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Comparison of Culture, Xpert MTB/RIF and EZN staining method to identify Mycobacterium tuberculosis from pulmonary and extra pulmonary specimens

Year 2020, Volume: 37 Issue: 4, 105 - 109, 11.09.2020

Abstract

Mycobacterium tuberculosis is a major health problem worldwide, especially in developing countries. The effective treatment of M. tuberculosis depends on early diagnosis. In this study, 1577 M. tuberculosis strains were evaluated retrospectively from clinical samples sent between March 2014 and June 2018. The rate of pulmonary samples was determined as 694 (44%). Positive sample rate was 74 (4.69%) in culture, 19 (1.20%) in EZN staining and 75 (4.75%) in Xpert MTB/RIF. Compared to standard culture, the sensitivity, specificity, positive and negative predictive values of the Xpert MTB / RIF system were 100%, 99.93%, 98.66% and 100%, respectively; The sensitivity, specificity, positive and negative predictive values of EZN were 57.36%, 100%, 100% and 96.46%, respectively. Early diagnosis and treatment of M. tuberculosis is of great importance. According to these results, it can be concluded that Xpert MTB / RIF is a fast and reliable system that can be used in the diagnosis of tuberculosis and when used together with conventional tests, it can make important contributions to the diagnosis of tuberculosis.

