Correlation Between MTB/RIF Gene Xpert Cycle Threshold Values and Clinical Radiological Severity of Pulmonary Tuberculosis
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The determination of bacterial load was essential for assessing disease severity, transmission rate, and prognosis. Gene Xpert is a diagnostic test that provides Cycle Threshold (Ct) value as a potential measure of Mycobacterium Tuberculosis (Mtb) load. Despite its potential, there are limited reports exploring the relationship between Ct value and clinicoradiological severity. This study aimed to correlate Ct value and clinicoradiological severity of pulmonary tuberculosis (TB). The study was a retrospective design using medical record data of confirmed TB patients from January to December 2022. These patients were identified based on Gene Xpert test and classified as high, moderate, or low detection Mtb when Ct value was <16, 16-22, and 22-28, respectively. In assessing the severity of clinical using the Bandim score, thoracic TB lesions was categorized by Chest XRay into minimal, moderate, and advanced. The total of 90 TB patients and the majority were males (78.9%) aged 46-65 years (59.0%), with comorbidities (95.0%). The most of the participants had mild clinical severity (44.4%), with Ct value of 16-22 (52.2%), and moderate lesions (35.6%). The most common lesions were fibroinfiltrates on the chest X-ray (61.1%). The Ct value of <16 had a significant correlation with clinical severity of TB (p<0.05) but no significant association with advanced lesions (p>0.05). Based on the results, Ct value had a strong correlation with clinical severity in pulmonary TB. In addition, it could be used as a predictor for managing pulmonary TB patients and an important indicator for control programs.
World Health Organization (WHO). Global Tuberculosis Report 2023. January. 2023. https://www.who.int/teams/global-tuberculosis-prog.
WHO. TB Joint External Monitoring Mission Report 2022. Jakarta; 2023. Available from: https://tbindonesia.or.id/wp-content/uploads/2021/06/INDONESIA-JEMM-2020-Eng-1.pdf
Boldi MO, Denis-Lessard J, Neziri R, Brouillet R, von-Garnier C, Chavez V, et al. Performance of microbiological tests for tuberculosis diagnostic according to the type of respiratory specimen: A 10-year retrospective study. Front Cell Infect Microbiol. 2023;13(March):1–11.
Steingart KR, Schiller I, Horne DJ, Pai M, Boehme CC, Dendukuri N. Xpert ® MTB / RIF assay for pulmonary tuberculosis and rifampicin resistance in adults ( Review ) Xpert ® MTB / RIF assay for pulmonary tuberculosis and rifampicin resistance in adults. Cochrane Libr. 2014;(1):1–3.
Fradejas I, Ontañón B, Muñoz-Gallego I, Ramírez-Vela MJ, López-Roa P. The value of Xpert MTB/RIF-generated CT values for predicting the smear status of patients with pulmonary tuberculosis. J Clin Tuberc Other Mycobact Dis. 2018;13(November 2017):9–12. Available from: https://doi.org/10.1016/j.jctube.2018.04.002
Bakesiima R, Olweny F, Id PL, Katamba A, Joloba M. Comparison of GeneXpert cycle threshold values with smear microscopy and culture as a measure of mycobacterial burden in five regional referral hospitals of Uganda- A cross- sectional study. PLOSONE. 2019;15:1–11.
Pires M, Pereira G, Barbosa M, Dias N. Association of Xpert MTB/RIF Cycle Threshold Values with Tuberculosis Treatment Outcomes. Lung. 2020;1–5.
Sahana N, Jain SRK, Manjunath M. Association Between Cycle Threshold Value of Cartridge-Based Nucleic Acid Amplification Test and Clinical Severity of Pulmonary Tuberculosis : A Cross-sectional Study. J Clin Diagnostic Res. 2023;17(8):1–5.
Lange B, Khan P, Kalmambetova G, Al-Darraji HA, Alland D, Antonenka U, et al. Diagnostic accuracy of the Xpert® MTB/RIF cycle threshold level to predict smear positivity: A meta-analysis. Int J Tuberc Lung Dis. 2017;21(5):493–502.
