Diagnostic accuracy of nucleic acid amplification tests (NAATs) in urine for genitourinary tuberculosis: a systematic review and meta-analysis

Altez-Fernandez, Carlos; Ortiz, Vanessa Duarte; Mirzazadeh, Majid; Zegarra, Luis; Seas, Carlos; Ugarte-Gil, César

doi:10.1186/s12879-017-2476-8

Cited by 33 publications

(25 citation statements)

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“…[16][17] UGTB is a serious, insidious disease, generally developing symptoms only at a late stage. 18 A spontaneous autonephrectomy with a nephrocutaneous fistula due to renal TB was described; the patient had recurrent UTI with ineffective antibacterial therapy but UGTB was not suspected. 19 Also, the case of a recurrent UTI was described.…”

Section: Discussionmentioning

confidence: 99%

“…21 Even when suggestive findings such as hematuria, sterile pyuria and recurrent urinary infections are present, we rarely remember this diagnostic possibility. 18 UPEC seems to be a pathogen of major significance to global human health. 22 In Hungary, the five most commonly occurring bacteria were E. coli, Enterococcus faecalis, Klebsiella pneumoniae, Pseudomonas aeruginosa and Proteus mirabilis.…”

Section: Discussionmentioning

confidence: 99%

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Urogenital tuberculosis: The cause of ineffective antibacterial therapy for urinary tract infections

Kulchavenya¹,

Cherednicenko²

2018

European Urology Supplements

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Background: Urogenital tuberculosis (UGTB) is one of the great imitators; it is commonly masked by urinary tract infections (UTIs). We aimed to estimate how many UGTB patients were among patients with a long history of UTIs. Material and Methods: A total of 244 patients with recurrent UTIs and suspected UGTB were enrolled in an open, noncomparative prospective study. Their urine and expressed prostate secretion or ejaculate were cultured (a total of 1446 samples), and 421 isolates with growth of ⩾10 4 colony-forming units (CFU)/ml were investigated for drug resistance. Typically, UGTB diagnosis is made by individual case. Results: All 244 patients had a long history of recurrent UTIs (on average, 7.9 ± 3.4 years); all received at least five courses of antibacterial therapy without good result. UGTB was diagnosed in 63 (25.8%), and in 41 of these (65.1%), there was comorbidity of UTI and UGTB. Of 1446 samples investigated, 421 (29.1%) were positive, and 1025 were negative. Escherichia coli was found in 57.3% of gram-negative microflora and in 29.0% only among all uropathogens. E. coli was resistant to amoxicillin/clavulanate in 51.5-57.1%, to cefotaxime in 50.0-52.0%, to gentamycin in 33.3-59.5%, to ciprofloxacin in 63.2-66.7%, to levofloxacin in 54.8-45.2%, and to nitrofurantoin in 23. 5-20.8% in 20155-20.8% in and 20165-20.8% in , respectively. If, in 2015 isolates of E. coli were susceptible to imipenem, in 2016, 7.1% of strains were resistant to this antibiotic. Level of drug-resistance was higher in 2016, excluding only levofloxacin and nitrofurantoin. Conclusions: Total prevalence of UGTB among UTI patients with poor results of antibacterial therapy was 25.8%. Comorbidity of UTI and UGTB was diagnosed in 65.1%.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Urogenital tuberculosis: The cause of ineffective antibacterial therapy for urinary tract infections

Kulchavenya¹,

Cherednicenko²

2018

European Urology Supplements

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“…PCR: PCR tests targeting IS6110, hsp65 (Rv0440), mpt64, fbp, mtp40 (Rv2351c), TRC4 (conserved repetitive element) -among others, have been devised using endometrial aspirates, EBs, renal biopsies, menstrual blood and urine specimens [2,4,10] but they often lead to false-positive and false-negative results. Detection of male UGTB within semen samples by PCR has also been reported that revealed superiority over MGIT-960 culture [6].…”

