1. The Simple One-Step (SOS) Stool Processing Method for Use with the Xpert MTB/RIF Assay for a Child-Friendly Diagnosis of Tuberculosis Closer to the Point of Care
- Author
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de Haas, Petra, Yenew, Bazezew, Mengesha, Endale, Slyzkyi, Andrii, Gashu, Zewdu, Lounnas, Manon, Tesfaye, Ephrem, Bedru, Ahmed, Tiemersma, Edine, Kremer, Kristin, Amare, Misikir, Diriba, Getu, Zerihun, Betselot, Gudina, Tilaye, Tegegn, Ben, Bonnet, Maryline, Negeri, Challa, Klinkenberg, Eveline, Ethiopian Public Health Institute (EPHI), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud]), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), and Amsterdam UMC - Amsterdam University Medical Center
- Subjects
Microbiology (medical) ,medicine.medical_specialty ,MESH: Mycobacterium tuberculosis ,Tuberculosis ,Point-of-Care Systems ,Xpert MTB/RIF ,MESH: Ethiopia ,Sensitivity and Specificity ,fluids and secretions ,MESH: Sputum ,Pulmonary tuberculosis ,Internal medicine ,Diagnosis ,Simple one-step stool method ,Humans ,Medicine ,MESH: Tuberculosis ,Children ,Point of care ,MESH: Humans ,biology ,business.industry ,Bacteriologically confirmed ,MESH: Child, Preschool ,Sputum ,Mycobacteriology and Aerobic Actinomycetes ,Mycobacterium tuberculosis ,medicine.disease ,biology.organism_classification ,MESH: Sensitivity and Specificity ,MESH: Point-of-Care Systems ,Processing methods ,[SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology ,Mycobacterium tuberculosis complex ,Stool ,Child, Preschool ,Ethiopia ,medicine.symptom ,business - Abstract
International audience; Young children cannot easily produce sputum for diagnosis of pulmonary tuberculosis (TB). Alternatively, Mycobacterium tuberculosis complex bacilli can be detected in stool by using the Xpert MTB/RIF (Ultra) assay (Xpert). Published stool processing methods contain somewhat complex procedures and require additional supplies. The aim of this study was to develop a simple one-step (SOS) stool processing method based on gravity sedimentation only, similar to Xpert testing of sputum samples, for the detection of M. tuberculosis in stool samples. We first assessed whether the SOS stool method could provide valid Xpert results without the need for bead-beating, dilution, and filtration steps. We concluded that this was the case, and we then validated the SOS stool method by testing spiked stool samples. By using the SOS stool method, 27 of the 29 spiked samples gave valid Xpert results, and M. tuberculosis was recovered from all 27 samples. The proof of principle of the SOS stool method was demonstrated in routine settings in Addis Ababa, Ethiopia. Nine of 123 children with presumptive TB had M. tuberculosis-positive results for nasogastric aspiration (NGA) samples, and 7 (77.8%) of those children also had M. tuberculosis-positive Xpert results for stool samples. Additionally, M. tuberculosis was detected in the stool samples but not the NGA samples from 2 children. The SOS stool processing method makes use of the standard Xpert assay kit, without the need for additional supplies or equipment. The method can potentially be rolled out to any Xpert site, bringing a bacteriologically confirmed diagnosis of TB in children closer to the point of care.
- Published
- 2021
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