Accuracy of genotype MTBDRplus line probe assay in patients with tuberculous pleural effusion: comparison with clinical and culture based diagnosis.
| Title: | Accuracy of genotype MTBDRplus line probe assay in patients with tuberculous pleural effusion: comparison with clinical and culture based diagnosis. |
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| Authors: | Irfan, Muhammad1 (AUTHOR) muhammad.irfan@aku.edu, Idrees, Farah2 (AUTHOR), Jabeen, Kauser3 (AUTHOR), Zubairi, Ali Bin Sarwar1 (AUTHOR), Butt, Sehrish2 (AUTHOR), Hasan, Rumina3 (AUTHOR) |
| Source: | Infectious Diseases. Apr2020, Vol. 52 Issue 4, p235-241. 7p. 1 Diagram, 3 Charts. |
| Subject Terms: | *PLEURAL effusions, *PLEURISY, *CROSS-cultural studies, *TUBERCULOSIS, *GENOTYPES, *DIAGNOSIS |
| Geographic Terms: | PAKISTAN |
| Abstract: | Background: Pleural tuberculosis (TB) diagnosis is challenging due to paucibacillary disease. Diagnostic accuracy of GenoType MTBDRplus Line Probe Assay (MTBDRplus) has been evaluated in this study for pleural TB diagnosis. Objective: To evaluate diagnostic accuracy of MTBDRplus for pleural TB diagnosis compared to clinical and microbiological diagnosis. Methods: This prospective study was conducted at the Aga Khan University, Pakistan. Pleural fluid from 203 suspected pleural TB patients was collected and tested for smear, culture and MTBDRplus. Diagnostic accuracy of MTBDRplus was determined using clinical diagnosis and culture as the gold standard. Results: Out of 203 TB suspect patients, MTBDRplus, culture and smear were positive in 14 (6. 9%), 27 (13.3%) and 4 (1.9%) cases, respectively. A total of 106/203 patients (27 culture positive and 79 culture negative) successfully completed TB treatment. Considering clinical diagnosis as gold standard, sensitivity of MTBDRplus was 13.2%; 95% CI (7.4–21.2%) and specificity was 100%; 95% CI (96.1–100%). The sensitivity and specificity of MTBDRplus in culture positive samples were 44.4%; 95% CI (25.5–64.7%) and 98.9%; 95% CI (95.9–99.9%), respectively. Excluding indeterminate results, MTBDRplus accurately detected isoniazid sensitivity in 5/6 and rifampicin sensitivity in 6/6 cases. Conclusion: MTBDRplus had a low sensitivity of 13.2% in clinically diagnosed and 44% in culture-confirmed pleural TB patients and therefore could not be included in most diagnostic algorithms. Due to a higher sensitivity than smear, MTBDRplus may have a role in tuberculous pleural effusion diagnosis if it is positive pending culture results and pleural biopsy. [ABSTRACT FROM AUTHOR] |
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| Items | – Name: Title Label: Title Group: Ti Data: Accuracy of genotype MTBDRplus line probe assay in patients with tuberculous pleural effusion: comparison with clinical and culture based diagnosis. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Irfan%2C+Muhammad%22">Irfan, Muhammad</searchLink><relatesTo>1</relatesTo> (AUTHOR)<i> muhammad.irfan@aku.edu</i><br /><searchLink fieldCode="AR" term="%22Idrees%2C+Farah%22">Idrees, Farah</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Jabeen%2C+Kauser%22">Jabeen, Kauser</searchLink><relatesTo>3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Zubairi%2C+Ali+Bin+Sarwar%22">Zubairi, Ali Bin Sarwar</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Butt%2C+Sehrish%22">Butt, Sehrish</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hasan%2C+Rumina%22">Hasan, Rumina</searchLink><relatesTo>3</relatesTo> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Infectious+Diseases%22">Infectious Diseases</searchLink>. Apr2020, Vol. 52 Issue 4, p235-241. 