Detection of Mycobacterium tuberculosis in urine by Xpert MTB/RIF Ultra: A useful adjunctive diagnostic tool in HIV-associated tuberculosis

Rachel R. Atherton, Fiona V. Cresswell, Jayne Ellis, Caleb Skipper, Kiiza K. Tadeo, Gerald Mugumya, Vincent Wadda, David B. Meya, David R. Boulware

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

In January 2017, the World Health Organisation recommended the Xpert® MTB/RIF Ultra assay (Ultra) for tuberculosis (TB) diagnosis. Ultra offers improved analytical sensitivity when compared with the initial Xpert® MTB/RIF (Xpert) assay for the detection of Mycobacterium tuberculosis. Ultra is therefore likely to be of particular benefit for detecting paucibacillary TB. We present a case from Uganda demonstrating Ultra positivity in urine from an HIV-infected patient presenting with altered mental status and urinary incontinence, and no other signs of active pulmonary or extrapulmonary TB. This represents the first published instance of a diagnosis of extrapulmonary TB made on the basis of a positive urine Ultra assay. The use of Ultra on urine may be a useful addition to the diagnostic armamentarium for disseminated TB in persons with HIV co-infection. The diagnostic accuracy of urine Ultra should be characterised further via prospective studies.

Original languageEnglish (US)
Pages (from-to)92-94
Number of pages3
JournalInternational Journal of Infectious Diseases
Volume75
DOIs
StatePublished - Oct 2018

Keywords

  • Mycobacterium tuberculosis
  • Renal tuberculosis
  • Urine
  • Xpert MTB/RIF Ultra

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