References

  • Arjomandzadegan, M., Owlia, P., Ranjbar, R., Farazi, AA, Sofian, M., Sadrnia, M., et al., 2011. Rapid and simple approach for identification of Mycobacterium tuberculosis and M. bovis by detection of regulatory gene whiB7. Acta Microbiol Immunol Hung. 58, 65–74.
  • Aryan, E., Makvandi, M., Farajzadeh, A., Huygen, K., Bifani, P., Mousavi, SL, et al., 2010. A novel and more sensitive loop-mediated isothermal amplification assay targeting IS6110 for detection of Mycobacterium tuberculosis complex. Microbiol Res. 165, 211–20.
  • Babacan, F., Hasdemir, U., 2008. Mycobacterium tuberculosis kompleks. In: Topçu, A.W., Söyletir, G., Doğanay, M., editors.: Enfeksiyon Hastalıkları ve Mikrobiyolojisi. 3rd ed. İstanbul, Turkey: Nobel Tıp Kitabevleri; pp. 2283–2302 (in Turkish).
  • Bunsow, E., Ruiz-Serrano, MJ, Roa, PL, Kestler, M., Viedma, DG, Bouza, E., 2014. Evaluation of GeneXpert MTB/RIF for the detection of Mycobacterium tuberculosis and resistance to rifampin in clinical specimens. J Infection. 68, 338–343.
  • Coelho, AC, Pinto, ML, Miranda, A., Coelho, AM, Pires, MA, Matos, M., 2010. Comparative evaluation of PCR in Ziehl-Neelsen stained smears and PCR in tissues for diagnosis of Mycobacterium avium subsp. paratuberculosis. Indian J Exp Biol. 48, 948–50.
  • Çöplü, N., 2002. Tüberkülozda mikrobiyolojik tanı. In: Uzun Ö, ÜnalS, editors. Güncel Bilgiler Işığında İnfeksiyon Hastalıkları II. Ankara, Turkey: Bilimsel Tıp Yayınevi (in Turkish) 859–873.
  • Davis, JL, Huang, L., Kovacs, JA, Masur, H., Murray, P., Havlir, DV, et al., 2009. Polymerase chain reaction of secA1 on sputum or oral wash samples for the diagnosis of pulmonary tuberculosis. Clin Infect Dis. 48, 725–32.
  • Durmaz, R., 2010. Mycobacterium tuberculosis suşlarında direncin belirlenmesinde moleküler yöntemler/son gelişmeler. ANKEM Derg. 24, 64–70 (in Turkish).
  • Elbir, H., Abdel-Muhsin, AM, Babiker, A., 2008. A one-step DNA PCR-based method for the detection of Mycobacterium tuberculosis com¬plex grown on Lowenstein-Jensen media. Am J Trop Med Hyg. 78, 316–7.
  • Espasa, M., Gonzalez-Martin, J., Alcaide, F., Aragon, LM, Lonca, J., Man¬terola, JM, et al., 2005. Direct detection in clinical samples of multiple gene mutations causing resistance of Mycobacterium tubercu¬losis to isoniazid and rifampicin using fluorogenic probes. J Anti¬microb Chemother. 55, 860–5.
  • Field, SK, Cowie, RL, 2006. Lung disease due to the more common nontuberculous mycobacteria. Chest. 129, 1653–72.
  • Forbes, BA, Sahm, DF, Weissfeld, AS, 2007. Bailey Scott’s Diagnostic Microbiology. 12. Edition. Missouri: Mosby Elsevier. 478.
  • Fuchs, M., Kampfer, S., Helmsing, S., Spallek, R., Oehlmann, W., Prilop, W., et al., 2014. Novel human recombinant antibodies against Mycobacterium tuberculosis antigen 85B. BMC Biotechnol. 14, 68.
  • Gopinath, K., Singh, S., 2009. Multiplex PCR assay for simultaneous detection and differentiation of Mycobacterium tuberculo¬sis, Mycobacterium avium complexes and other Mycobacte¬rial species directly from clinical specimens. J Appl Microbiol. 107, 425–35.
  • Helb, D., Jones, M., Story, E., Boehme, C., Wallace, E., Ho, K., Kop, J., Owens, MR, Rodgers, R., Banada, P., Safi, H., Blakemore, R., Lan, NT, Jones-López, EC, Levi, M., Burday, M., Ayakaka, I., Mugerwa, RD, McMillan, B., Winn-Deen, E., Christel, L., Dailey, P., Perkins, MD, Persing, DH, Alland, D., 2010. Rapid detection of Mycobacterium tuberculosis and rifampin resistance by use of ondemand, near-patient technology. J Clin Microbiol. 48, 229 –237.
  • Hillemann, D., Rüsch-Gerdes, S., Boehme, C., Richter, E., 2011. Rapid molecular detection of extrapulmonary tuberculosis by the automated GeneXpert MTB/RIF system. J Clin Microbiol. 49, 1202–1205.
  • Ioannidis, P., Papaventsis, D., Karabela, S., Nikolaou, S., Panagi, M., Raftopoulou, E., Konstantinidou, E., Marinou, I., Kanavaki, S., 2011. Cepheid GeneXpert MTB/RIF assay for Mycobacterium tuberculosis detection and rifampin resistance identification in patients with substantial clinical indications of tuberculosis and smear-negative microscopy results. J Clin Microbiol. 49, 3068–3070.
