Abstract
Rationale: Microbiological confirmation of pulmonary tuberculosis in children is desirable.Objectives: To investigate the diagnostic accuracy and incremental yield of Xpert MTB/RIF Ultra (Ultra; Cepheid), a new rapid test, on repeated induced sputum, nasopharyngeal aspirates, and combinations of specimens.Methods: Consecutive South African children hospitalized with suspected pulmonary tuberculosis were enrolled.Measurements and Main Results: Induced sputum (IS) and nasopharyngeal aspirates (NPAs) were obtained. NPAs were frozen; IS underwent liquid culture, and an aliquot was frozen. Ultra was performed on thawed NPAs and IS specimens individually. Children were categorized as confirmed, unconfirmed, or unlikely tuberculosis according to NIH consensus case definitions. The diagnostic accuracy of Ultra was compared with liquid culture on IS. In total, 195 children (median age: 23.3 mo; 32 [16.4%] HIV-infected) had one IS and NPA, and 130 had two NPAs. There were 40 (20.5%) culture-confirmed cases. Ultra was positive on NPAs in 26 (13.3%) and on IS in 31 (15.9%). Sensitivity and specificity of Ultra on one NPA were 46% and 98%, respectively, and similar by HIV status. Sensitivity and specificity of Ultra on one IS were 74.3% and...Continue Reading
References
Dec 16, 1998·Lancet·L M FranchiP Sheen
Dec 23, 2006·Archives of Disease in Childhood·S OwensJ B S Coulter
Jul 27, 2010·The Lancet Infectious Diseases·Richard A OberhelmanCarlton A Evans
Dec 16, 2010·The Pediatric Infectious Disease Journal·David P MooreShabir A Madhi
Jul 19, 2011·The Lancet Infectious Diseases·Mark P NicolHeather J Zar
Oct 26, 2011·The Journal of Infectious Diseases·Tom G ConnellMark P Nicol
Apr 5, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Andrea RachowMichael Hoelscher
Jul 4, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Heather J ZarMark P Nicol
Nov 9, 2012·The Lancet Infectious Diseases·Matthew BatesAlimuddin Zumla
Aug 12, 2014·The Lancet Global Health·Peter J DoddJames A Seddon
Aug 12, 2014·The Lancet Global Health·Heather J ZarMark P Nicol
Mar 31, 2015·The Lancet. Respiratory Medicine·Anne K DetjenAnna M Mandalakas
Sep 27, 2015·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Stephen M GrahamHeather J Zar
Nov 3, 2016·American Journal of Epidemiology·Samuel G SchumacherHeather J Zar
Aug 31, 2017·MBio·Soumitesh ChakravortyDavid Alland
Dec 5, 2017·The Lancet Infectious Diseases·Susan E DormanUNKNOWN study team
Feb 24, 2018·The Pediatric Infectious Disease Journal·Mark P NicolHeather J Zar
Jul 24, 2018·The Journal of Infection·Issa SabiKlaus Reither
Nov 13, 2018·The Pediatric Infectious Disease Journal·Elisabetta WaltersAnneke C Hesseling
Citations
May 30, 2020·American Journal of Respiratory and Critical Care Medicine
Aug 28, 2020·The Cochrane Database of Systematic Reviews·Alexander W KayAnna M Mandalakas
Sep 24, 2020·Expert Review of Respiratory Medicine·James A SeddonH Simon Schaaf
Aug 8, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Ben J Marais
Oct 1, 2020·Revista Da Sociedade Brasileira De Medicina Tropical·Rafaela Baroni AurilioClemax Couto Sant'Anna
Mar 17, 2020·American Journal of Respiratory and Critical Care Medicine·Saurav JainJagdish Prasad Goyal
Mar 17, 2020·American Journal of Respiratory and Critical Care Medicine·Heather J Zar
Jun 12, 2020·Journal of Clinical Microbiology·Lin SunAdong Shen
May 26, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·James Gaensbauer
Aug 7, 2019·American Journal of Respiratory and Critical Care Medicine·H Simon Schaaf, Ben J Marais
Jun 5, 2020·Journal of Clinical Microbiology·Willy SsengoobaDiana M Gibb
Apr 18, 2020·Infectious Diseases of Poverty·Li WanCha-Xiang Guan
Jan 9, 2021·Journal of the Pediatric Infectious Diseases Society·Devan JaganathAdithya Cattamanchi
Dec 5, 2020·The Journal of Infection·Xu-Hui LiuShui-Hua Lu
Nov 19, 2020·Infection and Drug Resistance·Guilian LiKanglin Wan
Feb 3, 2021·Scientific Reports·Carly A BobakJane E Hill
Feb 23, 2021·JAMA Pediatrics·Jeffrey R Starke, Andrea T Cruz
Feb 23, 2021·The Cochrane Database of Systematic Reviews·Jerry S ZifodyaDavid J Horne
Sep 29, 2020·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Chunyang LyuYongmei Jiang
Apr 13, 2021·Frontiers in Immunology·Prem PerumalKaren E Kempsell
Sep 14, 2021·Frontiers in Immunology·Ying LuoZiyong Sun
Sep 14, 2021·Frontiers in Pediatrics·Urvashi B SinghSushil K Kabra
Nov 5, 2021·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Xiaoshan PengChaomin Wan
Nov 15, 2021·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Lin SunAdong Shen
Oct 28, 2019·Pediatrics·Heather J Zar, Mark P Nicol