real-time polymerase chain reaction (RT-PCR) assay, with a turn-a-round time of 2 h, would prove effective for routine detection of MTB by clinical microbiology laboratories.MethodsA systematic literature search was performed for publications in any language on the detection of MTB in pathological samples by RT-PCR assay. The following sources were used MEDLINE via PubMed, EMBASE, BIOSIS Citation Index, Web of Science, SCOPUS, ISI Web of Knowledge and Cochrane Infectious Diseases Group Specialised Register, grey literature, World Health Organization and Centres for Disease Control and Prevention websites. Forty-six studies met set inclusion criteria. Generated pooled summary estimates (95% CIs) were calculated for overall accuracy and bivariate meta-regression model was used for meta-analysis.ResultsSummary estimates for pulmonary TB (31 studies) were as follows: sensitivity 0.82 (95% CI 0.81–0.83), specificity 0.99 (95% CI 0.99–0.99), positive likelihood ratio 43.00 (28.23–64.81), negative likelihood ratio 0.16 (0.12–0.20), diagnostic odds ratio 324.26 (95% CI 189.08–556.09) and area under curve 0.99. Summary estimates for extra-pulmonary TB (25 studies) were as follows: sensitivity 0.70 (95% CI 0.67–0.72), specificity 0.99 (95% CI 0.99–0.99), positive likelihood ratio 29.82 (17.86–49.78), negative likelihood ratio 0.33 (0.26–0.42), diagnostic odds ratio 125.20 (95% CI 65.75–238.36) and area under curve 0.96.ConclusionsRT-PCR assay demonstrated a high degree of sensitivity for pulmonary TB and good sensitivity for extra-pulmonary TB. It indicated a high degree of specificity for ruling in TB infection from sampling regimes. This was acceptable, but may better as a rule out add-on diagnostic test. RT-PCR assays demonstrate both a high degree of sensitivity in pulmonary samples and rapidity of detection of TB which is an important factor in achieving effective global control and for patient management in terms of initiating early and appropriate anti-tubercular therapy.Systematic review registrationPROSPERO CRD42015027534.Electronic supplementary materialThe online version of this article (10.1186/s13643-017-0608-2) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Effectiveness of real-time polymerase chain reaction assay for the detection of Mycobacterium tuberculosis in pathological samples: a systematic review and meta-analysis

et al. 2017

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“…Pediatric TB is difficult to diagnose, and efforts are made to improve its diagnostic accuracy, including trying different specimens, such as bronchoalveolar lavage fluid (BALF), induced sputum, nasopharynx swab [ 3 ]. Unfortunately, routine technologies performed on them cannot detect pediatric TB accurately [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of bronchial brushing and sputum in detection of pediatric pulmonary tuberculosis

Chen

Wang

2016

Ital J Pediatr

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The retrospective study aimed to evaluate the diagnostic value of bronchial brushing and sputum using acid fast bacilli smear, mycobacterial culture and real-time PCR in detection of pediatric pulmonary tuberculosis, sensitivity and specificity of bronchial brushing and sputum examined by the three methods were calculated and compared to each other. Data showed there were no significant difference in sensitivity between bronchial brushing and matched sputum using each method. But the specificity of real-time PCR on bronchial brushing was lower than on sputum. Compared with bronchial brushing, sputum was better specimen in detection of pediatric pulmonary tuberculosis.

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“…After screening all the titles and abstracts, removing the duplicates and excluding the ineligible studies, 20 articles (5, 536 samples/patients) [44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63] were selected for full-text review and meta-analysis (Fig. 1).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Eleven [44,47,48,52,54,56,57,58,60,62,63] reported detection of pulmonary TB (PTB), ten [44,45,46,49,50,51,53,55,59,61] reported detection of extra-pulmonary TB (EPTB) and one [44] reported on both types of clinical sample. Table 1 summarises the main characteristics of the included studies.…”

Section: Study Characteristicsmentioning

confidence: 99%

Paediatric Tuberculosis Diagnosis Using Mycobacterium Tuberculosis Real-time Polymerase Chain Reaction Assay: a Systematic Review and Meta-analysis

