Diagnostic contribution of GeneXpert Ultra in pediatric pulmonary tuberculosis.

IF 2.9 4区医学 Q2 RESPIRATORY SYSTEM

Jornal Brasileiro De Pneumologia Pub Date : 2025-03-31 eCollection Date: 2025-01-01 DOI:10.36416/1806-3756/e20240241

Claudia Stella Pereira Battaglia, Ana Alice Amaral Ibiapina Parente, Ronir Raggio Luiz, Rafaela Baroni Aurilio, Michely Alexandrino de Souza Pinheiro, Maria de Fátima Bazhuni Pombo Sant'Anna, Clemax Couto Sant'Anna

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引用次数: 0

Abstract

Objectives: To evaluate the contribution of Ultra to the diagnosis of pediatric pulmonary tuberculosis (PTB).

Methods: We analyzed prospective data from children and adolescents with presumed PTB whose specimens were tested with Ultra between January 2020 and December 2022. Diagnosis was based on clinical-radiological criteria, clinical response after a two-month treatment period, and microbiological analysis. Ultra was considered positive with a result of 'Detected' and 'Traces' in children under 10 years and in HIV-infected individuals. Fisher's exact test was used for group comparisons, and McNemar's test was used to compare Ultra results with the diagnostic presumption. The study was approved by the Ethics Committee (CAAE No. 02173518.2.0000.5264).

Results: A total of 41 patients were included, of whom 63% (26/41) were diagnosed with PTB. Among these, 9/26 (34%) had positive results only through Ultra, with negative AFB and culture. The sensitivity and specificity of Ultra were 50% (13/26) and 100% (15/15), respectively. The PPV was 100% (13/13), and the NPV was 54% (15/28). Of these 28 (68%) patients with negative Ultra results, 13 (46%) were diagnosed with PTB, mostly by MoH-SS. Considering culture as the reference, the PPV and NPV were 67% and 100%, respectively.

Conclusions: Ultra significantly contributed to the diagnosis of pediatric PTB, proving to be a promising tool for paucibacillary forms of the disease. However, it should not be used alone. Integrating laboratory tests with clinical evaluation is essential to improving diagnostic accuracy and the management of pediatric TB.

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GeneXpert Ultra在儿童肺结核诊断中的贡献。

目的：评价Ultra在小儿肺结核（PTB）诊断中的价值。方法：我们分析了2020年1月至2022年12月期间接受Ultra检测的推定患有肺结核的儿童和青少年的前瞻性数据。诊断基于临床放射学标准、两个月治疗期后的临床反应和微生物学分析。在10岁以下儿童和艾滋病毒感染者中，Ultra被认为是阳性的，结果是“检测到”和“痕量”。Fisher精确检验用于组间比较，McNemar检验用于比较Ultra结果与诊断推定。该研究已获得伦理委员会批准（CAAE No. 02173518.2.0000.5264）。结果：共纳入41例患者，其中63%（26/41）诊断为PTB。其中9/26（34%）仅通过Ultra阳性，AFB和培养阴性。Ultra的敏感性为50%(13/26)，特异性为100%（15/15）。PPV为100% (13/13)，NPV为54%（15/28）。在这28例（68%）Ultra结果为阴性的患者中，13例（46%）被诊断为肺结核，主要由MoH-SS检测。以培养为参照，PPV和NPV分别为67%和100%。结论：Ultra对儿童PTB的诊断有显著贡献，被证明是一种有前途的工具，用于疾病的少杆菌形式。然而，它不应该单独使用。将实验室检测与临床评估结合起来，对于提高诊断准确性和管理儿童结核病至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Jornal Brasileiro De Pneumologia RESPIRATORY SYSTEM-

CiteScore

3.50

自引率

14.80%

发文量

118

审稿时长

20 weeks

期刊介绍： The Brazilian Journal of Pulmonology publishes scientific articles that contribute to the improvement of knowledge in the field of the lung diseases and related areas.