Sharma Vishal, Singh Anoop, Gaur Mohita, Rawat Deepti, Yadav Anjali, Kumar Chanchal, Varma-Basil Mandira, Lohiya Sheelu, Khanna Vishal, Khanna Ashwani, Chaudhry Anil, Singh Yogendra, Misra Richa
Department of Zoology, University of Delhi, Delhi, 110007, India.
Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, 110007, India.
Eur J Clin Microbiol Infect Dis. 2022 Jun;41(6):893-906. doi: 10.1007/s10096-022-04449-w. Epub 2022 May 4.
Precise and timely detection of tuberculosis (TB) is crucial to reduce transmission. This study aims to assess the accuracy of Xpert MTB/RIF Ultra on stool samples and systematically review the performance of Xpert MTB/RIF Ultra with different sample types by meta-analysis. Stool samples of smear-negative pulmonary TB (PTB), cervical lymph node TB, and abdominal TB patients were tested on the Xpert MTB/RIF Ultra system. Meta-analysis was performed on a set of 44 studies. Data were grouped by sample type, and the pooled sensitivity and specificity of Xpert MTB/RIF Ultra were calculated. The sensitivity of Xpert MTB/RIF Ultra with stool samples was 100% for smear-negative PTB, 27.27% for cervical lymph node TB, and 50% for abdominal TB patients, with 100% specificity for all included TB groups. The summary estimate for all PTB samples showed 84.2% sensitivity and 94.5% specificity, and EPTB samples showed 88.6% sensitivity and 96.4% specificity. Among all sample types included in our meta-analysis, urine showed the best performance for EPTB diagnosis. This pilot study supports the use of stool as an alternative non-invasive sample on Xpert MTB/RIF Ultra for rapid testing, suitable for both PTB and EPTB diagnosis.
准确及时地检测结核病对于减少传播至关重要。本研究旨在评估Xpert MTB/RIF Ultra对粪便样本的检测准确性，并通过荟萃分析系统评价其在不同样本类型中的性能。对涂片阴性肺结核（PTB）、颈部淋巴结结核和腹部结核患者的粪便样本进行Xpert MTB/RIF Ultra系统检测。对44项研究进行荟萃分析。数据按样本类型分组，计算Xpert MTB/RIF Ultra的合并敏感性和特异性。Xpert MTB/RIF Ultra对涂片阴性PTB粪便样本的敏感性为100%，对颈部淋巴结结核为27.27%，对腹部结核患者为50%，所有纳入的结核组特异性均为100%。所有PTB样本的汇总估计显示敏感性为84.2%，特异性为94.5%，肺外结核（EPTB）样本显示敏感性为88.6%，特异性为96.4%。在我们荟萃分析纳入的所有样本类型中，尿液对EPTB诊断表现最佳。这项初步研究支持将粪便作为Xpert MTB/RIF Ultra上的一种替代非侵入性样本用于快速检测，适用于PTB和EPTB诊断。
