Evaluation of Xpert MTB/RIF Versus AFB Smear and Culture to Identify Pulmonary Tuberculosis in Patients With Suspected Tuberculosis From Low and Higher Prevalence Settings

Luetkemeyer, Anne F.; Firnhaber, Cynthia; Kendall, Michelle A.; Wu, Xingye; Mazurek, Gerald H.; Benator, Debra A.; Arduino, Roberto; Fernandez, Michel; Guy, Elizabeth; Johnson, Pamela; Metchock, Beverly; Sattler, Fred; Telzak, Edward; Wang, Yun F.; Weiner, Marc; Swindells, Susan; Sanne, Ian M.; Havlir, Diane V.; Grinsztejn, Beatriz; Alland, David

Evaluation of Xpert MTB/RIF Versus AFB Smear and Culture to Identify Pulmonary Tuberculosis in Patients With Suspected Tuberculosis From Low and Higher Prevalence Settings

Detalhes bibliográficos
Autor(a) principal:	Luetkemeyer, Anne F.
Data de Publicação:	2016
Outros Autores:	Firnhaber, Cynthia, Kendall, Michelle A., Wu, Xingye, Mazurek, Gerald H., Benator, Debra A., Arduino, Roberto, Fernandez, Michel, Guy, Elizabeth, Johnson, Pamela, Metchock, Beverly, Sattler, Fred, Telzak, Edward, Wang, Yun F., Weiner, Marc, Swindells, Susan, Sanne, Ian M., Havlir, Diane V., Grinsztejn, Beatriz, Alland, David
Tipo de documento:	Artigo
Idioma:	eng
Título da fonte:	Repositório Institucional da FIOCRUZ (ARCA)
DOI:	10.1093/cid/ciw035
Texto Completo:	https://arca.fiocruz.br/handle/icict/29439
Resumo:	AIDS Clinical Trials Group A5295 and Tuberculosis Trials Consortium Study 34 Teams.

