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Shaikh A, Sriraman K, Vaswani S, Shah I, Poojari V, Oswal V, Mane S, Rajagara S, Mistry N. SMaRT-PCR: sampling using masks and RT-PCR, a non-invasive diagnostic tool for paediatric pulmonary TB. Int J Tuberc Lung Dis 2024; 28:189-194. [PMID: 38563336 DOI: 10.5588/ijtld.23.0291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Key challenges in paediatric TB diagnosis are invasive sampling and poor sensitivity of standard methods. This study demonstrates the diagnostic potential of non-invasive sampling of bioaerosols from children using SMaRT-PCR, comprising mask sampling combined with reverse transcriptase-polymerase chain reaction (RT-PCR) for TB.METHODS Exhaled bioaerosols were captured on modified N-95 masks in a 10-min talk-cough-breathe process from 51 children (30 with TB confirmed using standard sampling methods and 21 without TB) aged 2-15 years. All mask samples were tested using in-house RT-PCR for 16s and rpoB RNA transcripts. Additional mask samples from children with TB were tested using Xpert® MTB/RIF (n = 3) and Xpert® MTB/RIF Ultra (n = 27).RESULTS SMaRT-PCR sensitivity for detecting TB among treatment-naïve children was 96% if 16s or rpoB was present, and 75% if both genes were present, comparable to standard methods (71%) in the same cohort. Specificity was better for both genes, at 95%, than 85% for a single gene detection. Mask sampling with Xpert MTB/RIF or Ultra had a sensitivity of only 13%.CONCLUSION This is the first study to provide evidence for testing bioaerosols as a promising alternative for detecting paediatric TB. Sampling is non-invasive and simple, with the potential for point-of-care applications. This pilot study also suggests that RNA transcript-based detection may improve TB diagnostic sensitivity in children; however, further investigation is required to establish its adaptability in clinical settings..
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Affiliation(s)
- A Shaikh
- The Foundation for Medical Research, Mumbai
| | - K Sriraman
- The Foundation for Medical Research, Mumbai
| | - S Vaswani
- The Foundation for Medical Research, Mumbai
| | - I Shah
- Paediatric TB Clinic, State Centre of Excellence for Paediatric DR-TB, Department of Paediatric Infectious Diseases, B.J. Wadia Hospital for Children, Mumbai
| | - V Poojari
- Paediatric TB Clinic, State Centre of Excellence for Paediatric DR-TB, Department of Paediatric Infectious Diseases, B.J. Wadia Hospital for Children, Mumbai
| | | | - S Mane
- State Centre of Excellence for Tuberculosis, Grant Medical College, Sir JJ Group of Hospitals, Mumbai, India
| | - S Rajagara
- State Centre of Excellence for Tuberculosis, Grant Medical College, Sir JJ Group of Hospitals, Mumbai, India
| | - N Mistry
- The Foundation for Medical Research, Mumbai
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