Comparison of two molecular methods and an automated liquid culture system for the early detection of Mycobacterium tuberculosis from both pulmonary and extrapulmonary specimens in Kuwait

Objective/background: Molecular methods for the detection of Mycobacterium tuberculosis (MTB) are widely used for the early diagnosis of tuberculosis (TB). The objectives of this study were to evaluate the performance of two molecular techniques for the detection of MTB for both pulmonary and extrap...

Full description

Bibliographic Details
Main Authors: E M Mokaddas, H Saadaldeen, S Ahmad
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2016-01-01
Series:International Journal of Mycobacteriology
Subjects:
Online Access:http://www.ijmyco.org/article.asp?issn=2212-5531;year=2016;volume=5;issue=5;spage=74;epage=75;aulast=Mokaddas
_version_ 1828770853286838272
author E M Mokaddas
H Saadaldeen
S Ahmad
author_facet E M Mokaddas
H Saadaldeen
S Ahmad
author_sort E M Mokaddas
collection DOAJ
description Objective/background: Molecular methods for the detection of Mycobacterium tuberculosis (MTB) are widely used for the early diagnosis of tuberculosis (TB). The objectives of this study were to evaluate the performance of two molecular techniques for the detection of MTB for both pulmonary and extrapulmonary specimens in comparison with conventional culture techniques in Kuwait and to correlate the results with clinical and histopathological diagnosis. Methods: A total of 9,594 consecutive pulmonary (n = 5,597) and extrapulmonary (n = 3,997) specimens received by the Kuwait National TB Reference Laboratory from November 2011 to December 2015 were processed for direct smear microscopy for acid-fast bacilli using a Zhiel-Neelsen stain, Xpert MTB/RIF assay, ProbTec polymerase chain reaction (PCR), and growth in fully automated MGIT 960 system tubes. The clinical and histopathological diagnoses were correlated with the results. Results: For pulmonary specimens, the overall sensitivity and specificity of both molecular methods together were 90.7% and 99.7%, respectively. The sensitivity and specificity of the Xpert MTB/RIF assay were 90.1% and 99.4%, respectively. The sensitivity and specificity of ProbTec PCR were 86% and 99.6%, respectively. For extrapulmonary specimens, the overall sensitivity and specificity of both molecular methods together were 87% and 97.8%, respectively. The sensitivity and specificity of Xpert MTB/RIF assay were 89.5% and 97.2%, respectively. The sensitivity and specificity of ProbTec PCR were 73% and 97.8%, respectively. When clinical and histopathological correlations were made with the assumed false-positive results from both molecular methods, the corrected sensitivity and specificity for pulmonary specimens were 91% and 99.9%, respectively, and 89.6% and 99.8% for extrapulmonary specimens, respectively. Conclusion: The performance of the Xpert MTB/RIF assay was superior to ProbTec PCR for the early detection of MTB from both pulmonary and extrapulmonary specimens.
first_indexed 2024-12-11T14:14:28Z
format Article
id doaj.art-74f9dbd3aef947ebaed73c639babce93
institution Directory Open Access Journal
issn 2212-5531
2212-554X
language English
last_indexed 2024-12-11T14:14:28Z
publishDate 2016-01-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series International Journal of Mycobacteriology
spelling doaj.art-74f9dbd3aef947ebaed73c639babce932022-12-22T01:03:14ZengWolters Kluwer Medknow PublicationsInternational Journal of Mycobacteriology2212-55312212-554X2016-01-0155747510.1016/j.ijmyco.2016.09.004Comparison of two molecular methods and an automated liquid culture system for the early detection of Mycobacterium tuberculosis from both pulmonary and extrapulmonary specimens in KuwaitE M MokaddasH SaadaldeenS AhmadObjective/background: Molecular methods for the detection of Mycobacterium tuberculosis (MTB) are widely used for the early diagnosis of tuberculosis (TB). The objectives of this study were to evaluate the performance of two molecular techniques for the detection of MTB for both pulmonary and extrapulmonary specimens in comparison with conventional culture