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Accuracy and incremental yield of urine Xpert MTB/RIF Ultra versus Determine TB-LAM for diagnosis of pulmonary tuberculosis.
- Source :
-
Diagnostic microbiology and infectious disease [Diagn Microbiol Infect Dis] 2020 Jan; Vol. 96 (1), pp. 114892. Date of Electronic Publication: 2019 Sep 04. - Publication Year :
- 2020
-
Abstract
- 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/μL. 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.<br /> (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Cross-Sectional Studies
False Positive Reactions
Female
HIV Infections microbiology
Humans
Male
Reproducibility of Results
Sensitivity and Specificity
Sputum microbiology
Young Adult
HIV Infections complications
Reagent Kits, Diagnostic standards
Tuberculosis, Pulmonary diagnosis
Tuberculosis, Pulmonary urine
Subjects
Details
- Language :
- English
- ISSN :
- 1879-0070
- Volume :
- 96
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Diagnostic microbiology and infectious disease
- Publication Type :
- Academic Journal
- Accession number :
- 31727376
- Full Text :
- https://doi.org/10.1016/j.diagmicrobio.2019.114892