  • Kocagöz, T., 2002. Tüberküloz tanısında kullanılan moleküler yöntemler. In: Ağaçfidan, A., Badur, S., Türkoğlu, S., editors.: İnfeksiyon Hastalıklarının Laboratuar Tanısında Moleküler Yöntemler. İstanbul, Turkey: M.G.G. AS Matbaacılık; pp. 189–195 (in Turkish).
  • Kox, LF, Rhienthong, D., Miranda, AM, Udomsantisuk, N., Ellis, K., van Leeuwen, J., et al., 1994. A more reliable PCR for detection of Mycobacterium tuberculosis in clinical samples. J Clin Microbiol. 32, 672–8.
  • Lawn, SD, Nicol, MP, 2011. Xpert®MTB/RIF assay: development, evaluation and implementation of a new rapid molecular diagnostic for tuberculosis and rifampicinresistance. Future Microbiol. 6, 1067–82.
  • Luetkemeyer, AF, Firnhaber, C., Kendall, MA, Wu, X., Mazurek, GH, Benator, DA, Arduino, R., Fernandez, M., Guy, E., Johnson, P., Metchock, B., Sattler, F., Telzak, E., Wang, YF, Weiner, M., Swindells, S., Sanne, IM, Havlir, DV, Grinsztejn, B., Alland, D., the AIDS Clinical Trials Group A5295 and Tuberculosis Trials Consortium Study 34 Teams., 2016. Evaluation of Xpert MTB/RIF Versus AFB Smear and Culture to Identify Pulmonary Tuberculosis in Patients With Suspected Tuberculosis From Low and Higher Prevalence Settings. Clinical Infectious Diseases. 62, 1081–8.
  • Mehta, PK, Kalra, M., Khuller, GK, Behera, D., Verma, I., 2012a. Development of an ultrasensitive polymerase chain reaction–amplified immunoassay based on mycobacterial RD antigens: implications for the serodiagnosis of tuberculosis. Diagn Microbiol Infect Dis. 72, 166–74.
  • Mehta, PK, Raj, A., Singh, N., Khuller, GK, 2012b. Diagnosis of extrapulmonary tuberculosis by PCR. FEMS Immunol Med Microbiol. 66, 20–36.
  • Mokaddas, E., Ahmad, S., 2007. Development and evaluation of a multiplex PCR for rapid detection and differentiation of Mycobacterium tuberculosis complex members from non-tuberculous mycobacteria. Jpn J Infect Dis. 60, 140–4.
  • Özkütük, N., Sürücüoğlu, S., 2014. Orta prevalanslı bölgede akciğer ve akciğer dışı tüberküloz tanısında Xpert MTB/RIF testinin değerlendirilmesi. Mikrobiyol Bul. 48, 223–232 (in Turkish).
  • Penz, E., Boffa, J., Roberts, DJ, Fisher, D., Cooper, R., Ronksley, PE, James, MT, 2015. Diagnostic accuracy of the XpertW MTB/RIF assay for extrapulmonary tuberculosis: a meta-analysis. Int J Tuberc Lung Dıs. 19, 278–284.
  • Ritis, K., Tzoanopoulos, D., Speletas, M., Papadopoulos, E., Arvanitidis, K., Kartali, S., et al., 2000. Amplification of IS6110 sequence for detection of Mycobacterium tuberculosis complex in HIV-negative patients with fever of unknown origin (FUO) and evidence of extrapulmonary disease. J Intern Med. 248, 415–24.
  • Sevilla, IA, Molina, E., Elguezabal, N., Perez, V., Garrido, JM, Juste, RA, 2015. Detection of mycobacteria, Mycobacterium avium subspecies and Mycobacterium tuberculosis complex by a novel tetraplex real-time PCR. J. Clin. Microbiol. 53, 930-940. Soini, H., Musser, JM, 2001. Molecular diagnosis of mycobacteria. Clin Chem. 47, 809–14.
  • Steingart, KR, Si, HDJ, Pai, M., Boehme, CC, Dendukuri, N., 2014. Xpert®MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults. Cochrane Database Syst Rev. 1:CD009593. https://doi.org/10.1002/14651858.CD009593.pub3.
  • Trent, RJ, 2005. Molecular Medicine: An Introductory Text. 3 ed. Elsevier Academic Press.
  • Vergara Gómez, A., González-Martín, J., García-Basteiro, AL, 2017. Xpert®MTB/RIF: utilidad en el diagnóstico de la tuberculosis y de la resistenciaa la rifampicina. Med Clin. (Barc) 149, 399–405.
  • World Health, Organization, 2011. Rapid implementation of the Xpert MTB/RIFdiagnostic test. Technical and operational “how to”; practical considerations. Ginebra, Suiza: World Health Organization 1–34 WHO/HTM/TB.
Year 2020, Volume: 37 Issue: 4, 105 - 109, 11.09.2020