7p. 1 Diagram, 3 Charts. – Name: Subject Label: Subject Terms Group: Su Data: *<searchLink fieldCode="DE" term="%22PLEURAL+effusions%22">PLEURAL effusions</searchLink><br />*<searchLink fieldCode="DE" term="%22PLEURISY%22">PLEURISY</searchLink><br />*<searchLink fieldCode="DE" term="%22CROSS-cultural+studies%22">CROSS-cultural studies</searchLink><br />*<searchLink fieldCode="DE" term="%22TUBERCULOSIS%22">TUBERCULOSIS</searchLink><br />*<searchLink fieldCode="DE" term="%22GENOTYPES%22">GENOTYPES</searchLink><br />*<searchLink fieldCode="DE" term="%22DIAGNOSIS%22">DIAGNOSIS</searchLink> – Name: SubjectGeographic Label: Geographic Terms Group: Su Data: <searchLink fieldCode="DE" term="%22PAKISTAN%22">PAKISTAN</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Background: Pleural tuberculosis (TB) diagnosis is challenging due to paucibacillary disease. Diagnostic accuracy of GenoType MTBDRplus Line Probe Assay (MTBDRplus) has been evaluated in this study for pleural TB diagnosis. Objective: To evaluate diagnostic accuracy of MTBDRplus for pleural TB diagnosis compared to clinical and microbiological diagnosis. Methods: This prospective study was conducted at the Aga Khan University, Pakistan. Pleural fluid from 203 suspected pleural TB patients was collected and tested for smear, culture and MTBDRplus. Diagnostic accuracy of MTBDRplus was determined using clinical diagnosis and culture as the gold standard. Results: Out of 203 TB suspect patients, MTBDRplus, culture and smear were positive in 14 (6. 9%), 27 (13.3%) and 4 (1.9%) cases, respectively. A total of 106/203 patients (27 culture positive and 79 culture negative) successfully completed TB treatment. Considering clinical diagnosis as gold standard, sensitivity of MTBDRplus was 13.2%; 95% CI (7.4–21.2%) and specificity was 100%; 95% CI (96.1–100%). The sensitivity and specificity of MTBDRplus in culture positive samples were 44.4%; 95% CI (25.5–64.7%) and 98.9%; 95% CI (95.9–99.9%), respectively. Excluding indeterminate results, MTBDRplus accurately detected isoniazid sensitivity in 5/6 and rifampicin sensitivity in 6/6 cases. Conclusion: MTBDRplus had a low sensitivity of 13.2% in clinically diagnosed and 44% in culture-confirmed pleural TB patients and therefore could not be included in most diagnostic algorithms. Due to a higher sensitivity than smear, MTBDRplus may have a role in tuberculous pleural effusion diagnosis if it is positive pending culture results and pleural biopsy. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Infectious Diseases is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1080/23744235.2019.1697462 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 7 StartPage: 235 Subjects: – SubjectFull: PAKISTAN Type: general – SubjectFull: PLEURAL effusions Type: general – SubjectFull: PLEURISY Type: general – SubjectFull: CROSS-cultural studies Type: general – SubjectFull: TUBERCULOSIS Type: general – SubjectFull: GENOTYPES Type: general – SubjectFull: DIAGNOSIS Type: general Titles: – TitleFull: Accuracy of genotype MTBDRplus line probe assay in patients with tuberculous pleural effusion: comparison with clinical and culture based diagnosis. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Irfan, Muhammad – PersonEntity: Name: NameFull: Idrees, Farah – PersonEntity: Name: NameFull: Jabeen, Kauser – PersonEntity: Name: NameFull: Zubairi, Ali Bin Sarwar – PersonEntity: Name: NameFull: Butt, Sehrish – PersonEntity: Name: NameFull: Hasan, Rumina IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 04 Text: Apr2020 Type: published Y: 2020 Identifiers: – Type: issn-print Value: 23744235 Numbering: – Type: volume Value: 52 – Type: issue Value: 4 Titles: – TitleFull: Infectious Diseases Type: main |
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