Metadados do item

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spelling	Luetkemeyer, Anne F.Firnhaber, CynthiaKendall, Michelle A.Wu, XingyeMazurek, Gerald H.Benator, Debra A.Arduino, RobertoFernandez, MichelGuy, ElizabethJohnson, PamelaMetchock, BeverlySattler, FredTelzak, EdwardWang, Yun F.Weiner, MarcSwindells, SusanSanne, Ian M.Havlir, Diane V.Grinsztejn, BeatrizAlland, David2018-10-08T18:25:56Z2018-10-08T18:25:56Z2016LUETKEMEYER, Anne. F. et al. Evaluation of Xpert MTB/RIF Versus AFB Smear and Culture to Identify Pulmonary Tuberculosis in Patients With Suspected Tuberculosis From Low and Higher Prevalence Settings. Clinical Infectious Diseases, v. 62, n. 9, p. 1081–1088, May 2016.1058-4838https://arca.fiocruz.br/handle/icict/2943910.1093/cid/ciw0351537-6591AIDS Clinical Trials Group A5295 and Tuberculosis Trials Consortium Study 34 Teams.This work was supported by the National Institute of Allergy and Infectious Diseases through the ACTG (grant numbers AI068634, U01AI068636, and UM1 AI106701); the CDC through the TBTC and the Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STD, and TB Prevention; the National Institute of Mental Health, and the National Institute of Dental and Craniofacial Research.Division of HIV, Infectious Diseases and Global Medicine. San Francisco General Hospital. University of California. USA.Clinical HIV Research Unit Department of Internal Medicine. Faculty of Health Sciences. University of the Witwatersrand Right to Care. Johannesburg, South Africa.Center for Biostatistics in AIDS Research. Harvard T.H. Chan School of Public Health. Boston, Massachusetts.Center for Biostatistics in AIDS Research. Harvard T.H. Chan School of Public Health. Boston, Massachusetts.Division of Tuberculosis Elimination. Centers for Disease Control and Prevention. Atlanta, Georgia.Infectious Diseases Section. Veterans Affairs Medical Center and The George Washington University. Washington, DC, USA.Department of Internal Medicine. Division of Infectious Diseases. The University of Texas Health Science Center at Houston. Houston, USA.University of North Texas Health Science Center. Tarrant County Health Department. Fort Worth, USA.Section of Pulmonary Critical Care and Sleep Medicine. Baylor College of Medicine. Ben Taub General Hospital. Houston, Texas, USA.Cepheid. Sunnyvale.Division of Tuberculosis Elimination. Centers for Disease Control and Prevention. Atlanta, Georgia, USA.Division of Infectious Diseases. Keck School of Medicine of USC. Los Angeles, California, USA.St. Barnabus Hospital Health System. Albert Einstein College of Medicine. Bronx, New York, USA.Emory University School of Medicine. Grady Memorial Hospital. Atlanta, Georgia, USA.Department of Medicine. University of Texas Health Science Center. Veterans Administration Medical Center. San Antonio, USA.Internal Medicine/Infectious Diseases. University of Nebraska Medical Center. Lincoln, USA.Right to Care. Johannesburg, South Africa Department of Internal Medicine. Faculty of Health Sciences. University of the Witwatersrand. Johannesburg, South Africa.Division of HIV. Infectious Diseases and Global Medicine. San Francisco General Hospital. University of California. USA.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Division of Infectious Disease. Rutgers New Jersey Medical School. Newark, USA.Background: The Xpert MTB/RIF (Xpert) assay is a rapid nucleic acid amplification test widely used in settings of high tuberculosis prevalence to detect tuberculosis as well asrpoBmutations associated with rifampin resistance. Data are needed on the diagnostic performance of Xpert in lower-prevalence settings to inform appropriate use for both tuberculosis detection and the need for respiratory isolation. Methods: Xpert was compared to 2 sputum samples, each evaluated with acid-fast bacilli (AFB) smear and mycobacterial culture using liquid and solid culture media, from participants with suspected pulmonary tuberculosis from the United States, Brazil, and South Africa. Results: Of 992 participants enrolled with evaluable results, 22% had culture-confirmed tuberculosis. In 638 (64%) US participants, 1 Xpert result demonstrated sensitivity of 85.2% (96.7% in participants with AFB smear-positive [AFB(+)] sputum, 59.3% with AFB smear-negative [AFB(-)] sputum), specificity of 99.2%, negative predictive value (NPV) of 97.6%, and positive predictive value of 94.9%. Results did not differ between higher- and low-prevalence settings. A second Xpert assay increased overall sensitivity to 91.1% (100% if AFB(+), 71.4% if AFB(-)), with specificity of 98.9%. In US participants, a single negative Xpert result predicted the absence of AFB(+)/culture-positive tuberculosis with an NPV of 99.7%; NPV of 2 Xpert assays was 100%, suggesting a role in removing patients from airborne infection isolation. Xpert detected tuberculosis DNA and mutations associated with rifampin resistance in 5 of 7 participants with rifampin-resistant, culture-positive tuberculosis. Specificity for rifampin resistance was 99.5% and NPV was 98.9%. Conclusions: In the United States, Xpert testing performed comparably to 2 higher-tuberculosis-prevalence settings. These data support the use of Xpert in the initial evaluation of tuberculosis suspects and in algorithms assessing need for respiratory isolation. Keywords: HIV/tuberculosis coinfection; Xpert MTB/RIF; nontuberculous mycobacteria; respiratory isolation; tuberculosis diagnosis.engOxfordEvaluation of Xpert MTB/RIF Versus AFB Smear and Culture to Identify Pulmonary Tuberculosis in Patients With Suspected Tuberculosis From Low and Higher Prevalence Settingsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleXpert MTB/RIFTuberculosis diagnosisRespiratory isolationNontuberculous mycobacteriaHIV/tuberculosis coinfectioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-82991https://arca.fiocruz.br/bitstreams/82057d05-e4cd-4175-8a74-503606a0e50f/download5a560609d32a3863062d77ff32785d58MD53falseAnonymousREADORIGINALve_Anne F. Luetkemeyer_etal_INI_2016.pdfve_Anne F. 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dc.title.none.fl_str_mv	Evaluation of Xpert MTB/RIF Versus AFB Smear and Culture to Identify Pulmonary Tuberculosis in Patients With Suspected Tuberculosis From Low and Higher Prevalence Settings
