Infectiousness of patients with smear-negative pulmonary tuberculosis, assessed by Real-time Polymerase Chain Reaction, XpertⓇMTB/RIF

Daniel Camprubí; Aina Gomila; Maria D Grijota-Camino; Laura Soldevila; Maria J Luque; Fernando Alcaide; Jordi Dorca; Miguel Santin

doi:10.1016/j.jinf.2019.12.023

Infectiousness of patients with smear-negative pulmonary tuberculosis, assessed by Real-time Polymerase Chain Reaction, Xpert^ⓇMTB/RIF

J Infect. 2020 Mar;80(3):298-300. doi: 10.1016/j.jinf.2019.12.023. Epub 2020 Jan 16.

Authors

Daniel Camprubí¹, Aina Gomila², Maria D Grijota-Camino³, Laura Soldevila³, Maria J Luque³, Fernando Alcaide⁴, Jordi Dorca⁵, Miguel Santin⁶

Affiliations

¹ Tuberculosis Unit, Infectious Disease Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, c/ de la Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain; ISGlobal, Hospital Clínic - University of Bercelona, Barcelona, Spain. Electronic address: dcamprub@clinic.cat.
² Tuberculosis Unit, Infectious Disease Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, c/ de la Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain; Infectious Diseases Department, Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain.
³ Tuberculosis Unit, Infectious Disease Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, c/ de la Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain.
⁴ Microbiology Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
⁵ University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain; Respirology Service, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
⁶ Tuberculosis Unit, Infectious Disease Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, c/ de la Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain; University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.

PMID: 31954744
DOI: 10.1016/j.jinf.2019.12.023

Abstract

Currently, pulmonary tuberculosis (TB) isolation recommendations are based on serial sputum smear microscopy. To assess infectiousness of smear-negative/GeneXpert-positive (Sm-/GXpert+) pulmonary TB, we evaluated 511 contacts of pulmonary TB patients attended at a teaching hospital in Spain (2010-2018). There were no statistically significant differences in rates of Mycobacterium tuberculosis infection (46.2% contacts of smear-positive and 34.6% contacts of Sm-/GXpert+ pulmonary TB patients, p = 0.112). Sm-/GXpert+ pulmonary TB poses a substantial risk of transmission of M. tuberculosis infection. Our results add evidence to support including Real-time Polymerase Chain Reaction (Xpert^ⓇMTB/RIF) in the work-up diagnosis of suspected pulmonary TB cases to make decisions on air-borne isolation.

Keywords: Isolation; Mycobacterium tuberculosis complex; Polymerase-Chain Reaction; Smear-negative pulmonary tuberculosis; Tuberculosis.

MeSH terms

Humans
Mycobacterium tuberculosis* / genetics
Real-Time Polymerase Chain Reaction
Sensitivity and Specificity
Spain / epidemiology
Sputum
Tuberculosis, Pulmonary* / diagnosis
Tuberculosis, Pulmonary* / epidemiology