Research progress of GeneXpert MTB/RIF stool test in children tuberculosis

doi:10.19982/j.issn.1000-6621.20230300

Abstract

Abstract:

Difficulties in obtaining specimens and low positive rates in pathogen diagnosis exist in pediatric active tuberculosis. Xpert, a real-time fluorescence quantitative nucleic acid amplification test for Mycobacterium tuberculosis (MTB) and rifampin resistance, is rapid and provides a reliable basis for the diagnosis of tuberculosis with high sensitivity and specificity. Currently, this method has been widely used for sputum or gastric fluid test, and the application value of fecal samples in pulmonary tuberculosis diagnosis has been almost affirmed, while further research is still needed for extra-pulmonary tuberculosis. This article reviewed the use of this method for detecting MTB in fecal samples of children with tuberculosis, aiming to provide reference for the clinical application of Xpert in fecal testing for children.

Key words: Tuberculosis, Feces, Molecular diagnostic techniques, Child

CLC Number:

Li Xiaoying, Fang Yulian, Ning Jing, Xu Yongsheng. Research progress of GeneXpert MTB/RIF stool test in children tuberculosis[J]. Chinese Journal of Antituberculosis, 2024, 46(1): 119-123. doi: 10.19982/j.issn.1000-6621.20230300

References 34

[1]	World Health Organization. WHO consolidated guidelines on Tuberculosis. Module 4:treatment. Tuberculosis care and support. Geneva:World Health Organization, 2022.
[2]	Dodd PJ, Sismanidis C, Seddon JA. Global burden of drug-resistant tuberculosis in children: a mathematical modelling study. Lancet Infect Dis, 2016, 16(10):1193-201. doi:10.1016/S1473-3099(16)30132-3. pmid: 27342768
[3]	Jenkins HE, Tolman AW, Yuen CM, et al. Incidence of multidrug-resistant tuberculosis disease in children: systematic review and global estimates. Lancet, 2014, 383(9928):1572-1579. doi:10.1016/S0140-6736(14)60195-1. pmid: 24671080
[4]	Nhu NT, Ha DT, Anh ND, et al. Evaluation of Xpert MTB/RIF MTB/RIF and MODS assay for the diagnosis of pediatric tuberculosis. BMC Infect Dis, 2013, 13:31. doi:10.1186/1471-2334-13-31.
[5]	Sekadde MP, Wobudeya E, Joloba ML, et al. Evaluation of the Xpert MTB/RIF MTB/RIF test for the diagnosis of childhood pulmonary tuberculosis in Uganda: a cross-sectional diagnostic study. BMC Infect Dis, 2013, 13:133. doi:10.1186/1471-2334-13-133.
[6]	Kayigire XA, Friedrich SO, Venter A, et al. Direct comparison of Xpert MTB/RIF MTB/RIF assay with liquid and solid mycobacterial culture for quantification of early bactericidal activity. Clin Microbiol, 2013, 51(6):1894-1898. doi:10.1128/JCM.03290-12.
[7]	Graham SM, Cuevas LE, Jean-Philippe P, et al. Clinical Case Definitions for Classification of Intrathoracic Tuberculosis in Children: An Update. Clin Infect Dis, 2015, 3:S179-87. doi:10.1093/cid/civ581.
[8]	李洁琼, 申阿东. 儿童结核病诊断进展及存在的问题. 中华实用儿科临床杂志, 2019, 34(9):655-659. doi:10.3760/cma.j.issn.2095-428X.2019.09.005.
[9]	Cordova J, Shiloh R, Gilman RH, et al. Evaluation of molecular tools for detection and drug susceptibility testing of Mycobacterium tuberculosis in stool specimens from patients with pulmonary tuberculosis. Clin Microbiol, 2010, 48(5):1820-1826. doi:10.1128/JCM.01161-09.
[10]	Liu XH, Xia L, Song B, et al. Stool-based Xpert MTB/RIF Ultra assay as a tool for detecting pulmonary tuberculosis in children with abnormal chest imaging: A prospective cohort study. J Infect, 2021, 82(1):84-89. doi:10.1016/j.jinf.2020.10.036.
[11]	World Health Organization. WHO consolidated guidelines on tuberculosis. Module 3: diagnosis-rapid diagnostics for tuberculosis detection. 2021 update. Geneva: World Health Organization,2021.
[12]	Chipinduro M, Mateveke K, Makamure B, et al. Stool Xpert MTB/RIF test for the diagnosis of childhood pulmonary tuberculosis at primary clinics in Zimbabwe. Int J Tuberc Lung Dis, 2017, 21(2):161-166. doi:10.5588/ijtld.16.0357. pmid: 28234079
[13]	Moussa HSh, Bayoumi FS, Mohamed AM. GeneXpert MTB/RIF for Direct Detection of Mycobacterium Tuberculosis in Stool Specimens from Children with Presumptive Pulmonary Tuberculosis. Ann Clin Lab Sci, 2016, 46(2):198-203.
[14]	Marcy O, Ung V, Goyet S, et al. Performance of Xpert MTB/RIF MTB/RIF and Alternative Specimen Collection Methods for the Diagnosis of Tuberculosis in HIV-Infected Children. Clin Infect Dis, 2016, 62(9):1161-1168. doi:10.1093/cid/ciw036.
[15]	Walters E, van der Zalm MM, Palmer M, et al. Xpert MTB/RIF MTB/RIF on Stool Is Useful for the Rapid Diagnosis of Tuberculosis in Young Children With Severe Pulmonary Disease. Pediatr Infect Dis J, 2017, 36(9):837-843. doi:10.1097/INF.0000000000001563.
