跳至主要内容

Stool as Appropriate Sample for the Diagnosis of Mycobacterium tuberculosis by Gene Xpert Test

Read  full  paper  at:
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=48637#.VK37bMnQrzE

ABSTRACT
Background: Diagnosis of pediatric pulmonary tuberculosis (PTB) is a challenge. Symptoms are nonspecific. Young children are unable to expectorate sputum samples; the procedures for obtaining respiratory samples are invasive. Thus Mycobacterium tuberculosis cultures and smears often are not performed. Stool samples were used as an alternative to respiratory samples for the diagnosis of pediatric PTB using stool Xpert MTB/RIF and its sensitivity for detecting the DNA of MTB in stool was determined. Methods: The study was a laboratory-based cross-sectional prospective design. Stool specimen was collected from PTB suspected children (<15 years) attended in Gertrude’s Children’s Hospital Nairobi and Kiambu District Hospital from September 2013 to March 2014. Stool for Xpert was processed in two ways, direct and prior extraction of DNA using QIAGEN stool DNA extraction kit. Result: A total sample of 91 stool specimen was collected from patients. Of these 53 (58.2%) had sputum ZN smear microscopy. Six (11.3%) of them were confirmed smear positive for PTB. Stool Gene Xpert was positive in all the six smear positive children. Four (7.5%) smear negative patients tested positive by stool Gene Xpert test. This association is significant (P = 0.000). Conclusion: This study reports that Mycobacterium tuberculosis DNA can be detected in stool using Xpert testing with a higher sensitivity. Therefore stool which can easily be obtained is an appropriate alternative sample for the diagnosis of PTB using Xpert assay for children unable to give respiratory samples. Furthermore Xpert turn round time is less than 2 hours.
 
Cite this paper
Welday, S. , Kimang’a, A. , Kabera, B. , Mburu, J. , Mwachari, C. , Mungai, E. , Ndwiga, S. , Mbuthia, J. and Revathi, G. (2014) Stool as Appropriate Sample for the Diagnosis of Mycobacterium tuberculosis by Gene Xpert Test. Open Journal of Respiratory Diseases, 4, 83-89. doi: 10.4236/ojrd.2014.43012.
 
References
[1]World Health Organization (2012) Global Tuberculosis Control. World Health Organization, Geneva.
 
[2]Grange, J.M. and Zumela, A. (2002) The Global Emergency of Tuberclosis: What Is the Cause? Journal of Royal Society for the Promotion of Health, 122, 78-81.
http://dx.doi.org/10.1177/146642400212200206
 
[3]GOK, Ministry of Public Health and Sanitation (2009) DLTLD Guidelines on Management of Leprosy and Tuberculosis. Government Printer, Nairobi.
 
[4]World Health Organization (2003) Treatment of Tuberculosis Guideline for National Programs. World Health Organization, Geneva.
 
[5]Khan, E.A. and Starke, J.R. (2006) Diagnosis of Tuberculosis in Children: Increased Need for Better Methods. International Journal of Tuberculosis and Lung Disease, 10, 1091-1097.
 
[6]Mukherjee, A., Lodha, R. and Kabara, S.K. (2012) Recent Advances in Diagnosis of Tuberculosis. Journal of Pediatric Infectious Diseases, 4, 45-50.
 
[7]Medicines Sans Frontieres for HIV and Tuberculosis (TB) (2010) Diagnosing Children, a Terrible Neglect. WHO, Geneva.
 
[8]Cordova, J., Shilho, R., Gilman, R.H., et al. (2010) Evaluation of Molecular Tools for Detection and Drug Susceptibility Testing of Mycobacterium Tuberculosis in Stool Specimens from Patients with Pulmonary Tuberculosis. Journal of Clinical Microbiology, 48, 1820-1826.
http://dx.doi.org/10.1128/JCM.01161-09
 
[9]Nicol, M.P., Spiers, K., Workman, L., Isaacs, W., Munro, J., Black, F., Zemanay, W. and Zar, H.J. (2013) Xpert MTB/RIF Testing of Stool Samples for the Diagnosis of Pulmonary Tuberculosis in Children. Clinical Infectious Disease Oxford Journals, 57, 2-12.
 
