ABSTRACT
BACKGROUND: According to reports, between 30 and 40 percent of extrapulmonary tuberculosis (EPTB) cases are caused by urinary tract tuberculosis (UTB). It is critical to identify UTB quickly since it frequently precedes delayed medical attention, which can have detrimental effects. This study examined the use of Xpert MTB/RIF, a PCR test that can detect MTB as well as resistance to an important drug, rifampicin (RIF), in UTB particularly, for the early identification of UTB. METHODS: 180 participants with clinically presumptive UTB whose urine samples were chosen for urine sediment smear, culture, Xpert MTB/RIF, and TB-DNA testing at Henan Chest Hospital between January 2019 and July 2022. Evaluation of test performance using Composite Reference Standards (CRSs). We studied and compared the positivity rate for various tests using the t-test. The effectiveness of smear, culture, Xpert MTB/RIF, and TB-DNA was assessed using McNemar test. RESULTS: In this subject, a total of 108 participants were diagnosed with UTB, and the positivity rate was 67.1%. Compared with CRS, the positivity rate of Xpert MTB/RIF, smear, culture, and TB-DNA was 29.69% (19/64, P < 0.001), 7.56% (9/119, P < 0.1), 12.12% (4/33, P > 0.05), and 18.75% (6/32, P < 0.1), respectively. The sensitivity of Xpert MTB/RIF assay was significantly better than that of smear and culture tests (78.9% vs. 77.8%, P < 0.05; 78.9% vs. 75%, P < 0.05). Under CRS, the positivity rate for Xpert, culture, and TB-DNA was 31.6% (6/19, P < 0.1), 6.2% (1/16, P > 0.05), and 26.7% (4/15, P > 0.05) for TB-DNA, respectively, compared to smear negative. Xpert MTB/RIF assay specificity was significant for culture and TB-DNA (53.6% vs. 25%, P < 0.01; 53.6% vs. 38.9%, P < 0.05), and Xpert MTB/RIF assay FPV was significant for culture and TB-DNA (53.6% vs. 0%, P < 0.001; 53.6% vs. 0%, P < 0.001). CONCLUSION: Xpert MTB/RIF outperforms smear, cultures, and TB-DNA in detecting UTB, plus Xpert MTB/RIF is better suited for early diagnosis in smear-negative UTB.
Subject(s)
Mycobacterium tuberculosis , Tuberculosis, Pulmonary , Humans , Rifampin/pharmacology , Tuberculosis, Pulmonary/diagnosis , Mycobacterium tuberculosis/genetics , Drug Resistance, Bacterial/genetics , Sensitivity and Specificity , Early Diagnosis , SputumABSTRACT
BACKGROUND: This paper aims to explore the application value of tuberculosis-specific enzyme-linked immunospot assay (T-SPOT.TB) in the diagnosis of tuberculosis. METHODS: Fifty one patients with tuberculosis (TB) admitted to Wuxi No.5 People's Hospital, Wuxi, China from June 2015 to June 2017 were selected as the TB group, and 40 patients without tuberculosis admitted in the same period were randomly selected as the non-TB group. Patients in the two groups received T-SPOT.TB, TB antibody (TB-Ab) test and mycobacterium TB deoxyribonucleic acid (TB-DNA) test, and the results were compared. RESULTS: Comparisons of the sensitivity of the three methods showed that the sensitivity of T-SPOT.TB was the highest, followed by TB-DNA from sputum samples, and that of TB-Ab was the lowest. The specificity of TB-Ab was the highest, followed by T-SPOT.TB, and that of TB-DNA from sputum samples was the lowest. In the receiver operating characteristic (ROC) curve analysis, the area under curve (AUC) of T-SPOT.TB (0.896) was the highest, followed by TB-DNA from sputum samples (0.772), and that of sputum smears (0.698) was the lowest. CONCLUSION: T-SPOT.TB can quickly and accurately determine the presence of tuberculosis infection, and it is a non-invasive examination, which can further assist in the diagnosis and guide the treatment.
