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. 2022 Jun 20;37(1):398.
doi: 10.4102/sajid.v37i1.398. eCollection 2022.

Xpert MTB/RIF Ultra and mycobacterial culture in routine clinical care at a paediatric hospital

Anthony K Enimil  1   2 , James J C Nuttall  3   4 , Chad M Centner  5   6 , Natalie Beylis  5 , Brian S Eley  3   4
Affiliations

Xpert MTB/RIF Ultra and mycobacterial culture in routine clinical care at a paediatric hospital

Anthony K Enimil et al. S Afr J Infect Dis. .

Abstract

Background: Microbiological confirmation of pulmonary tuberculosis (PTB) in children is a well-documented challenge. This study evaluated Xpert Mycobacterium Tuberculosis (MTB)/Rifampicin (RIF) Ultra (Ultra) and mycobacterial cultures in routine clinical care at a tertiary paediatric hospital.

Methods: Children treated for PTB and who had at least one respiratory specimen investigated by Ultra and mycobacterial culture before tuberculosis (TB) treatment was commenced were included. The findings of this retrospective study were summarised using descriptive and inferential statistics.

Results: A total of 174 children were included. The median age was 2.5 years. Microcytic anaemia, airway compression, cavitary disease and miliary TB were significantly observed in children with microbiologically confirmed TB (cTB). Tuberculosis was microbiologically confirmed in 93 (53.4%) children. The positive yield from testing the first respiratory specimens was 68/174 (39.1%) on Ultra and 82/174 (47.1%) on combined Ultra and mycobacterial culture. In the subset of children (n = 70) tested with Ultra on two sequential respiratory specimens, the incremental yield from the second specimen was 30.3%. In the subset of children (n = 16) tested with Ultra on three sequential respiratory specimens, the incremental yield from the second and third specimens was 16.7% and 0.0%, respectively. When Ultra and mycobacterial culture results were combined, the incremental yield in children who had two sequential respiratory specimens tested was 24.4% and 3.1% on Ultra and mycobacterial culture, respectively.

Conclusion: Ultra and mycobacterial culture on a single respiratory specimen resulted in a high microbiological yield. Ultra-testing on a second respiratory specimen increased the yield of microbiologically cTB. Additional diagnostic testing may require further study.

Keywords: Xpert MTB/RIF Ultra; diagnosing childhood tuberculosis; incremental yield; microcytic anaemia; mycobacterial culture; respiratory specimen.

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Conflict of interest statement

The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.

Figures

FIGURE 1
FIGURE 1
Selection of children with confirmed and unconfirmed pulmonary tuberculosis for data analysis.
See this image and copyright information in PMC

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