techniques in Kuwait and to correlate the results with clinical and histopathological diagnosis. Methods: A total of 9,594 consecutive pulmonary (n = 5,597) and extrapulmonary (n = 3,997) specimens received by the Kuwait National TB Reference Laboratory from November 2011 to December 2015 were processed for direct smear microscopy for acid-fast bacilli using a Zhiel-Neelsen stain, Xpert MTB/RIF assay, ProbTec polymerase chain reaction (PCR), and growth in fully automated MGIT 960 system tubes. The clinical and histopathological diagnoses were correlated with the results. Results: For pulmonary specimens, the overall sensitivity and specificity of both molecular methods together were 90.7% and 99.7%, respectively. The sensitivity and specificity of the Xpert MTB/RIF assay were 90.1% and 99.4%, respectively. The sensitivity and specificity of ProbTec PCR were 86% and 99.6%, respectively. For extrapulmonary specimens, the overall sensitivity and specificity of both molecular methods together were 87% and 97.8%, respectively. The sensitivity and specificity of Xpert MTB/RIF assay were 89.5% and 97.2%, respectively. The sensitivity and specificity of ProbTec PCR were 73% and 97.8%, respectively. When clinical and histopathological correlations were made with the assumed false-positive results from both molecular methods, the corrected sensitivity and specificity for pulmonary specimens were 91% and 99.9%, respectively, and 89.6% and 99.8% for extrapulmonary specimens, respectively. Conclusion: The performance of the Xpert MTB/RIF assay was superior to ProbTec PCR for the early detection of MTB from both pulmonary and extrapulmonary specimens.http://www.ijmyco.org/article.asp?issn=2212-5531;year=2016;volume=5;issue=5;spage=74;epage=75;aulast=MokaddasMycobacterium tuberculosisPulmonaryExtrapulmonaryGeneXpert TB/REFProbTec
spellingShingle E M Mokaddas
H Saadaldeen
S Ahmad
Comparison of two molecular methods and an automated liquid culture system for the early detection of Mycobacterium tuberculosis from both pulmonary and extrapulmonary specimens in Kuwait
International Journal of Mycobacteriology
Mycobacterium tuberculosis
Pulmonary
Extrapulmonary
GeneXpert TB/REF
ProbTec
title Comparison of two molecular methods and an automated liquid culture system for the early detection of Mycobacterium tuberculosis from both pulmonary and extrapulmonary specimens in Kuwait
title_full Comparison of two molecular methods and an automated liquid culture system for the early detection of Mycobacterium tuberculosis from both pulmonary and extrapulmonary specimens in Kuwait
title_fullStr Comparison of two molecular methods and an automated liquid culture system for the early detection of Mycobacterium tuberculosis from both pulmonary and extrapulmonary specimens in Kuwait
title_full_unstemmed Comparison of two molecular methods and an automated liquid culture system for the early detection of Mycobacterium tuberculosis from both pulmonary and extrapulmonary specimens in Kuwait
title_short Comparison of two molecular methods and an automated liquid culture system for the early detection of Mycobacterium tuberculosis from both pulmonary and extrapulmonary specimens in Kuwait
title_sort comparison of two molecular methods and an automated liquid culture system for the early detection of mycobacterium tuberculosis from both pulmonary and extrapulmonary specimens in kuwait
topic Mycobacterium tuberculosis
Pulmonary
Extrapulmonary
GeneXpert TB/REF
ProbTec
url http://www.ijmyco.org/article.asp?issn=2212-5531;year=2016;volume=5;issue=5;spage=74;epage=75;aulast=Mokaddas
work_keys_str_mv AT emmokaddas comparisonoftwomolecularmethodsandanautomatedliquidculturesystemfortheearlydetectionofmycobacteriumtuberculosisfrombothpulmonaryandextrapulmonaryspecimensinkuwait
AT hsaadaldeen comparisonoftwomolecularmethodsandanautomatedliquidculturesystemfortheearlydetectionofmycobacteriumtuberculosisfrombothpulmonaryandextrapulmonaryspecimensinkuwait
AT sahmad comparisonoftwomolecularmethodsandanautomatedliquidculturesystemfortheearlydetectionofmycobacteriumtuberculosisfrombothpulmonaryandextrapulmonaryspecimensinkuwait