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

doi:10.1016/j.ijid.2018.07.007

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

Medicine - Infectious Disease and International Medicine

Research output: Contribution to journal › Article › peer-review

24 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 language	English (US)
Pages (from-to)	92-94
Number of pages	3
Journal	International Journal of Infectious Diseases
Volume	75
DOIs	https://doi.org/10.1016/j.ijid.2018.07.007
State	Published - Oct 2018

Bibliographical note

Publisher Copyright:
© 2018 The Authors

Keywords

Mycobacterium tuberculosis
Renal tuberculosis
Urine
Xpert MTB/RIF Ultra

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Publisher link

10.1016/j.ijid.2018.07.007

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6170999

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Atherton, R. R., Cresswell, F. V., Ellis, J., Skipper, C., Tadeo, K. K., Mugumya, G., Wadda, V., Meya, D. B., & Boulware, D. R. (2018). Detection of Mycobacterium tuberculosis in urine by Xpert MTB/RIF Ultra: A useful adjunctive diagnostic tool in HIV-associated tuberculosis. International Journal of Infectious Diseases, 75, 92-94. https://doi.org/10.1016/j.ijid.2018.07.007

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

abstract = "In January 2017, the World Health Organisation recommended the Xpert{\textregistered} MTB/RIF Ultra assay (Ultra) for tuberculosis (TB) diagnosis. Ultra offers improved analytical sensitivity when compared with the initial Xpert{\textregistered} 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.",

keywords = "Mycobacterium tuberculosis, Renal tuberculosis, Urine, Xpert MTB/RIF Ultra",

author = "Atherton, {Rachel R.} and Cresswell, {Fiona V.} and Jayne Ellis and Caleb Skipper and Tadeo, {Kiiza K.} and Gerald Mugumya and Vincent Wadda and Meya, {David B.} and Boulware, {David R.}",

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year = "2018",

month = oct,

doi = "10.1016/j.ijid.2018.07.007",

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T2 - A useful adjunctive diagnostic tool in HIV-associated tuberculosis

AU - Atherton, Rachel R.

AU - Cresswell, Fiona V.

AU - Ellis, Jayne

AU - Skipper, Caleb

AU - Tadeo, Kiiza K.

AU - Mugumya, Gerald

AU - Wadda, Vincent

AU - Meya, David B.

AU - Boulware, David R.

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AB - 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.

KW - Mycobacterium tuberculosis

KW - Renal tuberculosis

KW - Urine

KW - Xpert MTB/RIF Ultra

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ER -

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

Abstract

Bibliographical note

Keywords

UN SDGs

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