ABSTRACT
Objective To investigate the value of quantitative TB‐DNA test ,interferon gamma release test and the detection of tuberculosis antibodies for the diagnosis of active pulmonary tuberculosis .Methods 51 patients were diagnosed as tuberculosis from 2013 July to 2014 June in the hospital ,whose sputum smear microscopy for acid fast bacilli were positive .Then TB‐DNA quantitative test ,interferon gamma release test (T‐SPOT .TB)and tuberculosis antibody detection were performed for those pa‐tients .All the result were retrospectively analysed .Results The positive rate of T‐SPOT .TB was 90 .1% ,the positive rate of quan‐titative TB‐DNA test was 74 .5% and the positive rate of tuberculosis antibody detection was 37 .3% .Conclusion Because the re‐sult of T‐SPOT .TB is not affected by the process of specimen collection ,it is the most sensitive test of the three tests at present , and has higher value in the auxiliary diagnosis of active pulmonary tuberculosis than the other two .
ABSTRACT
A novel sandwich-hybridization assay for simultaneous electrochemical detection of multiple DNA targets related to human immune deficiency virus (HIV) and tuberculosis (TB) was developed based on the different quantum dots-PowerVision(TM) polymer nanotracers. The polymer nanotracers were respectively fabricated by immobilizing SH-labeled oligonucleotides (s-HIV or s-TB), which can partially hybrid with virus DNA (HIV or TB), on gold nanoparticles (Au NPs) and then modified with PowerVision(TM) (PV) polymer-encapsulated quantum dots (CdS or PbS) as signal tags. PV is a dendrimer enzyme linked polymer, which can immobilize abundant QDs to amplify the stripping voltammetry signals from the metal ions (Pb or Cd). The capture probes were prepared through the immobilization of SH-labeled oligonucleotides, which can complementary with HIV and TB DNA, on the magnetic Fe3O4@Au (GMPs) beads. After sandwich-hybridization, the polymer nanotracers together with HIV and TB DNA targets were simultaneously introduced onto the surface of GMPs. Then the two encoding metal ions (Cd(2+) and Pb(2+)) were used to differentiate two viruses DNA due to the different subsequent anodic stripping voltammetric peaks at -0.84 V (Cd) and -0.61 V (Pb). Because of the excellent signal amplification of the polymer nanotracers and the great specificity of DNA targets, this assay could detect targets DNA as low as 0.2 femtomolar and exhibited excellent selectivity with the dynamitic range from 0.5 fM to 500 pM. Those results demonstrated that this electrochemical coding assay has great potential in applications for screening more viruses DNA while changing the probes.
Subject(s)
DNA, Bacterial/isolation & purification , DNA, Viral/isolation & purification , HIV Infections/diagnosis , HIV/genetics , Mycobacterium/genetics , Nucleic Acid Hybridization/methods , Tuberculosis/diagnosis , Biosensing Techniques/methods , DNA, Bacterial/genetics , DNA, Viral/genetics , HIV Infections/virology , Humans , Limit of Detection , Polymers/chemistry , Quantum Dots/chemistry , Quantum Dots/ultrastructure , Tuberculosis/microbiologyABSTRACT
Objective To evaluate the diagnostic value of Tuberculosis Infection in T Cell Test(T‐SPOT .TB) for smear negative pulmonary tuberculosis .Methods Separately used T‐SPOT .TB ,TB‐DNA ,TB‐DOT the three diagnostic methods for tuberculosis , separately detected with each method ,112 smear negative pulmonary tuberculosis ,and 60 non tuberculosis regarded as control group .Results The sensitivity of T‐SPOT .TB ,TB‐DNA ,TB‐DOT in proper sequence were 88 .3% ,25 .9% ,58 .9% .Contrasted to TB‐DNA and TB‐DOT ,the differences were statistically significant(X2 =86 .6 ,P<0 .01 ;X2 =23 .3 ,P<0 .01);the specificity of T‐SPOT .TB was 96 .7% ,significantly higher than TB‐DOT (78 .3% ) ,the differences were statistically significant(X2 = 9 .22 ,P<0 .05) .Conclusion T‐SPOT .TB has obvious advantages in sensitivity and specificity for smear negative pulmonary tuberculosis .It can be one auxiliary tool for smear negative pulmonary tuberculosis early diagnosis ,provided with the value of fast and accurate .
