Your browser doesn't support javascript.
loading
Multi-centric evaluation of Truenat MTB and MTB-RIF Dx assays for diagnosis of extrapulmonary tuberculosis.
Singh, Urvashi B; Singh, Manjula; Rodrigues, Camilla; Christopher, D J; Mahajan, Neeraj; Srivastav, Abhinav; Singh, Kh Jitenkumar; Kanswal, Sunita; Rao, M V V; Kazi, Mubin; Sawant, Damini; Thangakunam, Balamugesh; Vijay, Coelho Victor; Shankar, Deepa; Bhatnagar, Anuj; Mohan, Anant; Ahuja, Vineet.
Affiliation
  • Singh UB; Department of Microbiology, AIIMS, New Delhi, India. drurvashi@gmail.com.
  • Singh M; Division of Epidemiology and Communicable Diseases, ICMR, New Delhi, India.
  • Rodrigues C; Department of Microbiology, P D Hinduja Hospital, Mumbai, India.
  • Christopher DJ; Department of Pulmonary Medicine, CMC, Vellore, India.
  • Mahajan N; Department of Microbiology, AIIMS, New Delhi, India.
  • Srivastav A; Department of Microbiology, AIIMS, New Delhi, India.
  • Singh KJ; National Institute of Medical Statistics, ICMR, New Delhi, India.
  • Kanswal S; Department of Microbiology, AIIMS, New Delhi, India.
  • Rao MVV; Centralized Core Research Facility, AIIMS, New Delhi, India.
  • Kazi M; National Institute of Medical Statistics, ICMR, New Delhi, India.
  • Sawant D; Department of Microbiology, P D Hinduja Hospital, Mumbai, India.
  • Thangakunam B; Department of Microbiology, P D Hinduja Hospital, Mumbai, India.
  • Vijay CV; Department of Pulmonary Medicine, CMC, Vellore, India.
  • Shankar D; Department of Pulmonary Medicine, CMC, Vellore, India.
  • Bhatnagar A; Department of Pulmonary Medicine, CMC, Vellore, India.
  • Mohan A; Department of Tuberculosis and Chest Diseases, Rajan Babu Institute for Pulmonary Medicine and Tuberculosis, New Delhi, India.
  • Ahuja V; Department of Pulmonary Medicine, AIIMS, New Delhi, India.
Sci Rep ; 14(1): 15680, 2024 07 08.
Article in En | MEDLINE | ID: mdl-38977729
ABSTRACT
Extra-pulmonary TB (EPTB) is difficult to diagnose due to paucibacillary nature of disease. Current study evaluated accuracy of Truenat MTB and MTB-Rif Dx (TN), for detection of Mycobacterium tuberculosis and resistance to rifampicin. Samples were collected from 2103 treatment naive adults with presumptive EPTB, and tested by smear microscopy, liquid culture (LC) (MGIT-960) and GeneXpert MTB/RIF (GX) (Microbiological Reference Standards, MRS). TN results were compared to MRS and Composite Reference Standards (CRS, Microbiology, histopathology, radiology, clinical features prompting decision to treat, response to treatment). CRS grouped patients into 551 confirmed, 1096 unconfirmed, and 409 as unlikely TB. TN sensitivity and specificity was 73.7% and 90.4% against GX. Against LC, Overall sensitivity of GX was 67.6%, while that of TN was 62.3%. Highest sensitivity by TN was observed in pus samples (89%) and highest specificity (92%) in CSF samples, similar to GX. TN sensitivity was better in fluid and biopsy samples and slightly inferior for lymph node aspirates compared to GX. TN sensitivity for RIF resistance detection was slightly superior to GX. TN and GX results were further compared to Clinical Reference Standards. TN detected 170 TB patients initiated on treatment missed by GX, while GX detected 113 such patients missed by TN. Of 124 samples with RIF resistance discordance between GX and TN, GX reported 103/124 as sensitive, 3/124 as indeterminate and 18 as resistant (13/18 samples had low/very low DNA load) while TN reported RIF resistance indeterminate in 103/111 low/very low DNA load samples. Due to paucibacillary nature of EPTB samples, culture yield was poor and phenotypic drug susceptibility testing failed to resolve the discordance. The study establishes TN at par with GX and can be utilized for quick and accurate diagnosis of EPTB.
Subject(s)
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Rifampin / Sensitivity and Specificity / Tuberculosis, Extrapulmonary Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: En Journal: Sci Rep Year: 2024 Document type: Article Affiliation country: India

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Rifampin / Sensitivity and Specificity / Tuberculosis, Extrapulmonary Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: En Journal: Sci Rep Year: 2024 Document type: Article Affiliation country: India