A toolbox for tuberculosis diagnosis

An indian multicentric study (2006-2008): Microbiological results

Philippe H. Lagrange, Satheesh K. Thangaraj, Rajeshwar Dayal, Alka Despande, Nirmal K. Ganguly, Enrico Girardi, Beenu Joshi, Kiran Katoch, Vishwa M. Katoch, Manoj Kumar, Vemu Lakshmi, Marc Leportier, Christophe Longuet, Subbalaxmi V S Malladi, Deepali Mukerjee, Deepthi Nair, Alamelu Raja, Balambal Raman, Camilla Rodrigues, Pratibha Sharma & 6 others Amit Singh, Sarman Singh, Archana Sodha, Basirudeen S. Kabeer, Guy Vernet, Delia Goletti

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: The aim of this multicentric prospective study in India was to assess the value of several microbiological tools that contribute to the diagnosis of tuberculosis (TB) according to HIV status. Methods: Standard microbiological tools on individual specimens were analyzed. Results: Among the 807 patients with active TB, 131 were HIV-infected, 316 HIV-uninfected and 360 had HIV-unknown status. Among the 980 non-active TB subjects, 559 were at low risk and 421 were at high risk of M. tuberculosis (Mtb) exposure. Sensitivity of smear microscopy (SM) was significantly lower in HIV-infected (42.2%) than HIV-uninfected (75.9%) (p = 0.0001) and HIV-unknown pulmonary TB patients (61.4%) (p = 0.004). Specificity was 94.5% in non-TB patients and 100% in health care workers (HCW) and healthy family contacts. Automated liquid culture has significantly higher diagnostic performances than solid culture, measured by sensitivity (74.7% vs. 55.9%) (p = 0.0001) and shorter median time to detection (TTD) (12.0 vs. 34.0 days) (p = 0.0001). Specificity was 100% in HCW and cured-TB patients, but was lower in non-TB patients (89%) due to isolation of Mycobacteria other than tuberculosis (MOTT). TTD by both methods was related to AFB score. Contamination rate was low (1.4%). AccuProbe hybridization technique detected Mtb in almost all culture-positive specimens, but MOTT were found in 4.7% with a significantly higher frequency in HIV-infected (15%) than HIV-uninfected TB patients (0.5%) (p = 0.0007). Pre-test classification significantly increased the diagnostic value of all microbiological tests in pulmonary TB patients (p<0.0001) but to a lesser degree in extrapulmonary TB patients. Conclusions: Conventional microbiological tools led to results similar to those already described in India special features for HIV-infected TB patients included lower detection by SM and culture. New microbiological assays, such as the automated liquid culture system, showed increased accuracy and speed of detection.

Original languageEnglish
Article numbere43739
JournalPLoS One
Volume7
Issue number8
DOIs
Publication statusPublished - 24 Aug 2012
Externally publishedYes

Fingerprint

tuberculosis
Tuberculosis
HIV
Health care
Microscopic examination
Liquids
Contacts (fluid mechanics)
Assays
Contamination
Pulmonary Tuberculosis
Mycobacterium tuberculosis
India
Microscopy
Mycobacterium
health care workers
Delivery of Health Care
microscopy
lungs
liquids
disease diagnosis

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Lagrange, P. H., Thangaraj, S. K., Dayal, R., Despande, A., Ganguly, N. K., Girardi, E., ... Goletti, D. (2012). A toolbox for tuberculosis diagnosis: An indian multicentric study (2006-2008): Microbiological results. PLoS One, 7(8), [e43739]. https://doi.org/10.1371/journal.pone.0043739

A toolbox for tuberculosis diagnosis : An indian multicentric study (2006-2008): Microbiological results. / Lagrange, Philippe H.; Thangaraj, Satheesh K.; Dayal, Rajeshwar; Despande, Alka; Ganguly, Nirmal K.; Girardi, Enrico; Joshi, Beenu; Katoch, Kiran; Katoch, Vishwa M.; Kumar, Manoj; Lakshmi, Vemu; Leportier, Marc; Longuet, Christophe; Malladi, Subbalaxmi V S; Mukerjee, Deepali; Nair, Deepthi; Raja, Alamelu; Raman, Balambal; Rodrigues, Camilla; Sharma, Pratibha; Singh, Amit; Singh, Sarman; Sodha, Archana; Kabeer, Basirudeen S.; Vernet, Guy; Goletti, Delia.

In: PLoS One, Vol. 7, No. 8, e43739, 24.08.2012.

