Diagnostic accuracy of different bronchoscopic specimens in sputum Xpert MBT/RIF- negative pulmonary TB patients.

IF 2.3
Multidisciplinary Respiratory Medicine Pub Date : 2022-10-28 eCollection Date: 2022-01-12 DOI:10.4081/mrm.2022.872
Omaima Ibrahim Badr, Wael Aly Elrefaey, Mohammed Shabrawishi, Hamza M Assaggaf, Faisal Minshawi
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引用次数: 2

Abstract

Background: Tuberculosis (TB) control remains a critical public health problem worldwide. Rapid diagnosis and proper treatment are beneficial for the effective control of tuberculosis transmission. Diagnostic challenges arise when a patient has a clinical and radiological suspicion of tuberculosis but cannot produce sputum, sputum acid-fast bacilli, or Xpert Mycobacterium tuberculosis/rifampicin (Xpert MTB/RIF) is negative, resulting in suboptimal management. As a result, more invasive techniques must be used on these patients to establish the diagnosis.

Methods: A retrospective study recruited 330 suspected pulmonary TB patients with negative sputum of Xpert MBT/RIF who underwent bronchoscopy between March 2018 and December 2021. The diagnostic yields of bronchoalveolar lavage fluid (acid-fast bacilli, Xpert MTB/RIF, and culture) and histopathologic examination (HPE) were calculated and compared to the final diagnosis and culture as a gold standard.

Results: Out of 330 suspected pulmonary TB patients, 181 had a final diagnosis of TB, and 149 had non-TB. The sensitivity of BALF (culture, Xpert, acid-fast bacilli) and trans-bronchial lung biopsy (HPE) was 80.7%, 72.9%, 21.1%, and 87.1%, respectively. Multiple nodules were associated with significantly higher BALF Xpert MTB, bronchoalveolar lavage fluid culture, and trans-bronchial lung biopsy (HPE) positivity.

Conclusions: Bronchoscopic specimens are essential for accurate and rapid diagnosis of sputum Xpert MBT/RIF negative patients with high clinical and radiological suspicion of tuberculosis.

Abstract Image

不同支气管镜标本对MBT/RIF阴性肺结核患者的诊断准确性。
背景:结核病(TB)控制仍然是世界范围内一个重要的公共卫生问题。快速诊断和适当治疗有利于有效控制结核病的传播。当患者临床和放射学怀疑为结核病,但不能产生痰,痰抗酸杆菌或Xpert结核分枝杆菌/利福平(Xpert MTB/RIF)阴性时,就会出现诊断挑战,导致管理不理想。因此,必须对这些患者使用更具侵入性的技术来确定诊断。方法:回顾性研究招募了330例2018年3月至2021年12月间行支气管镜检查的Xpert MBT/RIF阴性疑似肺结核患者。计算支气管肺泡灌洗液(抗酸杆菌、Xpert MTB/RIF和培养)和组织病理学检查(HPE)的诊断率,并将其与最终诊断和培养作为金标准进行比较。结果:330例疑似肺结核患者中,最终诊断为结核181例,非结核149例。BALF(培养、Xpert、抗酸杆菌)和经支气管肺活检(HPE)的敏感性分别为80.7%、72.9%、21.1%和87.1%。多发结节与高BALF Xpert MTB、支气管肺泡灌洗液培养和经支气管肺活检(HPE)阳性相关。结论:痰Xpert MBT/RIF阴性患者临床及影像学高度怀疑为结核病,支气管镜标本是准确、快速诊断的必要条件。
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来源期刊
Multidisciplinary Respiratory Medicine
Multidisciplinary Respiratory Medicine Medicine-Pulmonary and Respiratory Medicine
自引率
0.00%
发文量
23
期刊介绍: Multidisciplinary Respiratory Medicine is the official journal of the Italian Respiratory Society - Società Italiana di Pneumologia (IRS/SIP). The journal publishes on all aspects of respiratory medicine and related fields, with a particular focus on interdisciplinary and translational research. The interdisciplinary nature of the journal provides a unique opportunity for researchers, clinicians and healthcare professionals across specialties to collaborate and exchange information. The journal provides a high visibility platform for the publication and dissemination of top quality original scientific articles, reviews and important position papers documenting clinical and experimental advances.
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