Accuracy and incremental yield of urine Xpert MTB/RIF Ultra versus Determine TB-LAM for diagnosis of pulmonary tuberculosis

被引：26

作者：

Andama, A. ^{[1
,2
]}

Jaganath, D. ^{[3
,4
,5
]}

Crowder, R. ^{[3
,5
]}

Asege, L. ^{[2
]}

Nakaye, M. ^{[2
]}

Katumba, D. ^{[2
]}

Mwebe, S. ^{[2
]}

Semitala, F. ^{[1
,2
]}

Worodria, W. ^{[1
,6
]}

Joloba, M. ^{[7
]}

Mohanty, S. ^{[8
]}

Somoskovi, A. ^{[9
]}

Cattamanchi, A. ^{[3
,5
,10
,11
]}

机构：

[1] Makerere Univ, Dept Internal Med, Coll Hlth Sci, Kampala, Uganda

[2] Infect Dis Res Collaborat, Kampala, Uganda

[3] Univ Calif San Francisco, Dept Med, Div Pulm & Crit Care Med, San Francisco, CA 94143 USA

[4] Univ Calif San Francisco, Dept Pediat, Div Pediat Infect Dis, San Francisco, CA USA

[5] Univ Calif San Francisco, Ctr TB, San Francisco, CA 94143 USA

[6] Mulago Natl Referral Hosp, Kampala, Uganda

[7] Makerere Univ, Dept Med Microbiol, Coll Hlth Sci, Kampala, Uganda

[8] Univ Utah, Dept Met Engn, Dept Chem Engn, Salt Lake City, UT 84112 USA

[9] Global Good Intellectual Ventures Lab, Seattle, WA USA

[10] Univ Calif San Francisco, Dept Med, Ctr Vulnerable Populat, San Francisco, CA 94143 USA

[11] Univ Calif San Francisco, Curry Int TB Ctr, San Francisco, CA 94143 USA

来源：

DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE | 2020年 / 96卷 / 01期

基金：

美国国家卫生研究院;

关键词：

Tuberculosis; Diagnostics; Urine; Xpert ultra; Lipoarabinomannan; RAPID DIAGNOSIS;

D O I：

10.1016/j.diagmicrobio.2019.114892

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

The performance of urine Xpert MTB/RIF Ultra (Xpert Ultra) for pulmonary TB diagnosis is unknown. HIV-positive and HIV-negative adults were enrolled at two health facilities in Kampala, Uganda. We compared the accuracy of urine Xpert Ultra and Determine TB-LAM in reference to sputum-based testing (positive Xpert MTB/RIF or culture), and assessed incremental yield. Urine Xpert Ultra had low sensitivity (17.2%, 95% CI 12.3-23.2) but high specificity (98.1%, 95% CI 94.4-99.6). Sensitivity reached 50.0% (95% CI 28.2-71.8) among HIV-positive patients with CD4 <100 cells/mu L. Compared to Determine TB-LAM, urine Xpert Ultra was 9.4% (95% CI 3.8-14.9, P = 0.01) more sensitive, and 17.2% (95% CI 4.5-29.8, P = 0.01) more sensitive among HIV-positive patients. However, the incremental sensitivity of urine Xpert Ultra relative to sputum Xpert MTB/RIF was only 1% (95% CI -0.9 to 2.8). Urine Xpert Ultra could be an alternative for patients with advanced HIV infection unable to produce sputum. (C) 2019 Elsevier Inc. All rights reserved.

引用

页数：6

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