Chest Infections: Chest Infections |

Comparative Studies of Xpert MTB/RIF and Pathologic and Bacteriologic Methods in the Diagnosis of Lymph Node Tuberculosis FREE TO VIEW

Shao Huang; Yi Han; Zhidong Liu, PhD
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Beijing Chest Hospital, Beijing, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A77. doi:10.1016/j.chest.2016.02.082
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SESSION TITLE: Chest Infections

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: Currently, superficial tuberculous lymphadenitis is diagnosed by radiological and pathologic methods. Those methods lack specificity, Xpert MTB/RIF also enables the simultaneous detection of Mmycobacterium tuberculosis and rifampin -resistance. The current study is was a prospective study aimed to assess the application of Gene-Xpert MTB/RIF in superficial lymph node TB diagnosis and to compare Gene-Xpert MIB/RIF with conventional diagnostic methods.

METHODS: March and July 2015, 48 consecutive cases of suspected TB lymph node specimens and 5 cases of non-tuberculous lymph node samples were collected and divided into two groups using needle aspiration and biopsy methods. One group was used for Xpert MTB/RIF, BACTEC MGIT960 culture, and Roche culture diagnosis. The other group was used for pathological diagnosis, acid-fast staining, and PCR diagnosis of tissue specimens

RESULTS: There were 48 patients-clinically suspected to have tuberculous lymphadenitis, 41 of whom were MTBC positive based on Xpert MTB/RIF (85%). The RopB gene mutation was detected in 3 patients (6.3%). Thirteen (27%) and 7(15%) patients were BACTEC MGIT960 and Roche culture- positive, The sensitivity of Xpert MTB/RIF for diagnosing tuberculous lymphadenitis was 93% (95% confidence interval [CI], 85.4%-100%) and the specificity was 100%.

CONCLUSIONS: Xpert MTB/RIF has high sensitivity and specificity in the diagnosis of tuberculous lymphadenitis and rifampin resistance. Xpert MTB/RIF is simple and fast. Compared with conventional diagnostic methods, Xpert MTB/RIF has a higher positive rate and specificity. Xpert MTB/RIF can also guide clinical medication decision-making. Xpert MTB/RIF is especially useful for cases in which a negative result is obtained with conventional diagnostic methods

CLINICAL IMPLICATIONS: Xpert MTB/RIF is a method, the results of which are operator-independent, Xpert MTB/RIF detects tuberculous lymphadenitis with high sensitivity and specificity. Xpert MTB/RIF is fast with results available within 3 h, which makes it useful for outpatient diagnosis. Xpert MTB/RIF has the advantage of providing diagnosticis evidence for culture- and pathology -negative patients. It Xpert MTB/RIF can also be used to monitor rifampicin -resistance and guide clinical practice

DISCLOSURE: The following authors have nothing to disclose: Shao Huang, Yi Han, Zhidong Liu

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