Diagnostic accuracy of a sequence-specific Mtb-DNA hybridization assay in urine: a case-control study including subclinical TB cases.

Détails

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Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_4CA88B9A5608
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Diagnostic accuracy of a sequence-specific Mtb-DNA hybridization assay in urine: a case-control study including subclinical TB cases.
Périodique
Microbiology spectrum
Auteur⸱e⸱s
Tschan Y., Sasamalo M., Hiza H., Fellay J., Gagneux S., Reither K., Hella J., Portevin D.
ISSN
2165-0497 (Electronic)
ISSN-L
2165-0497
Statut éditorial
Publié
Date de publication
04/06/2024
Peer-reviewed
Oui
Volume
12
Numéro
6
Pages
e0042624
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Tuberculosis (TB) caused by Mycobacterium tuberculosis (Mtb) remains one of the deadliest infectious diseases globally. Timely diagnosis is a key step in the management of TB patients and in the prevention of further transmission events. Current diagnostic tools are limited in these regards. There is an urgent need for new accurate non-sputum-based diagnostic tools for the detection of symptomatic as well as subclinical TB. In this study, we recruited 52 symptomatic TB patients (sputum Xpert MTB/RIF positive) and 58 household contacts to assess the accuracy of a sequence-specific hybridization assay that detects the presence of Mtb cell-free DNA in urine. Using sputum Xpert MTB/RIF as a reference test, the magnetic bead-capture assay could discriminate active TB from healthy household contacts with an overall sensitivity of 72.1% [confidence interval (CI) 0.59-0.86] and specificity of 95.5% (CI 0.90-1.02) with a positive predictive value of 93.9% and negative predictive value of 78.2%. The detection of Mtb-specific DNA in urine suggested four asymptomatic TB infection cases that were confirmed in all instances either by concomitant Xpert MTB/RIF sputum testing or by follow-up investigation raising the specificity of the index test to 100%. We conclude that sequence-specific hybridization assays on urine specimens hold promise as non-invasive tests for the detection of subclinical TB.
There is an urgent need for a non-sputum-based diagnostic tool allowing sensitive and specific detection of all forms of tuberculosis (TB) infections. In that context, we performed a case-control study to assess the accuracy of a molecular detection method enabling the identification of cell-free DNA from Mycobacterium tuberculosis that is shed in the urine of tuberculosis patients. We present accuracy data that would fulfill the target product profile for a non-sputum test. In addition, recent epidemiological data suggested that up to 50% of individuals secreting live bacilli do not present with symptoms at the time of screening. We report, here, that the investigated index test could also detect instances of asymptomatic TB infections among household contacts.
Mots-clé
Humans, Mycobacterium tuberculosis/genetics, Mycobacterium tuberculosis/isolation & purification, Case-Control Studies, Female, Male, Tuberculosis/diagnosis, Tuberculosis/urine, Tuberculosis/microbiology, Adult, DNA, Bacterial/genetics, DNA, Bacterial/urine, Sputum/microbiology, Middle Aged, Sensitivity and Specificity, Nucleic Acid Hybridization/methods, Young Adult, Aged, Tuberculosis, Pulmonary/diagnosis, Tuberculosis, Pulmonary/urine, Tuberculosis, Pulmonary/microbiology, cell-free DNA, diagnosis, non-sputum, tuberculosis, urine
Pubmed
Web of science
Open Access
Oui
Création de la notice
10/05/2024 13:34
Dernière modification de la notice
14/06/2024 6:11
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