Overdiagnosis of and treatment initiation delay in smear-negative pulmonary tuberculosis patients [Editorial]

Claassens, Mareli

doi:10.5588/pha.12.0095

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…Clinically diagnosed TB cases are subject to over-diagnosis [ 25 ] since the lack of bacteriologic confirmation may cause other infections, including NTM infections, to be misdiagnosed as TB cases. The potential for clinical over-diagnosis may be even higher in HIV-positive patients [ 26 ] and can reduce the apparent sensitivity of our iPRM assay in culture-negative vs. culture-positive TB cases in this study. Future study of iPRM performance with culture-negative TB cases is important, because rapid diagnosis of culture-negative TB cases is essential to reduce transmission as well as increased morbidity and mortality in HIV-affected populations prone to culture-negative cases.…”

Section: Discussionmentioning

confidence: 99%

Rapid diagnosis of new and relapse tuberculosis by quantification of a circulating antigen in HIV-infected adults in the Greater Houston metropolitan area

Fan

Zhang

Nguyen

et al. 2017

BMC Med

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BackgroundHIV-associated immune defects inhibit tuberculosis (TB) diagnosis, promote development of extrapulmonary TB and paucibacillary pulmonary TB cases with atypical radiographic features, and increase TB relapse rates. We therefore assessed the diagnostic performance of a novel assay that directly quantitates serum levels of the Mycobacterium tuberculosis (Mtb) virulence factor 10-kDa culture filtrate protein (CFP-10) to overcome limitations associated with detecting Mtb bacilli in sputum or tissue biopsies.MethodsThis study analyzed HIV-positive adults enrolled in a large, population-based TB screening and surveillance project, the Houston Tuberculosis Initiative, between October 1995 and September 2004, and assigned case designations using standardized criteria. Serum samples were trypsin-digested and immunoprecipitated for an Mtb-specific peptide of CFP-10 that was quantified by liquid chromatography-mass spectrometry for rapid and sensitive TB diagnosis.ResultsAmong the 1053 enrolled patients, 110 met all inclusion criteria; they included 60 tuberculosis cases (12 culture-negative TB), including 9 relapse TB cases, and 50 non-TB controls, including 15 cases with history of TB. Serum CFP-10 levels diagnosed 89.6% (77.3–96.5) and 66.7% (34.9–90.1) of culture-positive and culture-negative TB cases, respectively, and exhibited 88% (75.7–95.5) diagnostic specificity in all non-TB controls. Serum antigen detection and culture, respectively, identified 85% (73.4–92.9) and 80.0% (67.3–88.8) of all 60 TB cases.ConclusionsQuantitation of the Mtb virulence factor CFP-10 in serum samples of HIV-infected subjects diagnosed active TB cases with high sensitivity and specificity and detected cases missed by the gold standard of Mtb culture. These results suggest that serum CFP-10 quantitation holds great promise for the rapid diagnosis of suspected TB cases in patients who are HIV-infected.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-017-0952-z) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Rapid diagnosis of new and relapse tuberculosis by quantification of a circulating antigen in HIV-infected adults in the Greater Houston metropolitan area

Fan

Zhang

Nguyen

et al. 2017

BMC Med

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“…Distribusi usia ini sejalan dengan data statistik penderita TB di Amerika Serikat pada tahun 2016 yang menunjukkan adanya peningkatan insidens TB seiring dengan meningkatnya usia dengan usia 5-14 tahun hanya sebanyak < 1 kasus / 100,000 dan meningkat hingga 6.4 kasus / 100,000 pada usia ≥ 65 tahun (CDC, 2016). (Bhatt, 2012;Keikha, 2018 (Naderi, 2017;Claassens, 2012…”

Section: Pendahuluanunclassified

Penyerupa dan Penyerta Tuberkulosis Paru yang Terdiagnosis Berdasarkan Gambaran CT-scan Toraks Pada Rumah Sakit Rujukan Tersier

Bachtiar¹,

Asriyani²,

Murtala³

et al. 2021

MKP

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Latar belakang: Sistem rujukan berjenjang dapat mempengaruhi karakteristik lesi pada CT-scan toraks pasien terduga tuberkulosis (TB) paru pada rumah sakit rujukan tersier. Hal ini dapat menyamarkan keberadaan penyerupa dan penyerta TB paru. Metode Penelitian: Sampel adalah pasien yang terdiagnosis TB paru oleh ahli radiologi pada periode Oktober 2018 hingga Juni 2019. Analisis Chi-square dilakukan untuk menguji kesesuain 12 karakteristik CT-scan toraks (Konsolidasi, kavitas, tree-in-bud, fibrokalsifikasi, air-bronchogram-sign, lesi noduler, efusi pleura, atelektasis, bercak infiltrat, lymphadenopathy, bronchiectasis, ground glass opacity) dengan diagnosis akhir klinisi. Pencatatan penyerupa dan penyerta TB dilakukan setelah diagnosis akhir ditegakkan. Hasil: Dari 137 sampel, hanya 61 (44.5%) pasien yang terdiagnosis sebagai TB paru aktif, 38 (27.7%) terdiagnosis sebagai bekas TB paru dan 38 (27.7%) lainnya terdiagnosis sebagai penyakit paru bukan tuberkulosis. Dari 12 variabel yang dievaluasi, karakteristik yang sesuai dengan diagnosis klinisi adalah tree-in-bud (p = 0.019) dan lymphadenopathy (p = 0.039). Penyakit penyerupa dan penyerta terbanyak adalah tumor paru dan infected bronchiectasis. Simpulan: Gambaran CT-scan pasien TB paru sangat beragam pada rumah sakit rujukan tersier. Diperlukan ketelitian ahli radiologi dan kerja sama yang baik dengan klinisi untuk mendeteksi berbagai kemungkinan diagnosis yang dapat menyerupai dan menyertai TB paru

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Overdiagnosis of and treatment initiation delay in smear-negative pulmonary tuberculosis patients [Editorial]

Cited by 2 publications

References 5 publications

Rapid diagnosis of new and relapse tuberculosis by quantification of a circulating antigen in HIV-infected adults in the Greater Houston metropolitan area

Rapid diagnosis of new and relapse tuberculosis by quantification of a circulating antigen in HIV-infected adults in the Greater Houston metropolitan area

Penyerupa dan Penyerta Tuberkulosis Paru yang Terdiagnosis Berdasarkan Gambaran CT-scan Toraks Pada Rumah Sakit Rujukan Tersier

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