Association of Radiological Findings with the Xpert MTB/RIF Test in Patients with Suspected Pulmonary Tuberculosis

Lung. 2018 Dec;196(6):755-760. doi: 10.1007/s00408-018-0157-z. Epub 2018 Sep 3.

Abstract

Purpose: Tuberculosis (TB) treatment is often carried out empirically, based on clinical and radiological findings. Chest X-ray (CXR) has good sensitivity but poor specificity in TB diagnosis. Xpert MTB/RIF (Mycobacterium tuberculosis/Rifampicin) is increasingly used in many countries as the initial diagnostic test for TB. The aim of the present study was to evaluate the association of radiological findings with the Xpert MTB/RIF test in patients with suspected pulmonary TB.

Methods: Cross-sectional study in an outpatient TB clinic. Sputum AFB smear, culture, Xpert MTB/RIF, and CXR were collected in patients with suspected pulmonary TB.

Results: During the study period, 312 patients met the inclusion criteria and were included in the analysis. Among Xpert MTB/RIF-positive cases, the radiographic patterns were classified as typical of TB, compatible of TB, and normal in 78 (70.3%), 31 (27.9%), and 2 (1.8%) patients, respectively. CXRs were classified as typical of TB, compatible of TB, and normal in 20 (10.0%), 25 (12.4%), and 152 (75.6%) patients, respectively, in Xpert MTB/RIF-negative cases.

Conclusions: We found an association between radiographic patterns and Xpert MTB/RIF results in patients with suspected pulmonary TB. These results confirm the current recommended diagnosis algorithm.

Keywords: Chest radiography; Diagnosis; Pulmonary tuberculosis; Tuberculosis; Xpert MTB/RIF.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antibiotics, Antitubercular / pharmacology
  • Cross-Sectional Studies
  • DNA, Bacterial / analysis*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis / drug effects
  • Mycobacterium tuberculosis / genetics
  • Mycobacterium tuberculosis / isolation & purification*
  • Predictive Value of Tests
  • Radiography, Thoracic
  • Rifampin / pharmacology
  • Sputum / microbiology*
  • Tuberculosis, Pulmonary / diagnostic imaging*
  • Tuberculosis, Pulmonary / microbiology

Substances

  • Antibiotics, Antitubercular
  • DNA, Bacterial
  • Rifampin