Abstract

References

  • Arjomandzadegan, M., Owlia, P., Ranjbar, R., Farazi, AA, Sofian, M., Sadrnia, M., et al., 2011. Rapid and simple approach for identification of Mycobacterium tuberculosis and M. bovis by detection of regulatory gene whiB7. Acta Microbiol Immunol Hung. 58, 65–74.
  • Aryan, E., Makvandi, M., Farajzadeh, A., Huygen, K., Bifani, P., Mousavi, SL, et al., 2010. A novel and more sensitive loop-mediated isothermal amplification assay targeting IS6110 for detection of Mycobacterium tuberculosis complex. Microbiol Res. 165, 211–20.
  • Babacan, F., Hasdemir, U., 2008. Mycobacterium tuberculosis kompleks. In: Topçu, A.W., Söyletir, G., Doğanay, M., editors.: Enfeksiyon Hastalıkları ve Mikrobiyolojisi. 3rd ed. İstanbul, Turkey: Nobel Tıp Kitabevleri; pp. 2283–2302 (in Turkish).
  • Bunsow, E., Ruiz-Serrano, MJ, Roa, PL, Kestler, M., Viedma, DG, Bouza, E., 2014. Evaluation of GeneXpert MTB/RIF for the detection of Mycobacterium tuberculosis and resistance to rifampin in clinical specimens. J Infection. 68, 338–343.
  • Coelho, AC, Pinto, ML, Miranda, A., Coelho, AM, Pires, MA, Matos, M., 2010. Comparative evaluation of PCR in Ziehl-Neelsen stained smears and PCR in tissues for diagnosis of Mycobacterium avium subsp. paratuberculosis. Indian J Exp Biol. 48, 948–50.
  • Çöplü, N., 2002. Tüberkülozda mikrobiyolojik tanı. In: Uzun Ö, ÜnalS, editors. Güncel Bilgiler Işığında İnfeksiyon Hastalıkları II. Ankara, Turkey: Bilimsel Tıp Yayınevi (in Turkish) 859–873.
  • Davis, JL, Huang, L., Kovacs, JA, Masur, H., Murray, P., Havlir, DV, et al., 2009. Polymerase chain reaction of secA1 on sputum or oral wash samples for the diagnosis of pulmonary tuberculosis. Clin Infect Dis. 48, 725–32.
  • Durmaz, R., 2010. Mycobacterium tuberculosis suşlarında direncin belirlenmesinde moleküler yöntemler/son gelişmeler. ANKEM Derg. 24, 64–70 (in Turkish).
  • Elbir, H., Abdel-Muhsin, AM, Babiker, A., 2008. A one-step DNA PCR-based method for the detection of Mycobacterium tuberculosis com¬plex grown on Lowenstein-Jensen media. Am J Trop Med Hyg. 78, 316–7.
  • Espasa, M., Gonzalez-Martin, J., Alcaide, F., Aragon, LM, Lonca, J., Man¬terola, JM, et al., 2005. Direct detection in clinical samples of multiple gene mutations causing resistance of Mycobacterium tubercu¬losis to isoniazid and rifampicin using fluorogenic probes. J Anti¬microb Chemother. 55, 860–5.
  • Field, SK, Cowie, RL, 2006. Lung disease due to the more common nontuberculous mycobacteria. Chest. 129, 1653–72.
  • Forbes, BA, Sahm, DF, Weissfeld, AS, 2007. Bailey Scott’s Diagnostic Microbiology. 12. Edition. Missouri: Mosby Elsevier. 478.
  • Fuchs, M., Kampfer, S., Helmsing, S., Spallek, R., Oehlmann, W., Prilop, W., et al., 2014. Novel human recombinant antibodies against Mycobacterium tuberculosis antigen 85B. BMC Biotechnol. 14, 68.
  • Gopinath, K., Singh, S., 2009. Multiplex PCR assay for simultaneous detection and differentiation of Mycobacterium tuberculo¬sis, Mycobacterium avium complexes and other Mycobacte¬rial species directly from clinical specimens. J Appl Microbiol. 107, 425–35.
  • Helb, D., Jones, M., Story, E., Boehme, C., Wallace, E., Ho, K., Kop, J., Owens, MR, Rodgers, R., Banada, P., Safi, H., Blakemore, R., Lan, NT, Jones-López, EC, Levi, M., Burday, M., Ayakaka, I., Mugerwa, RD, McMillan, B., Winn-Deen, E., Christel, L., Dailey, P., Perkins, MD, Persing, DH, Alland, D., 2010. Rapid detection of Mycobacterium tuberculosis and rifampin resistance by use of ondemand, near-patient technology. J Clin Microbiol. 48, 229 –237.
  • Hillemann, D., Rüsch-Gerdes, S., Boehme, C., Richter, E., 2011. Rapid molecular detection of extrapulmonary tuberculosis by the automated GeneXpert MTB/RIF system. J Clin Microbiol. 49, 1202–1205.
  • Ioannidis, P., Papaventsis, D., Karabela, S., Nikolaou, S., Panagi, M., Raftopoulou, E., Konstantinidou, E., Marinou, I., Kanavaki, S., 2011. Cepheid GeneXpert MTB/RIF assay for Mycobacterium tuberculosis detection and rifampin resistance identification in patients with substantial clinical indications of tuberculosis and smear-negative microscopy results. J Clin Microbiol. 49, 3068–3070.
