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Abstract
Discussion Forum (0)
Abstract number: 4957

Session Type: ePosters

Session Title: ePosters

Authors(s): H. Tafa (1), S. Tafaj (1), L. Suraj (1), D. Mema (2), H. Hafizi (1)

Authors Affiliations(s): (1) University Hospital Shefqet Ndroqi, Albania, (2) Institute of Public Health, Albania

Background:

The paucibacillary nature of the extrapulmonary tuberculosis (EPTB) makes its diagnosis very challenging and time consuming by classical bacteriological methods such as culture. Xpert MTB/RIF Ultra (Ultra) has been recently introduced in Albania to improve detection of Mycobacterium tuberculosis complex (MTC) in paucibacillary specimens.  

Methods:

We conducted a cross sectional study from June 2019-April 2021, in order to assess the performance of Ultra. All extrapulmonary samples received for TB diagnosis were prospectively included. A total of 232 extrapulmonary samples were tested by direct Ziehl Neelsen microscopy and Ultra. 

Results:

The EPTB specimens comprised of pleural fluid (n = 190), pus (n = 15), CSF (n = 9), drainage fluid (n = 6), pericardial fluid (n = 3), bone tissue (n = 2), lymph nodes (n = 2), wound secretions (n = 2), urine (n = 2) and ascitic fluid (n = 1). Among the 232 samples tested, 19 (8.19%) were positive by Ultra but negative by microscopy and 1 (0.43%) was positive by both Ultra and microscopy. Amount of MTC DNA detected was very low in 7 (35%), trace in 6 (30%), low in 3 (15%), medium in 2 (10%) and high in 2 (10%). Genotypic RIF-R was not detected by Ultra in 14 samples, and indeterminate in the six samples semi-quantitated as “trace”. 

Conclusions:

In our setting, Ultra resulted a useful add-on test that contributed to a rapid diagnosis of EPTB with the advantage of results within hours. We evidenced a 19-fold improvement in MTC detection, compared to the Ziehl Neelsen microscopy. One of the limitations of Ultra is that it can not separate viable from non-viable bacilli and it cannot give information about drug resistance for “trace” positive samples. This may become an issue, especially if patients have been previously treated for TB. 

Keyword(s): Xpert MTB Ultra, Extrapulmonary TB, POC

Abstract number: 4957

Session Type: ePosters

Session Title: ePosters

Authors(s): H. Tafa (1), S. Tafaj (1), L. Suraj (1), D. Mema (2), H. Hafizi (1)

Authors Affiliations(s): (1) University Hospital Shefqet Ndroqi, Albania, (2) Institute of Public Health, Albania

Background:

The paucibacillary nature of the extrapulmonary tuberculosis (EPTB) makes its diagnosis very challenging and time consuming by classical bacteriological methods such as culture. Xpert MTB/RIF Ultra (Ultra) has been recently introduced in Albania to improve detection of Mycobacterium tuberculosis complex (MTC) in paucibacillary specimens.  

Methods:

We conducted a cross sectional study from June 2019-April 2021, in order to assess the performance of Ultra. All extrapulmonary samples received for TB diagnosis were prospectively included. A total of 232 extrapulmonary samples were tested by direct Ziehl Neelsen microscopy and Ultra. 

Results:

The EPTB specimens comprised of pleural fluid (n = 190), pus (n = 15), CSF (n = 9), drainage fluid (n = 6), pericardial fluid (n = 3), bone tissue (n = 2), lymph nodes (n = 2), wound secretions (n = 2), urine (n = 2) and ascitic fluid (n = 1). Among the 232 samples tested, 19 (8.19%) were positive by Ultra but negative by microscopy and 1 (0.43%) was positive by both Ultra and microscopy. Amount of MTC DNA detected was very low in 7 (35%), trace in 6 (30%), low in 3 (15%), medium in 2 (10%) and high in 2 (10%). Genotypic RIF-R was not detected by Ultra in 14 samples, and indeterminate in the six samples semi-quantitated as “trace”. 

Conclusions:

In our setting, Ultra resulted a useful add-on test that contributed to a rapid diagnosis of EPTB with the advantage of results within hours. We evidenced a 19-fold improvement in MTC detection, compared to the Ziehl Neelsen microscopy. One of the limitations of Ultra is that it can not separate viable from non-viable bacilli and it cannot give information about drug resistance for “trace” positive samples. This may become an issue, especially if patients have been previously treated for TB. 

