TY - JOUR
T1 - A toolbox for tuberculosis diagnosis
T2 - An indian multicentric study (2006-2008): Microbiological results
AU - Lagrange, Philippe H.
AU - Thangaraj, Satheesh K.
AU - Dayal, Rajeshwar
AU - Despande, Alka
AU - Ganguly, Nirmal K.
AU - Girardi, Enrico
AU - Joshi, Beenu
AU - Katoch, Kiran
AU - Katoch, Vishwa M.
AU - Kumar, Manoj
AU - Lakshmi, Vemu
AU - Leportier, Marc
AU - Longuet, Christophe
AU - Malladi, Subbalaxmi V S
AU - Mukerjee, Deepali
AU - Nair, Deepthi
AU - Raja, Alamelu
AU - Raman, Balambal
AU - Rodrigues, Camilla
AU - Sharma, Pratibha
AU - Singh, Amit
AU - Singh, Sarman
AU - Sodha, Archana
AU - Kabeer, Basirudeen Syed Ahamed
AU - Vernet, Guy
AU - Goletti, Delia
PY - 2012/8/24
Y1 - 2012/8/24
N2 - Background: The aim of this multicentric prospective study in India was to assess the value of several microbiological tools that contribute to the diagnosis of tuberculosis (TB) according to HIV status. Methods: Standard microbiological tools on individual specimens were analyzed. Results: Among the 807 patients with active TB, 131 were HIV-infected, 316 HIV-uninfected and 360 had HIV-unknown status. Among the 980 non-active TB subjects, 559 were at low risk and 421 were at high risk of M. tuberculosis (Mtb) exposure. Sensitivity of smear microscopy (SM) was significantly lower in HIV-infected (42.2%) than HIV-uninfected (75.9%) (p = 0.0001) and HIV-unknown pulmonary TB patients (61.4%) (p = 0.004). Specificity was 94.5% in non-TB patients and 100% in health care workers (HCW) and healthy family contacts. Automated liquid culture has significantly higher diagnostic performances than solid culture, measured by sensitivity (74.7% vs. 55.9%) (p = 0.0001) and shorter median time to detection (TTD) (12.0 vs. 34.0 days) (p = 0.0001). Specificity was 100% in HCW and cured-TB patients, but was lower in non-TB patients (89%) due to isolation of Mycobacteria other than tuberculosis (MOTT). TTD by both methods was related to AFB score. Contamination rate was low (1.4%). AccuProbe hybridization technique detected Mtb in almost all culture-positive specimens, but MOTT were found in 4.7% with a significantly higher frequency in HIV-infected (15%) than HIV-uninfected TB patients (0.5%) (p = 0.0007). Pre-test classification significantly increased the diagnostic value of all microbiological tests in pulmonary TB patients (p
AB - Background: The aim of this multicentric prospective study in India was to assess the value of several microbiological tools that contribute to the diagnosis of tuberculosis (TB) according to HIV status. Methods: Standard microbiological tools on individual specimens were analyzed. Results: Among the 807 patients with active TB, 131 were HIV-infected, 316 HIV-uninfected and 360 had HIV-unknown status. Among the 980 non-active TB subjects, 559 were at low risk and 421 were at high risk of M. tuberculosis (Mtb) exposure. Sensitivity of smear microscopy (SM) was significantly lower in HIV-infected (42.2%) than HIV-uninfected (75.9%) (p = 0.0001) and HIV-unknown pulmonary TB patients (61.4%) (p = 0.004). Specificity was 94.5% in non-TB patients and 100% in health care workers (HCW) and healthy family contacts. Automated liquid culture has significantly higher diagnostic performances than solid culture, measured by sensitivity (74.7% vs. 55.9%) (p = 0.0001) and shorter median time to detection (TTD) (12.0 vs. 34.0 days) (p = 0.0001). Specificity was 100% in HCW and cured-TB patients, but was lower in non-TB patients (89%) due to isolation of Mycobacteria other than tuberculosis (MOTT). TTD by both methods was related to AFB score. Contamination rate was low (1.4%). AccuProbe hybridization technique detected Mtb in almost all culture-positive specimens, but MOTT were found in 4.7% with a significantly higher frequency in HIV-infected (15%) than HIV-uninfected TB patients (0.5%) (p = 0.0007). Pre-test classification significantly increased the diagnostic value of all microbiological tests in pulmonary TB patients (p
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U2 - 10.1371/journal.pone.0043739
DO - 10.1371/journal.pone.0043739
M3 - Article
C2 - 22937088
AN - SCOPUS:84865282683
VL - 7
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 8
M1 - e43739
ER -