[10]QIAamp (2012) QIAamp DNA Stool Handbook for DNA Purification from Stool Samples. 2nd Edition, New England Biolabs, Ipswich.
www.qiagen.com
 
[11]GOK, Ministry of Public Health and Sanitation (2013) National Guidelines on Management of Tuberculosis in Children. 2nd Edition, Government Printer, Nairobi.
 
[12]Wolf, H., Mendez, M., Gilman, R.H., Sheen, P., Soto, G., Velarde, A.K., Zimic, M. and Escombe, A.R. (2008) Diagnosis of Pediatric Pulmonary Tuberculosis by Stool PCR. America Journal of Tropical Medicine Hygiene, 79, 893-898.
 
[13]Triasih, R. and Graham, S.M. (2011) Limitations of the Indonesian Pediatric Tuberculosis Scoring System in the Context of Child Contact Investigation. Paediatrica Indonesiana, 51, 332-337.
 
[14]Fjallbrant, H. (2008) BCG Vaccination and the Tuberculin Skin Test in a Country with Low Prevalence of Tuberculosis. Geson Hylte Tryck, Sweden.                                                                          eww150108lx
标签：

评论

发表评论

此博客中的热门博文

A Comparison of Methods Used to Determine the Oleic/Linoleic Acid Ratio in Cultivated Peanut (Arachis hypogaea L.)

Cultivated peanut ( Arachis hypogaea L.) is an important oil and food crop. It is also a cheap source of protein, a good source of essential vitamins and minerals, and a component of many food products. The fatty acid composition of peanuts has become increasingly important with the realization that oleic acid content significantly affects the development of rancidity. And oil content of peanuts significantly affects flavor and shelf-life. Early generation screening of breeding lines for high oleic acid content greatly increases the efficiency of developing new peanut varieties. The objective of this study was to compare the accuracy of methods used to classify individual peanut seed as high oleic or not high oleic. Three hundred and seventy-four (374) seeds, spanning twenty-three (23) genotypes varying in oil composition (i.e. high oleic (H) or normal/not high oleic (NH) inclusive of all four peanut market-types (runner, Spanish, Valencia and Virginia), were individually tested ...
发表评论
阅读全文

Location Optimization of a Coal Power Plant to Balance Costs against Plant’s Emission Exposure

Fuel and its delivery cost comprise the biggest expense in coal power plant operations. Delivery of electricity from generation to consumers requires investment in power lines and transmission grids. Placing a coal power plant or multiple power plants near dense population centers can lower transmission costs. If a coalmine is nearby, transportation costs can also be reduced. However, emissions from coal plants play a key role in worsening health crises in many countries. And coal upon combustion produces CO 2 , SO 2 , NO x , CO, Metallic and Particle Matter (PM10 & PM2.5). The presence of these chemical compounds in the atmosphere in close vicinity to humans, livestock, and agriculture carries detrimental health consequences. The goal of the research was to develop a methodology to minimize the public’s exposure to harmful emissions from coal power plants while maintaining minimal operational costs related to electric distribution losses and coal logistics. The objective was...
发表评论
阅读全文

Evaluation of the Safety and Efficacy of Continuous Use of a Home-Use High-Frequency Facial Treatment Appliance

At present, many home-use beauty devices are available in the market. In particular, many products developed for facial treatment use light, e.g., a flash lamp or a light-emitting diode (LED). In this study, the safety of 4 weeks’ continuous use of NEWA TM , a high-frequency facial treatment appliance, every alternate day at home was verified, and its efficacy was evaluated in Japanese individuals with healthy skin aged 30 years or older who complained of sagging of the facial skin.  Transepidermal water loss (TEWL), melanin levels, erythema levels, sebum secretion levels, skin color changes and wrinkle improvement in the facial skin were measured before the appliance began to be used (study baseline), at 2 and 4 weeks after it had begun to be used, and at 2 weeks after completion of the 4-week treatment period (6 weeks from the study baseline). In addition, data obtained by subjective evaluation by the subjects themselves on a visual analog scale (VAS) were also analyzed. Fur...
发表评论
阅读全文