PMID- 29740714
OWN - NLM
STAT- MEDLINE
DCOM- 20181108
LR  - 20181114
IS  - 1435-4373 (Electronic)
IS  - 0934-9723 (Linking)
VI  - 37
IP  - 8
DP  - 2018 Aug
TI  - Xpert MTB/RIF diagnosis of childhood tuberculosis from sputum and stool samples
      in a high TB-HIV-prevalent setting.
PG  - 1465-1473
LID - 10.1007/s10096-018-3272-0 [doi]
AB  - The Xpert MTB/RIF assay is a major advance for diagnosis of tuberculosis (TB) in 
      high-burden countries but is limited in children by their difficulty to produce
      sputum. We investigated TB in sputum and stool from children with the aim of
      improving paediatric TB diagnosis. A prospective cohort of children with
      presumptive TB, provided two sputum or induced sputum at enrolment in a regional 
      referral hospital in Uganda. Stool was collected from those started on TB
      treatment. All specimen were tested for Xpert MTB/RIF, mycobacteria growth
      indicator tube (MGIT), Lowenstein Jensen cultures and microscopy (except stool). 
      We compared TB detection between age categories and assessed the performance of
      Xpert MTB/RIF in sputum and stool. Of the 392 children enrolled, 357 (91.1%)
      produced at least one sputum sample. Sputum culture yield was 13/357 (3.6%):
      3/109 (2.6%), 3/89 (3.2%), 3/101 (2.6%) and 4/44 (8.2%) among children of < 2,
      2-5, >/= 5-10 and > 10 years, respectively (p = 0.599). Xpert MTB/RIF yield was
      14/350 (4.0%): 3/104 (2.9%), 4/92 (4.3%), 3/88 (2.9%) and 4/50 (.0%),
      respectively (p = 0.283). Sensitivity and specificity of Xpert MTB/RIF in sputum 
      against sputum culture were 90.9% (95% CI 58.7-99.8) and 99.1% (99.1-99.8). In
      stool, it was 55.6% (21.2-86.3) and 98.2% (98.2-100) against Xpert MTB/RIF and
      culture in sputum. Only a minority of children had microbiologically confirmed TB
      with a higher proportion in children above 10 years. Although sensitivity of
      Xpert MTB/RIF in stool was low, with good optimization, it might be a good
      alternative to sputum in children.
FAU - Orikiriza, Patrick
AU  - Orikiriza P
AD  - Epicentre Mbarara Research Centre, P.O Box 1956, Mbarara, Uganda.
      patrick.orikiriza@epicentre.msf.org.
AD  - Universite de Montpellier, Montpellier, France.
      patrick.orikiriza@epicentre.msf.org.
FAU - Nansumba, Margaret
AU  - Nansumba M
AD  - Epicentre Mbarara Research Centre, P.O Box 1956, Mbarara, Uganda.
FAU - Nyehangane, Dan
AU  - Nyehangane D
AD  - Epicentre Mbarara Research Centre, P.O Box 1956, Mbarara, Uganda.
FAU - Bastard, Mathieu
AU  - Bastard M
AD  - Epicentre, Paris, France.
FAU - Mugisha, Ivan Taremwa
AU  - Mugisha IT
AD  - Epicentre Mbarara Research Centre, P.O Box 1956, Mbarara, Uganda.
FAU - Nansera, Denis
AU  - Nansera D
AD  - Mbarara University of Science and Technology, Mbarara, Uganda.
FAU - Mwanga-Amumpaire, Juliet
AU  - Mwanga-Amumpaire J
AD  - Epicentre Mbarara Research Centre, P.O Box 1956, Mbarara, Uganda.
AD  - Mbarara University of Science and Technology, Mbarara, Uganda.
FAU - Boum, Yap 2nd
AU  - Boum Y 2nd
AD  - Epicentre Mbarara Research Centre, P.O Box 1956, Mbarara, Uganda.
AD  - Mbarara University of Science and Technology, Mbarara, Uganda.
FAU - Kumbakumba, Elias
AU  - Kumbakumba E
AD  - Mbarara University of Science and Technology, Mbarara, Uganda.
FAU - Bonnet, Maryline
AU  - Bonnet M
AD  - Epicentre Mbarara Research Centre, P.O Box 1956, Mbarara, Uganda.
AD  - Universite de Montpellier, Montpellier, France.
AD  - IRD UMI233/ INSERM U1175, Montpellier, France.
LA  - eng
PT  - Journal Article
DEP - 20180508
PL  - Germany
TA  - Eur J Clin Microbiol Infect Dis
JT  - European journal of clinical microbiology & infectious diseases : official
      publication of the European Society of Clinical Microbiology
JID - 8804297
SB  - IM
MH  - Adolescent
MH  - Aging
MH  - Child
MH  - Child, Preschool
MH  - Feces/*microbiology
MH  - HIV Infections/complications/*epidemiology
MH  - Humans
MH  - Infant
MH  - Mycobacterium tuberculosis/isolation & purification
MH  - Nucleic Acid Amplification Techniques
MH  - Prevalence
MH  - Sensitivity and Specificity
MH  - Sputum/*microbiology
MH  - Tuberculosis/complications/*diagnosis/epidemiology
MH  - Uganda/epidemiology
OTO - NOTNLM
OT  - Childhood tuberculosis
OT  - Sputum
OT  - Stool
OT  - Xpert MTB/RIF
EDAT- 2018/05/10 06:00
MHDA- 2018/11/09 06:00
CRDT- 2018/05/10 06:00
PHST- 2018/04/14 00:00 [received]
PHST- 2018/05/02 00:00 [accepted]
PHST- 2018/05/10 06:00 [pubmed]
PHST- 2018/11/09 06:00 [medline]
PHST- 2018/05/10 06:00 [entrez]
AID - 10.1007/s10096-018-3272-0 [doi]
AID - 10.1007/s10096-018-3272-0 [pii]
PST - ppublish
SO  - Eur J Clin Microbiol Infect Dis. 2018 Aug;37(8):1465-1473. doi:
      10.1007/s10096-018-3272-0. Epub 2018 May 8.