Using simultaneous amplification and testing method for evaluating the treatment outcome of pulmonary tuberculosis

Abstract

BackgroundTo evaluate the utility of Simultaneous Amplification and Testing (SAT-TB) Method for monitoring anti-TB treatment response.MethodsSerial morning sputum specimens were obtained from 377 active pulmonary tuberculosis (PTB) cases at baseline, weeks 2, months 2, 5 and 6 (newly diagnosed patients) or 8 (previously treated patients) for AmpSure assay, smear fluorescence microscopy (FM) and BACTEC MGIT 960 culture assay.ResultsAfter treatment of 2 weeks, sputum culture was positive in 280 patients (74.27%). Among whom, 219 patients tested positive for SAT-TB assay and 143 patients smear FM positive. The detection rate of SAT-TB (78.21%) was significantly higher than sputum FM (51.07%, χ2 = 45.128, P < 0.001). At the end of the second month of treatment, 157 patients (41.64%) were still culture-positive, 115 patients of them SAT-TB positive and 79 smear FM positive. The difference of detection rate between SAT-TB (73.25%) and sputum FM (50.32%) was significant (χ2 = 17.480, P < 0.001). When patients underwent five months of treatment, 65 patients (17.24%) with sputum culture positive was defined as treatment failure. Among whom, 60 patients (92.31%) were SAT-TB positive and 38 patients (58.46%) were smear FM positive. The detection rate of SAT-TB assay was significantly higher than sputum FM (χ2 = 17.333, P < 0.001).ConclusionResults of AmpSure assays for monitoring treatment responses can be obtained without waiting for the results of BACTEC MGIT 960 assays and most patients with treatment failures could be detected after 5 months.

Biomarkers That Correlate with Active Pulmonary Tuberculosis Treatment Response: a Systematic Review and Meta-analysis

“…Forty-nine biomarkers were evaluated in just one study. Most of the biomarkers were host-response markers, with the exception of lipoarabinomannan (LAM) in urine, sputum, and plasma ( 30 , 34 , 48 , 86 ), 16s rRNA in sputum ( 39 , 41 , 42 , 75 , 87 ), 85B mRNA in sputum ( 19 , 60 , 64 , 81 ), and IS6110 insertion element in sputum ( 60 ). Among the host-response biomarkers, most biomarkers were cytokine proteins measured in blood, both proinflammatory (e.g., IL-1, IL-6, and TNF-α) and anti-inflammatory (e.g., IL-4 and IL-10), which were most commonly analyzed using plasma or serum samples on commercially available research enzyme-linked immunosorbent assay (ELISA) kits.…”

The Diagnostic Value of the Thermostatic Amplification of Ribonucleic Acid in Bronchoalveolar Lavage Fluid in Smear-Negative Pulmonary Tuberculosis

“…At the same time, the real-time amplification signal Ct values generated by SAT-TB can be used for the relative quantification of TB bacteria, which may contribute to the clinical management of TB treatment. The continuous dilution of Mtb indicated that SAT-TB detection had high sensitivity with a detectable 100 CFU/ml ( 16 ). Of the 119 patients without TB who were included, 22 with obsolete TB tested negative for SAT-TB, indicating that this test could evaluate the evolving trend of patients with TB.…”

Strategies for advanced personalized tuberculosis diagnosis: Current technologies and clinical approaches

“…The positive result of SAT could indicate treatment failure after 5 months without waiting for the results from culture. 50 The signal intensity of LAM in the urine of six children with TB/HIV became undetectable 3 months after anti-tuberculosis chemotherapy, suggesting that the LAM concentration in urine might be a potential biomarker to monitor the effectiveness of chemotherapy. 51 Longitudinally detecting the serum concentration of MTB-specific peptide fragments by NanoDisk and high-throughput mass spectrometry also has this effect.…”