Research output: Contribution to journalArticle

Lagrange, PH, Thangaraj, SK, Dayal, R, Despande, A, Ganguly, NK, Girardi, E, Joshi, B, Katoch, K, Katoch, VM, Kumar, M, Lakshmi, V, Leportier, M, Longuet, C, Malladi, SVS, Mukerjee, D, Nair, D, Raja, A, Raman, B, Rodrigues, C, Sharma, P, Singh, A, Singh, S, Sodha, A, Kabeer, BS, Vernet, G & Goletti, D 2012, 'A toolbox for tuberculosis diagnosis: An indian multicentric study (2006-2008): Microbiological results', PLoS One, vol. 7, no. 8, e43739. https://doi.org/10.1371/journal.pone.0043739
Lagrange PH, Thangaraj SK, Dayal R, Despande A, Ganguly NK, Girardi E et al. A toolbox for tuberculosis diagnosis: An indian multicentric study (2006-2008): Microbiological results. PLoS One. 2012 Aug 24;7(8). e43739. https://doi.org/10.1371/journal.pone.0043739
Lagrange, Philippe H. ; Thangaraj, Satheesh K. ; Dayal, Rajeshwar ; Despande, Alka ; Ganguly, Nirmal K. ; Girardi, Enrico ; Joshi, Beenu ; Katoch, Kiran ; Katoch, Vishwa M. ; Kumar, Manoj ; Lakshmi, Vemu ; Leportier, Marc ; Longuet, Christophe ; Malladi, Subbalaxmi V S ; Mukerjee, Deepali ; Nair, Deepthi ; Raja, Alamelu ; Raman, Balambal ; Rodrigues, Camilla ; Sharma, Pratibha ; Singh, Amit ; Singh, Sarman ; Sodha, Archana ; Kabeer, Basirudeen S. ; Vernet, Guy ; Goletti, Delia. / A toolbox for tuberculosis diagnosis : An indian multicentric study (2006-2008): Microbiological results. In: PLoS One. 2012 ; Vol. 7, No. 8.
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abstract = "Background: The aim of this multicentric prospective study in India was to assess the value of several microbiological tools that contribute to the diagnosis of tuberculosis (TB) according to HIV status. Methods: Standard microbiological tools on individual specimens were analyzed. Results: Among the 807 patients with active TB, 131 were HIV-infected, 316 HIV-uninfected and 360 had HIV-unknown status. Among the 980 non-active TB subjects, 559 were at low risk and 421 were at high risk of M. tuberculosis (Mtb) exposure. Sensitivity of smear microscopy (SM) was significantly lower in HIV-infected (42.2{\%}) than HIV-uninfected (75.9{\%}) (p = 0.0001) and HIV-unknown pulmonary TB patients (61.4{\%}) (p = 0.004). Specificity was 94.5{\%} in non-TB patients and 100{\%} in health care workers (HCW) and healthy family contacts. Automated liquid culture has significantly higher diagnostic performances than solid culture, measured by sensitivity (74.7{\%} vs. 55.9{\%}) (p = 0.0001) and shorter median time to detection (TTD) (12.0 vs. 34.0 days) (p = 0.0001). Specificity was 100{\%} in HCW and cured-TB patients, but was lower in non-TB patients (89{\%}) due to isolation of Mycobacteria other than tuberculosis (MOTT). TTD by both methods was related to AFB score. Contamination rate was low (1.4{\%}). AccuProbe hybridization technique detected Mtb in almost all culture-positive specimens, but MOTT were found in 4.7{\%} with a significantly higher frequency in HIV-infected (15{\%}) than HIV-uninfected TB patients (0.5{\%}) (p = 0.0007). Pre-test classification significantly increased the diagnostic value of all microbiological tests in pulmonary TB patients (p<0.0001) but to a lesser degree in extrapulmonary TB patients. Conclusions: Conventional microbiological tools led to results similar to those already described in India special features for HIV-infected TB patients included lower detection by SM and culture. New microbiological assays, such as the automated liquid culture system, showed increased accuracy and speed of detection.",
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T1 - A toolbox for tuberculosis diagnosis

T2 - An indian multicentric study (2006-2008): Microbiological results

AU - Lagrange, Philippe H.

AU - Thangaraj, Satheesh K.

AU - Dayal, Rajeshwar

AU - Despande, Alka

AU - Ganguly, Nirmal K.

AU - Girardi, Enrico

AU - Joshi, Beenu

AU - Katoch, Kiran

AU - Katoch, Vishwa M.