Namugenyi J, Musaazi J, Katamba A, Kalyango J, Sendaula E, Kambugu A, et al. Baseline Xpert MTB/RIF ct values predict sputum conversion during the intensive phase of anti-TB treatment in HIV infected patients in Kampala, Uganda: a retrospective study. BMC Infect Dis. 2021;21(1):1–9.
Sarkar K, Kashyap B, Jhamb R, Madhu S V. Assessing Pulmonary Tuberculosis Using Bandim Tuberculosis and Karnofsky Performance Scale Scores with Serum Adenosine Deaminase Levels. Korean Acad Fam Med. 2023;44:234–9.
Singh SK, Tiwari KK. Clinicoradiological Profile of Lower Lung Field Tuberculosis Cases among Young Adult and Elderly People in a Teaching Hospital of Madhya Pradesh , India. J Trop Med. 2015;2015(4):1–7.
Horton KC, MacPherson P, Houben RMGJ, White RG, Corbett EL. Sex Differences in Tuberculosis Burden and Notifications in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis. Metcalfe JZ, editor. PLOS Med. 2016 Sep;13(9):e1002119.
Miller PB, Zalwango S, Galiwango R, Kakaire R, Sekandi J, Steinbaum L, et al. Association between tuberculosis in men and social network structure in Kampala, Uganda. BMC Infect Dis. 2021 Dec;21(1):1023.
Noviyani A, Nopsopon T, Pongpirul K. Variation of tuberculosis prevalence across diagnostic approaches and geographical areas of Indonesia. PLoS One. 2021;16(10 October):1–12. Available from: http://dx.doi.org/10.1371/journal.pone.0258809.
Hapsari BAP, Wulaningrum PA, Rimbun R. Association between Smoking Habit and Pulmonary Tuberculosis at Dr. Soetomo General Academic Hospital. Biomol Heal Sci J. 2021;4(2):89.
John C. Smulian Sonja A. Rasmussen MD MS. The aging lung: Physiology, disease, and immunity. Ann Oncol. 2020;(January):19–21.
Y, Atwine D, Orikiriza P, Assimwe J, Page AL, Mwanga-Amumpaire J, et al. Male Gender is independently associated with pulmonary tuberculosis among sputum and non-sputum producers people with presumptive tuberculosis in Southwestern Uganda. BMC Infect Dis. 2014;14(1):1–8.
Olmo-Fontánez AM, Turner J. Tuberculosis in an Aging World. Pathogens. 2022;11(10):1–13.
Ravimohan S, Kornfeld H, Weissman D, Bisson GP. Tuberculosis and lung damage: from epidemiology to pathophysiology. Eur Respir Rev. 2018 Mar;27(147):170077.
Chowdhury S, Chakraborty P pratim. Radiological difference between new sputum"‘positive and sputum"‘negative pulmonary tuberculosis. J Fam Med Prim Care. 2017;6(2):169–70. Available from: http://www.jfmpc.com/article.asp?issn=2249-4863;year=2017;volume=6;issue=1;spage=169;epage=170;aulast=Faizi
Ssengooba W, Respeito D, Mambuque E, Blanco S, Bulo H, Mandomando I, et al. Do Xpert MTB / RIF Cycle Threshold Values Provide Information about Patient Delays for Tuberculosis Diagnosis.PLoS One. 2016;302:1–10.
Najjingo I, Muttamba W, Kirenga BJ, Nalunjogi J, Bakesiima R, Olweny F, et al. Comparison of GeneXpert cycle threshold values with smear microscopy and culture as a measure of mycobacterial burden in five regional referral hospitals of Uganda- A cross-sectional study. Wilkinson KA, editor. PLoS One. 2019 May;14(5):e0216901.
Zaporojan N, Negrean RA, HodiÈ™an R, Zaporojan C, Csep A, Zaha DC. Evolution of Laboratory Diagnosis of Tuberculosis. Clin Pract.2024;14(2):388–416.
Zhang C, Zhang Q, Du J lin, Deng D, Gao Y lei, Wang C lin, et al. Correlation Between the Clinical Severity, Bacterial Load, and Inflammatory Reaction in Children with Mycoplasma Pneumoniae Pneumonia. Curr Med Sci. 2020;40(5):822–8.
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