Section: Naatsmentioning

confidence: 99%

“…Urogenital tuberculosis (UGTB) is the second most common form of extrapulmonary TB (EPTB) in developing nations with severe epidemic situations. For example, India (comprising 45% of EPTB cases) and the third most common form in locations with a lower incidence of TB [1,2], which include both renal and genital TB. However, concomitant UGTB and pulmonary TB (PTB) are found in 2-10 and 15-20% of patients in developed and developing nations, respectively [2].…”

mentioning

confidence: 99%

“…For example, India (comprising 45% of EPTB cases) and the third most common form in locations with a lower incidence of TB [1,2], which include both renal and genital TB. However, concomitant UGTB and pulmonary TB (PTB) are found in 2-10 and 15-20% of patients in developed and developing nations, respectively [2]. In fact, UGTB occurs after a prolonged period of latent infection followed by hematogenous spread to the kidneys, fallopian tubes and epididymis [3].…”

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confidence: 99%

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Recent Trends in Diagnosis of Urogenital Tuberculosis

Mehta

Kamra

2020

Future Microbiol.

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the efficient diagnosis of UGTB by reliable tests would certainly reduce the infertility in both men and women and the other sequelae associated with disease. " Urogenital tuberculosis (UGTB) is the second most common form of extrapulmonary TB (EPTB) in developing nations with severe epidemic situations. For example, India (comprising 45% of EPTB cases) and the third most common form in locations with a lower incidence of TB [1,2], which include both renal and genital TB. However, concomitant UGTB and pulmonary TB (PTB) are found in 2-10 and 15-20% of patients in developed and developing nations, respectively [2]. In fact, UGTB occurs after a prolonged period of latent infection followed by hematogenous spread to the kidneys, fallopian tubes and epididymis [3]. The clinical manifestations of female UGTB include primary or secondary infertility, menstrual dysfunction and pelvic inflammatory disease [4]. Infertility is the most common complication, which occurs in 5-16% of Indian women caused by irreversible damage to the fallopian tubes. Mostly, fallopian tubes are associated with congestion and miliary tubercles, while endometrium is linked with caseation and ulceration in 50-80% cases, resulting in Asherman's syndrome [5]. Similarly, the most frequent sites for male UGTB are the epididymis and prostate followed by seminal vesicles and testicles originating from renal foci, which also lead to infertility [6]. Owing to asymptomatic nature and varied clinical presentations (ranging from vague urinary symptoms to chronic kidney disease) that mimic several urologic and genital diseases, diagnosis of UGTB is a daunting challenge [3].Smear/culture, histopathology, interferon-γ release assays (IGRAs), intravenous pyelography, laparoscopy and nucleic acid amplification tests (NAATs) are the main modalities employed in the diagnosis of UGTB [6][7][8], which have certain limitations. Smear microscopy and culture for Mycobacterium tuberculosis identification (on Lowenstein-Jensen medium or BACTEC-460/MGIT-960) are commonly used methods but they lead to poor sensitivities due to paucibacillary nature of specimens [7]. Though urine culture is considered the gold standard, it requires skillful technicians and has a prolonged turnaround time of approximately 6-8 weeks [7] when irreparable damage to the fallopian tubes and epididymis already occurs. Delayed diagnosis also leads to nonfunctioning unilateral kidney, contracted bladder and renal failure [1]. Endoscopic procedures such as laparoscopy/hysteroscopy are often linked with operative risks and mostly cause flaring of infection [5], while histopathological examination can be confirmatory only when it demonstrates acid-fast bacilli in the tissues that are very scarce in endometrial biopsies (EBs) [7]. Intravenous pyelography may be suggestive of UGTB but it is nonspecific and often mimics other pathologic lesions [1]. IGRAsImmunological procedures such as IGRAs are widely employed for the early detection of UGTB cases. Notably, Kim et al. [8] reported a sensitivity of 52.6%...

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