Babafemi

Cherian

Ouma

et al. 2021

Preprint

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Background:Rapid and accurate diagnosis of paediatric tuberculosis (TB) is key to manage the disease and to control and prevent its transmission. Collection of quality sputum samples without invasion methods from paediatrics (age <16 years) with presumptive pulmonary tuberculosis (PTB) remains a challenge. Clinical management is especially challenging, and recommendations are based on restricted evidence. Many established diagnostic methods suffer from low sensitivity or delay of timely results and are inadequate for rapid detection of Mycobacterium tuberculosis (MTB) in pulmonary and extra-pulmonary clinical samples. This study assessed the overall accuracy of a real-time polymerase chain reaction (RT-PCR) based assay, with a turn-a-round time of 2 h, for routine diagnosis of MTB in different samples from paediatrics with active pulmonary and extra-pulmonary tuberculosis using mycobacterial culture as the gold standard in clinical microbiology laboratories.Methods:We conducted a systematic review and meta-analysis to examine the diagnostic accuracy of RT-PCR based assay for the detection of MTB in paediatric clinical samples. A systematic literature search was performed for publications in any language. The following sources were used MEDLINE via PubMed, EMBASE, BIOSIS Citation Index, Web of Science, SCOPUS, ISI Web of Knowledge, World Health Organization and Centres for Disease Control and Prevention websites, Cochrane Infectious Diseases Group Specialised Register, and grey literature. Twenty studies (5,536 specimens) that met set inclusion criteria were included. Bivariate random-effects model of meta-analysis were performed to generate pooled summary estimates (95% CIs) for overall accuracy of RT-PCR based assay compared to mycobacterial culture as the reference standard. Results:Of the 1592 candidate studies, twenty eligible studies met our inclusion criteria. In total, the review and meta-analysis included 5, 536 (3, 209 PTB and 2, 327 EPTB). Summary estimates for pulmonary TB (11 studies) were as follows: sensitivity 56 (95% CI 51-62), specificity 97 (95% CI 96-98), positive likelihood ratio 70.73 (95% CI 8.55-585.40), negative likelihood ratio 0.43 (0.28-0.66), diagnostic odds ratio 193.06 (95% CI 51.21- 727.83) and summary receiver operating characteristic (SROC) area under curve 0.98. Summary estimates for extra-pulmonary TB (10 studies) were as follows: sensitivity 87 (95% CI 82-91)) specificity 100 (95% CI 99-100), positive likelihood ratio 111.91(53.97-232.04), negative likelihood ratio 0.15 (0.07-0.30), diagnostic odds ratio 1337.84 (95% CI 441.92- 4050.12) and summary receiver operating characteristic (SROC) area under curve 0.99. There was significant heterogeneity in sensitivity and specificity among the enrolled studies (p< 0.001).Conclusions:Our results suggested that the RT-PCR based assay could be a useful test for the diagnosis of paediatrics TB with high sensitivity and specificity in low-income/high-burden and upper medium income/low-burden settings.RT-PCR assay demonstrated a high degree of sensitivity for extra-pulmonary TB and good sensitivity for pulmonary TB. It indicated a high degree of specificity for ruling in TB infection from sampling regimes. This was acceptable but may better as a rule out add-on diagnostic test. RT-PCR based assays demonstrate both a high degree of sensitivity in extra-pulmonary and moderate sensitivity in pulmonary samples and rapidity of detection of TB which is an important factor in achieving effective global control and for patient management in terms of initiating early and appropriate anti-tubercular therapy. Systematic review registration: PROSPERO CRD42018104052

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Value of real-time polymerase chain reaction in bronchoalveolar lavage fluid for diagnosis of pediatric pulmonary tuberculosis

Cited by 5 publications

References 5 publications

Effectiveness of real-time polymerase chain reaction assay for the detection of Mycobacterium tuberculosis in pathological samples: a systematic review and meta-analysis

Effectiveness of real-time polymerase chain reaction assay for the detection of Mycobacterium tuberculosis in pathological samples: a systematic review and meta-analysis

Comparison of bronchial brushing and sputum in detection of pediatric pulmonary tuberculosis

Paediatric Tuberculosis Diagnosis Using Mycobacterium Tuberculosis Real-time Polymerase Chain Reaction Assay: a Systematic Review and Meta-analysis

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