ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1938

Evaluating Diagnostic Performance of Mycobacterium Tuberculosis Derived Cell-free DNA (CF-DNA) for Diagnosis of Osteoarticular Tuberculosis (OATB): A Novel Method

Kusum Sharma1, Aman Sharma2, Mandeep Singh Dhillon3 and Salony Verma4, 1PGIMER, Chandigarh, Chandigarh, India, 2PGIMER, Chandigarh, India, Chandigarh, Chandigarh, India, 3Postgraduate Institute of Medical Education and Research, Chandigarh, Chandigarh, Chandigarh, India, 4Postgraduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India

Meeting: ACR Convergence 2024

Keywords: ,

Session Information

Date: Monday, November 18, 2024

Title: Health Services Research – ACR/ARP Poster III

Session Type: Poster Session C

Session Time: 10:30AM-12:30PM

Background/Purpose: Diagnostic delay not only worsens the outcomes of tuberculosis but also important impediments to TB elimination efforts. The DNA present in cell-free form is expected to give higher detection yield. Prompt and accurate diagnosis of osteoarticular tuberculosis (OATB) is crucial to decrease the morbidity and associated sequelae. Therefore, Cell –free DNA (CF-DNA) based Multi targeted real-time polymerase chain reaction assay (MRTPCR), was evaluated for the first time for diagnosis of OATB from pus and synovial fluid samples. CF-DNA MRTPCR was compared with Gene Xpert Ultra (GX Ultra).

Methods: Total of 110 synovial fluid/pus samples (25 microbiologically confirmed OATB [culture-positive], 60 clinically suspected OATB [culture-negative], and 25 control patients) were subjected to CF-DNA based MRTPCR(using IS6110, IS1081 and nrdz genes) and Xpert Ultra (GX Ultra) assay. Their performance was evaluated against both culture and composite reference standard. rpoB gene sequencing was carried out in all positive cases for detection of Rifampicin susceptibility.

Results: The overall sensitivity and specificity of CF-DNA based MRTPCR in diagnosing OATB was 77.64% (66/85) and 100%, respectively. The sensitivity was 80% (22/25) for microbiologically confirmed cases and 73.3% (44/60) for clinically suspected OATB cases. Performance of CF-DNA based MRTPCR was superior to Xpert ultra (sensitivity = 70%).Overall, sensitivity and specificity of GX ultra was 70% and 100%. However, sensitivity of GX Ultra was 75% in culture confirmed cases and 65% (39/60) in clinically suspected cases of OATB. GX Ultra correctly reported Rifampicin resistance in four cases when compared with phenotypic DST and rpoB gene sequencing.

Conclusion: CF-DNA based MRTPCR is robust and promising technique for diagnosis of OATB, yielding higher detection rate than contemporary platform of Xpert Ultra. 

Disclosures: K. Sharma: None; A. Sharma: None; M. Dhillon: None; S. Verma: None.

To cite this abstract in AMA style:

Sharma K, Sharma A, Dhillon M, Verma S. Evaluating Diagnostic Performance of Mycobacterium Tuberculosis Derived Cell-free DNA (CF-DNA) for Diagnosis of Osteoarticular Tuberculosis (OATB): A Novel Method [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/evaluating-diagnostic-performance-of-mycobacterium-tuberculosis-derived-cell-free-dna-cf-dna-for-diagnosis-of-osteoarticular-tuberculosis-oatb-a-novel-method/. Accessed .

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/evaluating-diagnostic-performance-of-mycobacterium-tuberculosis-derived-cell-free-dna-cf-dna-for-diagnosis-of-osteoarticular-tuberculosis-oatb-a-novel-method/