Keyword(s): Xpert MTB Ultra, Extrapulmonary TB, POC

Xpert® MTB/RIF Ultra for rapid diagnosis of extrapulmonary tuberculosis in a limited resource setting
Dr. Holta Tafa
Dr. Holta Tafa
Affiliations:
Pulmonologist at University Hospital "Shefqet Ndroqi", Tirana, Albania
ESCMID eAcademy. Tafa H. 07/09/2021; 332423; 4957;
user
Dr. Holta Tafa
Affiliations:
Pulmonologist at University Hospital "Shefqet Ndroqi", Tirana, Albania
Abstract
Discussion Forum (0)
Abstract number: 4957

Session Type: ePosters

Session Title: ePosters

Authors(s): H. Tafa (1), S. Tafaj (1), L. Suraj (1), D. Mema (2), H. Hafizi (1)

Authors Affiliations(s): (1) University Hospital Shefqet Ndroqi, Albania, (2) Institute of Public Health, Albania

Background:

The paucibacillary nature of the extrapulmonary tuberculosis (EPTB) makes its diagnosis very challenging and time consuming by classical bacteriological methods such as culture. Xpert MTB/RIF Ultra (Ultra) has been recently introduced in Albania to improve detection of Mycobacterium tuberculosis complex (MTC) in paucibacillary specimens.  

Methods:

We conducted a cross sectional study from June 2019-April 2021, in order to assess the performance of Ultra. All extrapulmonary samples received for TB diagnosis were prospectively included. A total of 232 extrapulmonary samples were tested by direct Ziehl Neelsen microscopy and Ultra. 

Results:

The EPTB specimens comprised of pleural fluid (n = 190), pus (n = 15), CSF (n = 9), drainage fluid (n = 6), pericardial fluid (n = 3), bone tissue (n = 2), lymph nodes (n = 2), wound secretions (n = 2), urine (n = 2) and ascitic fluid (n = 1). Among the 232 samples tested, 19 (8.19%) were positive by Ultra but negative by microscopy and 1 (0.43%) was positive by both Ultra and microscopy. Amount of MTC DNA detected was very low in 7 (35%), trace in 6 (30%), low in 3 (15%), medium in 2 (10%) and high in 2 (10%). Genotypic RIF-R was not detected by Ultra in 14 samples, and indeterminate in the six samples semi-quantitated as “trace”. 

Conclusions:

In our setting, Ultra resulted a useful add-on test that contributed to a rapid diagnosis of EPTB with the advantage of results within hours. We evidenced a 19-fold improvement in MTC detection, compared to the Ziehl Neelsen microscopy. One of the limitations of Ultra is that it can not separate viable from non-viable bacilli and it cannot give information about drug resistance for “trace” positive samples. This may become an issue, especially if patients have been previously treated for TB. 

Keyword(s): Xpert MTB Ultra, Extrapulmonary TB, POC

Abstract number: 4957

Session Type: ePosters

Session Title: ePosters

Authors(s): H. Tafa (1), S. Tafaj (1), L. Suraj (1), D. Mema (2), H. Hafizi (1)

Authors Affiliations(s): (1) University Hospital Shefqet Ndroqi, Albania, (2) Institute of Public Health, Albania

Background:

The paucibacillary nature of the extrapulmonary tuberculosis (EPTB) makes its diagnosis very challenging and time consuming by classical bacteriological methods such as culture. Xpert MTB/RIF Ultra (Ultra) has been recently introduced in Albania to improve detection of Mycobacterium tuberculosis complex (MTC) in paucibacillary specimens.  

Methods:

We conducted a cross sectional study from June 2019-April 2021, in order to assess the performance of Ultra. All extrapulmonary samples received for TB diagnosis were prospectively included. A total of 232 extrapulmonary samples were tested by direct Ziehl Neelsen microscopy and Ultra. 

Results:

The EPTB specimens comprised of pleural fluid (n = 190), pus (n = 15), CSF (n = 9), drainage fluid (n = 6), pericardial fluid (n = 3), bone tissue (n = 2), lymph nodes (n = 2), wound secretions (n = 2), urine (n = 2) and ascitic fluid (n = 1). Among the 232 samples tested, 19 (8.19%) were positive by Ultra but negative by microscopy and 1 (0.43%) was positive by both Ultra and microscopy. Amount of MTC DNA detected was very low in 7 (35%), trace in 6 (30%), low in 3 (15%), medium in 2 (10%) and high in 2 (10%). Genotypic RIF-R was not detected by Ultra in 14 samples, and indeterminate in the six samples semi-quantitated as “trace”. 

Conclusions:

In our setting, Ultra resulted a useful add-on test that contributed to a rapid diagnosis of EPTB with the advantage of results within hours. We evidenced a 19-fold improvement in MTC detection, compared to the Ziehl Neelsen microscopy. One of the limitations of Ultra is that it can not separate viable from non-viable bacilli and it cannot give information about drug resistance for “trace” positive samples. This may become an issue, especially if patients have been previously treated for TB. 

Keyword(s): Xpert MTB Ultra, Extrapulmonary TB, POC

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