Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jun 15:9:1107.
doi: 10.3389/fmicb.2018.01107. eCollection 2018.

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

Lin Fan  1 , Danfeng Li  2 , Shaojun Zhang  1 , Lan Yao  1 , Xiaohui Hao  1 , Jin Gu  1 , Hong Li  1 , Jinxia Niu  2 , Zhemin Zhang  1 , Changtai Zhu  2
Affiliations

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

Lin Fan et al. Front Microbiol. .

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.

Keywords: SAT-TB; Xpert MTB/RIF; culture; diagnostic performance; parallel tests; pulmonary tuberculosis; smear-negative.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
The positive rates of culture, Xpert MB/RIF and SAT-TB in different specimen types. BALF, bronchoalveolar lavage fluid.
FIGURE 2
FIGURE 2
MTB loads according to Xpert MTB/RIF results. BALF, bronchoalveolar lavage fluid.
FIGURE 3
FIGURE 3
Positive rates of parallel tests using culture, Xpert MB/RIF, and SAT-TB in different specimen types. BALF, bronchoalveolar lavage fluid.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Afsar I., Afsar F. S. (2016). Evaluation of laboratory diagnosis for cutaneous tuberculosis. Indian J. Pathol. Microbiol. 59 274–278. 10.4103/0377-4929.188132 - DOI - PubMed
    1. Amaral L., van Soolingen D. (2015). A novel advanced laboratory diagnosis to guide tuberculosis drug therapy. Recent Pat. Antiinfect. Drug Discov. 10 71–73. 10.2174/1574891X10666150803153138 - DOI - PubMed
    1. Barnard M., Warren R., Gey Van Pittius N., van Helden P., Bosman M., Streicher E., et al. (2012). Genotype MTBDRsl line probe assay shortens time to diagnosis of extensively drug-resistant tuberculosis in a high-throughput diagnostic laboratory. Am. J. Respir. Crit. Care Med. 186 1298–1305. 10.1164/rccm.201205-0960OC - DOI - PubMed
    1. Bhirud P., Joshi A., Hirani N., Chowdhary A. (2017). Rapid laboratory diagnosis of pulmonary tuberculosis. Int. J. Mycobacteriol. 6 296–301. 10.4103/ijmy.ijmy_61_17 - DOI - PubMed
    1. Brent A. J., Mugo D., Musyimi R., Mutiso A., Morpeth S., Levin M., et al. (2011). Performance of the MGIT TBc identification test and meta-analysis of MPT64 assays for identification of the Mycobacterium tuberculosis complex in liquid culture. J. Clin. Microbiol. 49 4343–4346. 10.1128/JCM.05995-11 - DOI - PMC - PubMed