Accuracy of cell-free Mycobacterium tuberculosis DNA testing in pleural effusion for diagnosing tuberculous pleurisy: a multicenter cross-sectional study.

Publication date: Aug 22, 2024

The diagnosis of tuberculous pleurisy (TP) presents a significant challenge due to the low bacterial load in pleural effusion (PE) samples. Cell-free Mycobacterium tuberculosis DNA (cf-TB) in PE samples is considered an optimal biomarker for diagnosing TP. This study aimed to evaluate the applicability of cf-TB testing across diverse research sites with a relatively large sample size. Patients suspected of TP and presenting with clinical symptoms and radiological evidence of PE were consecutively enrolled by treating physicians from 11 research sites across 6 provinces in China between April 2020 and August 2022. Following centrifugation, sediments obtained from PE were used for Xpert MTB/RIF (Xpert) and mycobacterial culture, while the supernatants were subjected to cf-TB testing. This study employed a composite reference standard to definite TP, which was characterized by any positive result for Mycobacterium tuberculosis (MTB) through either PE culture, PE Xpert, or pleural biopsy. A total of 1412 participants underwent screening, and 1344 (95. 2%) were subsequently enrolled in this study. Data from 1241 (92. 3%) participants were included, comprising 284 with definite TP, 677 with clinically diagnosed TP, and 280 without TP. The sensitivity of cf-TB testing in definite TP was 73. 6% (95% CI 68. 2-78. 4), significantly higher than both Xpert (40. 8%, 95% CI 35. 3-46. 7, P 

Concepts Keywords
April Diagnosis
Biopsy Pleural effusion (PE)
China Tuberculous pleurisy (TP)
Mycobacterium
Tuberculosis

Semantics

Type Source Name
disease MESH pleural effusion
disease MESH tuberculous pleurisy

Original Article

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