  • Kocagöz, T., 2002. Tüberküloz tanısında kullanılan moleküler yöntemler. In: Ağaçfidan, A., Badur, S., Türkoğlu, S., editors.: İnfeksiyon Hastalıklarının Laboratuar Tanısında Moleküler Yöntemler. İstanbul, Turkey: M.G.G. AS Matbaacılık; pp. 189–195 (in Turkish).
  • Kox, LF, Rhienthong, D., Miranda, AM, Udomsantisuk, N., Ellis, K., van Leeuwen, J., et al., 1994. A more reliable PCR for detection of Mycobacterium tuberculosis in clinical samples. J Clin Microbiol. 32, 672–8.
  • Lawn, SD, Nicol, MP, 2011. Xpert®MTB/RIF assay: development, evaluation and implementation of a new rapid molecular diagnostic for tuberculosis and rifampicinresistance. Future Microbiol. 6, 1067–82.
  • Luetkemeyer, AF, Firnhaber, C., Kendall, MA, Wu, X., Mazurek, GH, Benator, DA, Arduino, R., Fernandez, M., Guy, E., Johnson, P., Metchock, B., Sattler, F., Telzak, E., Wang, YF, Weiner, M., Swindells, S., Sanne, IM, Havlir, DV, Grinsztejn, B., Alland, D., the AIDS Clinical Trials Group A5295 and Tuberculosis Trials Consortium Study 34 Teams., 2016. Evaluation of Xpert MTB/RIF Versus AFB Smear and Culture to Identify Pulmonary Tuberculosis in Patients With Suspected Tuberculosis From Low and Higher Prevalence Settings. Clinical Infectious Diseases. 62, 1081–8.
  • Mehta, PK, Kalra, M., Khuller, GK, Behera, D., Verma, I., 2012a. Development of an ultrasensitive polymerase chain reaction–amplified immunoassay based on mycobacterial RD antigens: implications for the serodiagnosis of tuberculosis. Diagn Microbiol Infect Dis. 72, 166–74.
  • Mehta, PK, Raj, A., Singh, N., Khuller, GK, 2012b. Diagnosis of extrapulmonary tuberculosis by PCR. FEMS Immunol Med Microbiol. 66, 20–36.
  • Mokaddas, E., Ahmad, S., 2007. Development and evaluation of a multiplex PCR for rapid detection and differentiation of Mycobacterium tuberculosis complex members from non-tuberculous mycobacteria. Jpn J Infect Dis. 60, 140–4.
  • Özkütük, N., Sürücüoğlu, S., 2014. Orta prevalanslı bölgede akciğer ve akciğer dışı tüberküloz tanısında Xpert MTB/RIF testinin değerlendirilmesi. Mikrobiyol Bul. 48, 223–232 (in Turkish).
  • Penz, E., Boffa, J., Roberts, DJ, Fisher, D., Cooper, R., Ronksley, PE, James, MT, 2015. Diagnostic accuracy of the XpertW MTB/RIF assay for extrapulmonary tuberculosis: a meta-analysis. Int J Tuberc Lung Dıs. 19, 278–284.
  • Ritis, K., Tzoanopoulos, D., Speletas, M., Papadopoulos, E., Arvanitidis, K., Kartali, S., et al., 2000. Amplification of IS6110 sequence for detection of Mycobacterium tuberculosis complex in HIV-negative patients with fever of unknown origin (FUO) and evidence of extrapulmonary disease. J Intern Med. 248, 415–24.
  • Sevilla, IA, Molina, E., Elguezabal, N., Perez, V., Garrido, JM, Juste, RA, 2015. Detection of mycobacteria, Mycobacterium avium subspecies and Mycobacterium tuberculosis complex by a novel tetraplex real-time PCR. J. Clin. Microbiol. 53, 930-940. Soini, H., Musser, JM, 2001. Molecular diagnosis of mycobacteria. Clin Chem. 47, 809–14.
  • Steingart, KR, Si, HDJ, Pai, M., Boehme, CC, Dendukuri, N., 2014. Xpert®MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults. Cochrane Database Syst Rev. 1:CD009593. https://doi.org/10.1002/14651858.CD009593.pub3.
  • Trent, RJ, 2005. Molecular Medicine: An Introductory Text. 3 ed. Elsevier Academic Press.
  • Vergara Gómez, A., González-Martín, J., García-Basteiro, AL, 2017. Xpert®MTB/RIF: utilidad en el diagnóstico de la tuberculosis y de la resistenciaa la rifampicina. Med Clin. (Barc) 149, 399–405.
  • World Health, Organization, 2011. Rapid implementation of the Xpert MTB/RIFdiagnostic test. Technical and operational “how to”; practical considerations. Ginebra, Suiza: World Health Organization 1–34 WHO/HTM/TB.
There are 32 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Clinical Research
Authors