AU - Kumar, Manoj

AU - Lakshmi, Vemu

AU - Leportier, Marc

AU - Longuet, Christophe

AU - Malladi, Subbalaxmi V S

AU - Mukerjee, Deepali

AU - Nair, Deepthi

AU - Raja, Alamelu

AU - Raman, Balambal

AU - Rodrigues, Camilla

AU - Sharma, Pratibha

AU - Singh, Amit

AU - Singh, Sarman

AU - Sodha, Archana

AU - Kabeer, Basirudeen S.

AU - Vernet, Guy

AU - Goletti, Delia

PY - 2012/8/24

Y1 - 2012/8/24

N2 - Background: The aim of this multicentric prospective study in India was to assess the value of several microbiological tools that contribute to the diagnosis of tuberculosis (TB) according to HIV status. Methods: Standard microbiological tools on individual specimens were analyzed. Results: Among the 807 patients with active TB, 131 were HIV-infected, 316 HIV-uninfected and 360 had HIV-unknown status. Among the 980 non-active TB subjects, 559 were at low risk and 421 were at high risk of M. tuberculosis (Mtb) exposure. Sensitivity of smear microscopy (SM) was significantly lower in HIV-infected (42.2%) than HIV-uninfected (75.9%) (p = 0.0001) and HIV-unknown pulmonary TB patients (61.4%) (p = 0.004). Specificity was 94.5% in non-TB patients and 100% in health care workers (HCW) and healthy family contacts. Automated liquid culture has significantly higher diagnostic performances than solid culture, measured by sensitivity (74.7% vs. 55.9%) (p = 0.0001) and shorter median time to detection (TTD) (12.0 vs. 34.0 days) (p = 0.0001). Specificity was 100% in HCW and cured-TB patients, but was lower in non-TB patients (89%) due to isolation of Mycobacteria other than tuberculosis (MOTT). TTD by both methods was related to AFB score. Contamination rate was low (1.4%). AccuProbe hybridization technique detected Mtb in almost all culture-positive specimens, but MOTT were found in 4.7% with a significantly higher frequency in HIV-infected (15%) than HIV-uninfected TB patients (0.5%) (p = 0.0007). Pre-test classification significantly increased the diagnostic value of all microbiological tests in pulmonary TB patients (p<0.0001) but to a lesser degree in extrapulmonary TB patients. Conclusions: Conventional microbiological tools led to results similar to those already described in India special features for HIV-infected TB patients included lower detection by SM and culture. New microbiological assays, such as the automated liquid culture system, showed increased accuracy and speed of detection.

AB - Background: The aim of this multicentric prospective study in India was to assess the value of several microbiological tools that contribute to the diagnosis of tuberculosis (TB) according to HIV status. Methods: Standard microbiological tools on individual specimens were analyzed. Results: Among the 807 patients with active TB, 131 were HIV-infected, 316 HIV-uninfected and 360 had HIV-unknown status. Among the 980 non-active TB subjects, 559 were at low risk and 421 were at high risk of M. tuberculosis (Mtb) exposure. Sensitivity of smear microscopy (SM) was significantly lower in HIV-infected (42.2%) than HIV-uninfected (75.9%) (p = 0.0001) and HIV-unknown pulmonary TB patients (61.4%) (p = 0.004). Specificity was 94.5% in non-TB patients and 100% in health care workers (HCW) and healthy family contacts. Automated liquid culture has significantly higher diagnostic performances than solid culture, measured by sensitivity (74.7% vs. 55.9%) (p = 0.0001) and shorter median time to detection (TTD) (12.0 vs. 34.0 days) (p = 0.0001). Specificity was 100% in HCW and cured-TB patients, but was lower in non-TB patients (89%) due to isolation of Mycobacteria other than tuberculosis (MOTT). TTD by both methods was related to AFB score. Contamination rate was low (1.4%). AccuProbe hybridization technique detected Mtb in almost all culture-positive specimens, but MOTT were found in 4.7% with a significantly higher frequency in HIV-infected (15%) than HIV-uninfected TB patients (0.5%) (p = 0.0007). Pre-test classification significantly increased the diagnostic value of all microbiological tests in pulmonary TB patients (p<0.0001) but to a lesser degree in extrapulmonary TB patients. Conclusions: Conventional microbiological tools led to results similar to those already described in India special features for HIV-infected TB patients included lower detection by SM and culture. New microbiological assays, such as the automated liquid culture system, showed increased accuracy and speed of detection.

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