[16]	Welday SH, Kimang’a AN, Kabera BM, et al. Stool as Appropriate Sample for the Diagnosis of Mycobacterium Tuberculosis by Gene Xpert MTB/RIF Test. Open J Resp Dis, 2014, 4:83-89.
[17]	Banada PP, Naidoo U, Deshpande S, et al. A Novel Sample Processing Method for Rapid Detection of Tuberculosis in the Stool of Pediatric Patients Using the Xpert MTB/RIF Assay. PLoS One, 2016, 11(3):e0151980. doi:10.1371/journal.pone.0151980.
[18]	Walters E, Scott L, Nabeta P, et al. Molecular Detection of Mycobacterium tuberculosis from Stools in Young Children by Use of a Novel Centrifugation-Free Processing Method. J Clin Microbiol, 2018, 56(9):e00781-18. doi:10.1128/JCM.00781-18.
[19]	Andriyoko B, Janiar H, Kusumadewi R, et al. Simple stool processing method for the diagnosis of pulmonary tuberculosis using GeneXpert MTB/RIF. Eur Respir J, 2019, 14, 53(3):1801832. doi:10.1183/13993003.01832-2018.
[20]	MacLean E, Sulis G, Denkinger CM, et al. Diagnostic Accuracy of Stool Xpert MTB/RIF for Detection of Pulmonary Tuberculosis in Children: a Systematic Review and Meta-analysis. J Clin Microbiol, 2019, 57(6):e02057-18. doi:10.1128/JCM.02057-18.
[21]	Lounnas M, Diack A, Nicol MP, et al. Laboratory development of a simple stool sample processing method diagnosis of pediatric tuberculosis using Xpert MTB/RIF Ultra. Tuberculosis (Edinb), 2020, 125:102002. doi:10.1016/j.tube.2020.102002.
[22]	de Haas P, Yenew B, Mengesha E, et al. The Simple One-Step (SOS) Stool Processing Method for Use with the Xpert MTB/RIF Assay for a Child-Friendly Diagnosis of Tuberculosis Closer to the Point of Care. J Clin Microbiol, 2021, 59(8):e0040621. doi:10.1128/JCM.00406-21.
[23]	Jasumback CL, Dlamini Q, Kahari J, et al. Laboratory comparison of stool processing methods for Xpert MTB/RIFUltra. Public health action, 2021, 11(2):55-57. doi:10.5588/pha.20.0079. pmid: 34159062
[24]	Hillemann D, Rüsch-Gerdes S, Boehme C, et al. Rapid mole-cular detection of extrapulmonary tuberculosis by the automated GeneXpert MTB/RIF system. J Clin Microbiol, 2011, 49(4):1202-1205. doi:10.1128/JCM.02268-10. pmid: 21270230
[25]	Walters E, Gie RP, Hesseling AC, et al. Rapid diagnosis of pediatric intrathoracic tuberculosis from stool samples using the Xpert MTB/RIF Assay: a pilot study. Pediatr Infect Dis J, 2012, 31(12):1316. doi:10.1097/INF.0b013e318266c21c. pmid: 23188101
[26]	Alvarez-Uria G, Azcona JM, Midde M, et al. Rapid Diagnosis of Pulmonary and Extrapulmonary Tuberculosis in HIV-Infected Patients. Comparison of LED Fluorescent Microscopy and the GeneXpert MTB/RIF Assay in a District Hospital in India. Tuberc Res Treat, 2012, 2012:932862. doi:10.1155/2012/932862.
[27]	MacLean E, Sulis G, Denkinger CM, et al. Diagnostic accuracy of stool Xpert MTB/RIF for the detection of pulmonary tuberculosis in children: a systematic review and meta-analysis. J Clin Microbiol, 2019, 57:1-12. doi.org/10.1128/JCM.02057-18.
[28]	Mesman AW, Rodriguez C, Ager E, et al. Diagnostic accuracy of molecular detection of Mycobacterium tuberculosis in pediatric stool samples: a systematic review and meta-analysis. Tuberculosis, 2019, 119:101878. doi:10.1016/j.tube.2019.101878.
[29]	Kokuto H, Sasaki Y, Yoshimatsu S, et al. Detection of Mycobacterium tuberculosis (MTB) in Fecal Specimens From Adults Diagnosed With Pulmonary Tuberculosis Using the Xpert MTB/Rifampicin Test. Open forum Infect Dis, 2015, 2(2):ofv074. doi:10.1093/ofid/ofv074.
[30]	Hasan Z, Arif F, Shakoor S, et al. Effective testing for pulmonary tuberculosis using Xpert MTB/RIF assay for stool specimens in immunocompetent Pakistani children. Int J Mycobacteriol, 2016, 5 Suppl 1:S8-S9. doi:10.1016/j.ijmyco.2016.09.068.
[31]	Sun L, Liu Y, Fang M, et al. Use of Xpert MTB/RIF Ultra assay on stool and gastric aspirate samples to diagnose pulmonary tuberculosis in children in a high-tuberculosis-burden but resource-limited area of China. Int J Infect Dis, 2022, 114:236-243. doi:10.1016/j.ijid.2021.11.012.
[32]	World Health Organization. WHO consolidated guidelines on tuberculosis Module 5: Management of tuberculosis in children and adolescents. Geneva:World Health Organization, 2022.
[33]	Bellam BL, Mandavdhare HS, Sharma K, et al. Utility of tissue Xpert-Mtb/Rif for the diagnosis of intestinal tuberculosis in patients with ileocolonic ulcers. Ther Adv Infect Dis, 2019, 6: 2049936119863939. doi:10.1177/2049936119863939.
[34]	熊瑜, 高绪胜, 丁彩红, 等. 粪便Gene Xpert MTB/RIF检测对HIV阴性肠结核的早期快速诊断价值. 中国临床医学, 2020, 27(4):679-683. doi:10.12025/j.issn.1008-6358.2020.20200459.