Systematic Review of Pooling Sputum as an Efficient Method for Xpert MTB/RIF Tuberculosis Testing during COVID-19 Pandemic


Por: Cuevas, LE, Santos, VS, Lima, SVMA, Kontogianni, K, Bimba, JS, Iem, V, Dominguez, J, Adams, E, Atienzar, AC, Edwards, T, Squire, SB, Hall, PJ and Creswell, J

Publicada: 1 mar 2021
Resumen:
GeneXpert-based testing with Xpert MTB/RIF or Ultra assays is essential for tuberculosis diagnosis. However, testing may be affected by cartridge and staff shortages. More efficient testing strategies could help, especially during the coronavirus disease pandemic. We searched the literature to systematically review whether GeneXpert-based testing of pooled sputum samples achieves sensitivity and specificity similar to testing individual samples; this method could potentially save time and preserve the limited supply of cartridges. From 6 publications, we found 2-sample pools using Xpert MTB/RIF had 87.5% and 96.0% sensitivity (average sensitivity 94%; 95% CI 89.0%-98.0%) (2 studies). Four-sample pools averaged 91% sensitivity with Xpert MTB/RIF (2 studies) and 98% with Ultra (2 studies); combining >4 samples resulted in lower sensitivity. Two studies reported that pooling achieved 99%-100% specificity and 27%-31% in cartridge savings. Our results show that pooling may improve efficiency of GeneXpert-based testing.

Filiaciones:
Cuevas, LE:
 Univ Liverpool Liverpool Sch Trop Med, Pembroke Pl, Liverpool L3 5QA, Merseyside, England

Santos, VS:
 Univ Fed Alagoas, Arapiraca, Brazil

Lima, SVMA:
 Univ Fed Sergipe, Aracaju, Brazil

Kontogianni, K:
 Univ Liverpool Liverpool Sch Trop Med, Pembroke Pl, Liverpool L3 5QA, Merseyside, England

Bimba, JS:
 Bingham Univ, Karu, Nigeria

Iem, V:
 Univ Liverpool Liverpool Sch Trop Med, Pembroke Pl, Liverpool L3 5QA, Merseyside, England

 Natl TB Control Program, Viangchan, Laos

:
 Inst Invest Germans Trias & Pujol, Badalona, Spain

 Univ Autonoma Barcelona, Badalona, Spain

Adams, E:
 Univ Liverpool Liverpool Sch Trop Med, Pembroke Pl, Liverpool L3 5QA, Merseyside, England

Atienzar, AC:
 Univ Liverpool Liverpool Sch Trop Med, Pembroke Pl, Liverpool L3 5QA, Merseyside, England

Edwards, T:
 Univ Liverpool Liverpool Sch Trop Med, Pembroke Pl, Liverpool L3 5QA, Merseyside, England

Squire, SB:
 Univ Liverpool Liverpool Sch Trop Med, Pembroke Pl, Liverpool L3 5QA, Merseyside, England

Hall, PJ:
 Ctr Dis Control & Prevent, Atlanta, GA USA

Creswell, J:
 Stop TB Partnership, Innovat & Grants, Geneva, Switzerland
ISSN: 10806059





Emerging Infectious Diseases
Editorial
Centers for Disease Control and Prevention (CDC), 1600 CLIFTON RD, ATLANTA, GA 30333 USA, Estados Unidos America
Tipo de documento: Review
Volumen: 27 Número: 3
Páginas: 719-727
WOS Id: 000634463000006
ID de PubMed: 33622482
imagen Green Published, gold, Green Accepted

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