Yeliz Tanrıverdi

İlknur Bıyık

Asuman Bırıncı

Publication Date September 11, 2020
Submission Date January 28, 2020
Acceptance Date April 6, 2020
Published in Issue Year 2020 Volume: 37 Issue: 4

Cite

APA Tanrıverdi, Y., Bıyık, İ., & Bırıncı, A. (2020). Comparison of Culture, Xpert MTB/RIF and EZN staining method to identify Mycobacterium tuberculosis from pulmonary and extra pulmonary specimens. Journal of Experimental and Clinical Medicine, 37(4), 105-109.
AMA Tanrıverdi Y, Bıyık İ, Bırıncı A. Comparison of Culture, Xpert MTB/RIF and EZN staining method to identify Mycobacterium tuberculosis from pulmonary and extra pulmonary specimens. J. Exp. Clin. Med. September 2020;37(4):105-109.
Chicago Tanrıverdi, Yeliz, İlknur Bıyık, and Asuman Bırıncı. “Comparison of Culture, Xpert MTB/RIF and EZN Staining Method to Identify Mycobacterium Tuberculosis from Pulmonary and Extra Pulmonary Specimens”. Journal of Experimental and Clinical Medicine 37, no. 4 (September 2020): 105-9.
EndNote Tanrıverdi Y, Bıyık İ, Bırıncı A (September 1, 2020) Comparison of Culture, Xpert MTB/RIF and EZN staining method to identify Mycobacterium tuberculosis from pulmonary and extra pulmonary specimens. Journal of Experimental and Clinical Medicine 37 4 105–109.
IEEE Y. Tanrıverdi, İ. Bıyık, and A. Bırıncı, “Comparison of Culture, Xpert MTB/RIF and EZN staining method to identify Mycobacterium tuberculosis from pulmonary and extra pulmonary specimens”, J. Exp. Clin. Med., vol. 37, no. 4, pp. 105–109, 2020.
ISNAD Tanrıverdi, Yeliz et al. “Comparison of Culture, Xpert MTB/RIF and EZN Staining Method to Identify Mycobacterium Tuberculosis from Pulmonary and Extra Pulmonary Specimens”. Journal of Experimental and Clinical Medicine 37/4 (September 2020), 105-109.
JAMA Tanrıverdi Y, Bıyık İ, Bırıncı A. Comparison of Culture, Xpert MTB/RIF and EZN staining method to identify Mycobacterium tuberculosis from pulmonary and extra pulmonary specimens. J. Exp. Clin. Med. 2020;37:105–109.
MLA Tanrıverdi, Yeliz et al. “Comparison of Culture, Xpert MTB/RIF and EZN Staining Method to Identify Mycobacterium Tuberculosis from Pulmonary and Extra Pulmonary Specimens”. Journal of Experimental and Clinical Medicine, vol. 37, no. 4, 2020, pp. 105-9.
Vancouver Tanrıverdi Y, Bıyık İ, Bırıncı A. Comparison of Culture, Xpert MTB/RIF and EZN staining method to identify Mycobacterium tuberculosis from pulmonary and extra pulmonary specimens. J. Exp. Clin. Med. 2020;37(4):105-9.