Diagnosing childhood pulmonary tuberculosis using a single sputum specimen on Xpert MTB/RIF at point of care

South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
Natasha GousW S Stevens

Abstract

The GeneXpertMTB/RIF (Cepheid, USA) (Xpert) has proved successful for pulmonary tuberculosis (TB) diagnosis on decontaminated/concentrated induced sputum specimens from children. Capacity to perform induction in many settings is limited. To assess: (i) volumes of 'routinely obtained' sputum in a district-level academic hospital; (ii) whether sputum specimens not meeting Xpert-required testing volumes could still be tested; and (iii) performance of Xpert on a single paediatric sputum specimen at point of care (POC). Two sputa were collected from paediatric TB suspects (£14 years) at Rahima Moosa Mother and Child Hospital, Johannesburg, South Africa. One specimen was weighed at POC; if the volume was ≥0.1 mL but <0.5 mL, it was increased to 0.5 mL using saline. On-site Xpert testing (G3 cartridge) was performed by a dedicated laboratory technician. The second specimen was referred for TB smear microscopy and culture as per standard of care (SOC). A total of 484 patients presumed to have TB (median age 24 months) were eligible for this study, performed between June 2011 and May 2012. Xpert could not be used on 4.1% of specimens because of volumes<0.1 mL, and 62.8% required addition of saline prior to Xpert testing. Xpert generated...Continue Reading

Citations

Feb 6, 2018·Experimental and Therapeutic Medicine·Lu ChengJing Wang
Aug 28, 2020·The Cochrane Database of Systematic Reviews·Alexander W KayAnna M Mandalakas
Jan 7, 2017·Current Opinion in HIV and AIDS·Lesley ScottChristopher M Gilpin
Mar 1, 2021·Archives of Microbiology·Anwar Sheed KhanMuhammad Irfan
Nov 7, 2021·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Wentzel Bruce DowlingPieter Nel

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