Bacteriological diagnosis of childhood TB: a prospective observational study
Childhood TB diagnosis is challenging. Studies in adults suggest Microscopic Observation Drug Susceptibility (MODS) culture or the Xpert MTB/RIF assay might be used to expand bacteriological diagnosis. However data from children are more limited. We prospectively compared MODS and Xpert MTB/RIF with...
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| Format: | Journal article |
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Springer Nature
2017
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| _version_ | 1797079691904942080 |
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| author | Brent, A Mugo, D Musyimi, R Mutiso, A Morpeth, S Levin, M Scott, J |
| author_facet | Brent, A Mugo, D Musyimi, R Mutiso, A Morpeth, S Levin, M Scott, J |
| author_sort | Brent, A |
| collection | OXFORD |
| description | Childhood TB diagnosis is challenging. Studies in adults suggest Microscopic Observation Drug Susceptibility (MODS) culture or the Xpert MTB/RIF assay might be used to expand bacteriological diagnosis. However data from children are more limited. We prospectively compared MODS and Xpert MTB/RIF with standard microscopy and culture using the BD MGIT 960 system among 1442 Kenyan children with suspected TB. 97 specimens from 54 children were TB culture-positive: 91 (94%) by MGIT and 74 (76%) by MODS (p = 0.002). 72 (74%) culture-positive and 7 culture-negative specimens were Xpert MTB/RIF positive. Xpert MTB/RIF specificity was 100% (99.7-100%) among 1164 specimens from 892 children in whom TB was excluded, strongly suggesting all Xpert MTB/RIF positives are true positives. The sensitivity of MGIT, MODS and Xpert MTB/RIF was 88%, 71% and 76%, respectively, among all 104 true positive (culture and/or Xpert MTB/RIF positive) specimens. MGIT, MODS and Xpert MTB/RIF on the initial specimen identified 40/51 (78%), 33/51 (65%) and 33/51 (65%) culture-confirmed pulmonary TB cases, respectively; Xpert MTB/RIF detected 5 additional culture-negative cases. The high sensitivity and very high specificity of the Xpert MTB/RIF assay supports its inclusion in the reference standard for bacteriological diagnosis of childhood TB in research and clinical practice. |
| first_indexed | 2024-03-07T00:49:23Z |
| format | Journal article |
| id | oxford-uuid:85d633e0-3315-480d-a889-ddb3133ea1b5 |
| institution | University of Oxford |
| last_indexed | 2024-03-07T00:49:23Z |
| publishDate | 2017 |
| publisher | Springer Nature |
| record_format | dspace |
| spelling | oxford-uuid:85d633e0-3315-480d-a889-ddb3133ea1b52022-03-26T22:00:10ZBacteriological diagnosis of childhood TB: a prospective observational studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:85d633e0-3315-480d-a889-ddb3133ea1b5Symplectic Elements at OxfordSpringer Nature2017Brent, AMugo, DMusyimi, RMutiso, AMorpeth, SLevin, MScott, JChildhood TB diagnosis is challenging. Studies in adults suggest Microscopic Observation Drug Susceptibility (MODS) culture or the Xpert MTB/RIF assay might be used to expand bacteriological diagnosis. However data from children are more limited. We prospectively compared MODS and Xpert MTB/RIF with standard microscopy and culture using the BD MGIT 960 system among 1442 Kenyan children with suspected TB. 97 specimens from 54 children were TB culture-positive: 91 (94%) by MGIT and 74 (76%) by MODS (p = 0.002). 72 (74%) culture-positive and 7 culture-negative specimens were Xpert MTB/RIF positive. Xpert MTB/RIF specificity was 100% (99.7-100%) among 1164 specimens from 892 children in whom TB was excluded, strongly suggesting all Xpert MTB/RIF positives are true positives. The sensitivity of MGIT, MODS and Xpert MTB/RIF was 88%, 71% and 76%, respectively, among all 104 true positive (culture and/or Xpert MTB/RIF positive) specimens. MGIT, MODS and Xpert MTB/RIF on the initial specimen identified 40/51 (78%), 33/51 (65%) and 33/51 (65%) culture-confirmed pulmonary TB cases, respectively; Xpert MTB/RIF detected 5 additional culture-negative cases. The high sensitivity and very high specificity of the Xpert MTB/RIF assay supports its inclusion in the reference standard for bacteriological diagnosis of childhood TB in research and clinical practice. |
| spellingShingle | Brent, A Mugo, D Musyimi, R Mutiso, A Morpeth, S Levin, M Scott, J Bacteriological diagnosis of childhood TB: a prospective observational study |
| title | Bacteriological diagnosis of childhood TB: a prospective observational study |
| title_full | Bacteriological diagnosis of childhood TB: a prospective observational study |
| title_fullStr | Bacteriological diagnosis of childhood TB: a prospective observational study |
| title_full_unstemmed | Bacteriological diagnosis of childhood TB: a prospective observational study |
| title_short | Bacteriological diagnosis of childhood TB: a prospective observational study |
| title_sort | bacteriological diagnosis of childhood tb a prospective observational study |
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