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An observational report of universal GeneXpert testing of inpatients with diagnosed or presumptive TB in the Philippines

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Title: An observational report of universal GeneXpert testing of inpatients with diagnosed or presumptive TB in the Philippines
Authors: Thi, Aye Myat / Lee, Nathaniel / Parris, Victoria / Marin, Flora P / Roy, Lynsil / Calapis, Rugaiya W / Ariyoshi, Koya / Parry, Christopher M / Cox, Sharon E
Issue Date: 27-Jun-2020
Publisher: Oxford University Press
Citation: Transactions of the Royal Society of Tropical Medicine and Hygiene, 114(9), pp.682-686; 2020
Abstract: BACKGROUND: The Philippines is a high TB and multidrug-resistant TB burden country. Although the scale-up of GeneXpert testing is occurring, the benefits of universal Xpert-Mycobacterium tuberculosis/ rifampicin (MTB/RIF) testing in inpatients have not been documented. METHODS: Routine GeneXpert testing irrespective of priority criteria for testing was conducted within a prospective cohort of all adults with known or presumptive TB admitted to a tertiary infectious diseases hospital in Manila. Study-specific TB diagnosis was decided upon bacteriological results, chest x-ray assessment, if already on anti-TB treatment (ATT) at admission and a cough duration of ≥2 wk. RESULTS: Of submitted sputum samples, 87.1% (277/318) had valid acid-fast bacilli (AFB) microscopy and Xpert® MTB/RIF results. Xpert® MTB/RIF was positive in 97.7% (n = 87/89) of AFB-positive patients and 25.5% (n = 48/188) of AFB-negative patients. Bacteriological confirmation in smear negative cases not on ATT prior to admission was 25.2% (34/135). Rifampicin resistance was detected in 26/135 Xpert positive cases (19.3%), including nine who might not otherwise have been detected, representing a 53% increase in yield. CONCLUSION: Universal GeneXpert testing in this setting enhanced the yield of bacterial confirmation, revealing a high incidence of rifampicin resistance and suggesting a need for further investigations in Xpert-negative/smear-positive patients who may not have mycobacterial TB.
Keywords: adults / inpatients / TB diagnostics / Xpert® MTB/RIF
URI: http://hdl.handle.net/10069/40255
ISSN: 00359203
DOI: 10.1093/trstmh/traa044
Rights: © The Author(s) 2020. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
Type: Journal Article
Text Version: publisher
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/40255

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