Evaluation of trace calls by Xpert MTB/RIF ultra for clinical management in low TB burden settings

Background Clinical interpretation of trace results by Xpert MTB/RIF Ultra assay (Ultra) used as an initial diagnostic test for tuberculosis (TB) may be challenging. The aim of the study was to evaluate the frequency and epidemiology of trace readouts in routine clinical practice in a low TB prevalence setting and to propose guidance on how to manage patients with trace calls considering the data available (clinical, radiological, bacteriological etc.). Materials and methods A retrospective, observational, monocentric study was conducted at IRCCS Azienda Ospedaliero-Universitaria of Bologna, Italy between November 2017—December 2020. Presumptive TB patients with at least one Ultra trace result during diagnostic workup before treatment were included in the study. Patients with ongoing anti-TB treatment at the time of the trace call result or with no clinical data available were excluded from the study. Results Fifty-nine presumptive TB patients with Ultra trace readouts were included in the study (mean age 37.0 years, 61% males). Four patients had a history of TB in the last 2 years. Twenty-five (42.4%) of the 59 samples with trace results were respiratory material. 57/59 (96.6%) patients started anti-TB treatment soon after obtaining trace results, based on clinical, radiological or other information available, while for two patients with a recent history of TB the trace result did not lead to anti-TB treatment. Culture was positive for M. tuberculosis for 31/59 (52.5%) samples with trace calls: 13/25 (52.0%) were respiratory samples and 18/33 (54.5%) non-respiratory samples. The clinical and/or radiological findings of 47/57 (82.4%) patients given anti-TB therapy improved during treatment. Conclusion In low TB incidence settings, Ultra trace calls in presumptive TB patients should be considered as true-positive and treatment should be started promptly, except in cases of recent history of TB, where careful evaluation of other diagnostic criteria is necessary before starting anti-TB treatment. A decisional algorithm for clinical management is proposed

IGRA test for TB in COVID-19: role of corticosteroids

not availabl

Diagnóstico da adequação de objetivos, conteúdos e metodologia utilizados pelos professores do Departamento de Matemática na UFSM nos diversos cursos onde atuam

This paper presents a general evaluation of the Mathematics Department aiming at reestructuring its activities. Such an avaluation was made with basis on answers from coornators, professors and students from all courses to wich the Mathematics Department offers courses.Este artigo trata de una avaliação geral do Departamento de temática, com vistas a um replanejamento de suas atividades. Esta foi feita a partir das respostas de coordenadores, professores e alunos de todos os cursos para os quais o Departamento de Matemática oferece alguma disciplina.