title	Evaluation of Xpert MTB/RIF Versus AFB Smear and Culture to Identify Pulmonary Tuberculosis in Patients With Suspected Tuberculosis From Low and Higher Prevalence Settings
spellingShingle	Evaluation of Xpert MTB/RIF Versus AFB Smear and Culture to Identify Pulmonary Tuberculosis in Patients With Suspected Tuberculosis From Low and Higher Prevalence Settings Luetkemeyer, Anne F. Xpert MTB/RIF Tuberculosis diagnosis Respiratory isolation Nontuberculous mycobacteria HIV/tuberculosis coinfection
title_short	Evaluation of Xpert MTB/RIF Versus AFB Smear and Culture to Identify Pulmonary Tuberculosis in Patients With Suspected Tuberculosis From Low and Higher Prevalence Settings
title_full	Evaluation of Xpert MTB/RIF Versus AFB Smear and Culture to Identify Pulmonary Tuberculosis in Patients With Suspected Tuberculosis From Low and Higher Prevalence Settings
title_fullStr	Evaluation of Xpert MTB/RIF Versus AFB Smear and Culture to Identify Pulmonary Tuberculosis in Patients With Suspected Tuberculosis From Low and Higher Prevalence Settings
title_full_unstemmed	Evaluation of Xpert MTB/RIF Versus AFB Smear and Culture to Identify Pulmonary Tuberculosis in Patients With Suspected Tuberculosis From Low and Higher Prevalence Settings
title_sort	Evaluation of Xpert MTB/RIF Versus AFB Smear and Culture to Identify Pulmonary Tuberculosis in Patients With Suspected Tuberculosis From Low and Higher Prevalence Settings
author	Luetkemeyer, Anne F.
author_facet	Luetkemeyer, Anne F. Firnhaber, Cynthia Kendall, Michelle A. Wu, Xingye Mazurek, Gerald H. Benator, Debra A. Arduino, Roberto Fernandez, Michel Guy, Elizabeth Johnson, Pamela Metchock, Beverly Sattler, Fred Telzak, Edward Wang, Yun F. Weiner, Marc Swindells, Susan Sanne, Ian M. Havlir, Diane V. Grinsztejn, Beatriz Alland, David
author_role	author
author2	Firnhaber, Cynthia Kendall, Michelle A. Wu, Xingye Mazurek, Gerald H. Benator, Debra A. Arduino, Roberto Fernandez, Michel Guy, Elizabeth Johnson, Pamela Metchock, Beverly Sattler, Fred Telzak, Edward Wang, Yun F. Weiner, Marc Swindells, Susan Sanne, Ian M. Havlir, Diane V. Grinsztejn, Beatriz Alland, David
author2_role	author author author author author author author author author author author author author author author author author author author
dc.contributor.author.fl_str_mv	Luetkemeyer, Anne F. Firnhaber, Cynthia Kendall, Michelle A. Wu, Xingye Mazurek, Gerald H. Benator, Debra A. Arduino, Roberto Fernandez, Michel Guy, Elizabeth Johnson, Pamela Metchock, Beverly Sattler, Fred Telzak, Edward Wang, Yun F. Weiner, Marc Swindells, Susan Sanne, Ian M. Havlir, Diane V. Grinsztejn, Beatriz Alland, David
dc.subject.en.none.fl_str_mv	Xpert MTB/RIF Tuberculosis diagnosis Respiratory isolation Nontuberculous mycobacteria HIV/tuberculosis coinfection
topic	Xpert MTB/RIF Tuberculosis diagnosis Respiratory isolation Nontuberculous mycobacteria HIV/tuberculosis coinfection
description	AIDS Clinical Trials Group A5295 and Tuberculosis Trials Consortium Study 34 Teams.
publishDate	2016
dc.date.issued.fl_str_mv	2016
dc.date.accessioned.fl_str_mv	2018-10-08T18:25:56Z
dc.date.available.fl_str_mv	2018-10-08T18:25:56Z
dc.type.status.fl_str_mv	info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv	info:eu-repo/semantics/article
format	article
status_str	publishedVersion
dc.identifier.citation.fl_str_mv	LUETKEMEYER, Anne. F. et al. Evaluation of Xpert MTB/RIF Versus AFB Smear and Culture to Identify Pulmonary Tuberculosis in Patients With Suspected Tuberculosis From Low and Higher Prevalence Settings. Clinical Infectious Diseases, v. 62, n. 9, p. 1081–1088, May 2016.
dc.identifier.uri.fl_str_mv	https://arca.fiocruz.br/handle/icict/29439
dc.identifier.issn.none.fl_str_mv	1058-4838
dc.identifier.doi.none.fl_str_mv	10.1093/cid/ciw035
dc.identifier.eissn.none.fl_str_mv	1537-6591
identifier_str_mv	LUETKEMEYER, Anne. F. et al. Evaluation of Xpert MTB/RIF Versus AFB Smear and Culture to Identify Pulmonary Tuberculosis in Patients With Suspected Tuberculosis From Low and Higher Prevalence Settings. Clinical Infectious Diseases, v. 62, n. 9, p. 1081–1088, May 2016. 1058-4838 10.1093/cid/ciw035 1537-6591
url	https://arca.fiocruz.br/handle/icict/29439
dc.language.iso.fl_str_mv	eng
language	eng
dc.rights.driver.fl_str_mv	info:eu-repo/semantics/openAccess
eu_rights_str_mv	openAccess
dc.publisher.none.fl_str_mv	Oxford
publisher.none.fl_str_mv	Oxford
dc.source.none.fl_str_mv	reponame:Repositório Institucional da FIOCRUZ (ARCA) instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ
instname_str	Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str	FIOCRUZ
institution	FIOCRUZ
reponame_str	Repositório Institucional da FIOCRUZ (ARCA)
collection	Repositório Institucional da FIOCRUZ (ARCA)
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Evaluation of Xpert MTB/RIF Versus AFB Smear and Culture to Identify Pulmonary Tuberculosis in Patients With Suspected Tuberculosis From Low and Higher Prevalence Settings

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