Stool testing for pulmonary TB diagnosis in adults

Abstract

BACKGROUND: Mycobacterium tuberculosis is acid-fast and able to survive in the gastrointestinal tract. Thus, bacteria can be found in stool if sputum is swallowed. In this study, the accuracy of different diagnostic stool methods (microscopy, polymerase chain reaction PCR and culture) among adults with pulmonary TB (PTB) were assessed and compared with sputum culture.METHODS: Embase and PubMed were searched to identify studies with data on stool testing among patients with clinically presumed or microbiologically verified PTB.RESULTS: Thirteen relevant studies were included. A pooled sensitivity of one or more of the three TB identifying methods was 79.1% (95% CI 61.5–92.5). The sensitivity of stool microscopy, PCR and culture was respectively 41.1% (95%CI 24.9–58.2), 89.7% (95% CI 81.4–95.9) and 38.0% (95% CI 26.2–50.6). The heterogeneity of the studies included was high.CONCLUSION: Our review findings indicate that the analysis of stool specimens as part of PTB diagnostics is useful. PCR methods were particularly helpful in detecting a substantial proportion of patients with PTB.

Genomic insights into anthropozoonotic tuberculosis in captive sun bears (Helarctos malayanus) and an Asiatic black bear (Ursus thibetanus) in Cambodia

“…1 and 2 . Sample sites are broadly categorised as pulmonary or extra-pulmonary, with positive cultures from gastric fluid or faeces, in the absence of any macroscopic evidence of extra-pulmonary disease, considered to be of pulmonary origin 45 , 46 . M. tuberculosis was cultured from extra-pulmonary sites in 7/10 (70%) Lineage 2 cases, including three cases with no evidence of pulmonary disease, whereas in Lineage 1 M .…”

Blazing the trail for innovative tuberculosis diagnostics

“…Given the challenges in collecting sputum samples from children, WHO advised utilizing Xpert MTB/ RIF (Xpert; Cepheid, CA, USA) testing of stool samples as a primary diagnostic test for TB in children presenting pulmonary TB signs and symptoms in 2020 [115]. Its application in adults has also been researched, and the pooled sensitivity of stool PCR was reported to be 89.7% (95% CI 81.4-95.9%) [116].…”