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. 2014 Jun 12;9(6):e99129.
doi: 10.1371/journal.pone.0099129. eCollection 2014.

Availability and use of molecular microbiological and immunological tests for the diagnosis of tuberculosis in europe

Marc Tebruegge  1 , Nicole Ritz  2 , Karsten Koetz  3 , Antoni Noguera-Julian  4 , James A Seddon  5 , Steven B Welch  6 , Maria Tsolia  7 , Beate Kampmann  8
Affiliations

Availability and use of molecular microbiological and immunological tests for the diagnosis of tuberculosis in europe

Marc Tebruegge et al. PLoS One. .

Abstract

Introduction: Currently only limited data exist regarding the availability and clinical use of molecular and immunological tests for tuberculosis (TB) in the European setting.

Methods: Web-based survey of Paediatric-Tuberculosis-Network-European-Trialsgroup (ptbnet) and Tuberculosis-Network-European-Trialsgroup (TBnet) members conducted June to December 2013. Both networks comprise clinicians, microbiologists, epidemiologists and researchers predominately based in Europe.

Results: 191 healthcare professionals from 31 European countries participated. Overall, 26.8% of respondents did not have access to the Xpert MTB/RIF assay; only 44.6% had access to the assay in-house. However, a substantial proportion had access to other commercial and/or non-commercial PCR-based assays for TB (68.8% and 31.8%, respectively). Only 6.4% did not have access to any PCR-based assays for TB. A large proportion of participants with access to the Xpert MTB/RIF assay had used it for the analysis of non-respiratory samples [pleural fluid: 36.5%, gastric aspirates: 34.7%, cerebrospinal fluid: 34.7%, stool samples: 4.3%, blood/serum: 2.6%, 'other samples' (which included biopsy/tissue samples, lymph node aspirates, joint aspirates and urine samples): 16.5%]. Regarding interferon-gamma release assays, a greater proportion of respondents had access to the QuantiFERON-TB Gold assay (84.7%) than to the T-SPOT.TB assay (52.2%).

Conclusions: Both immunological and molecular TB tests are widely available across Europe. The QuantiFERON-TB Gold assay is more widely used than the T-SPOT.TB assay, which may reflect the difficulties of integrating an ELISPOT assay into the routine laboratory setting. Although Xpert MTB/RIF assays are optimised and solely licensed for the analysis of sputum samples, in clinical practice they are commonly used for non-respiratory samples. Further research is needed to establish how current molecular TB tests impact on patient care and outcome in the routine clinical setting.

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Conflict of interest statement

Competing Interests: M. Tebruegge is a PLOS ONE Editorial Board member. This does not alter the authors' adherence to PLOS ONE editorial policies and criteria.

Figures

Figure 1
Figure 1. Summary of participants' responses regarding their access to immunological, conventional microbiological and molecular tests for tuberculosis.
Figure 2
Figure 2. Summary of participants' responses regarding their access to the Xpert MTB/RIF assay according to country.
See this image and copyright information in PMC

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