TY - JOUR T1 - Xpert MTB/RIF testing of pooled induced sputum JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P2602 AU - M.Y. Chew AU - J. Ng AU - V. Palanichamy AU - T.K. Lim Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P2602.abstract N2 - Some studies have suggested that Xpert MTB/RIF testing neither expedite pulmonary tuberculosis (PTB) treatment nor impact tuberculosis related morbidity in low and high disease burden settings. But this has not been evaluated in intermediate burden settings. We hypothesize that performing the Xpert MTB/RIF test on two induced sputa (IS) pooled together on the same day would improve diagnostic yield and impact treatment in symptomatic patients with active PTB. This is a prospective audit of adult patients suspected of PTB from June 2013 in a university hospital. In patients who were smear negative or unable to expectorate, 2 IS were collected and processed as one for acid fast bacilli, culture and Xpert. The reference standard for diagnosis of PTB was any positive culture. Patients were reviewed over 3 months. We report on the first 115 patients. PTB was diagnosed in 11/115(9.6%). Positive Xpert in pooled IS detected 5/11 (45%) cases. 3/5(60%) were smear, culture and Xpert positive. 2/5(40%) were smear negative, Xpert and culture positive. One smear negative, rifampicin resistant case was detected by Xpert. Additional 6 cases of PTB were detected from other respiratory specimens. All 11 patients were started on treatment on a positive smear and/or Xpert test the same day. Detection of rifampicin resistance resulted in the use of second line drugs. There were also 5 cases of non-tuberculous mycobacteria of which 4 were smear positive. Among these, 1 patient who had positive smear but indeterminate Xpert test received empirical PTB treatment. We conclude that there is a potential role for Xpert testing of pooled IS to improve diagnostic yield and expedite treatment in nearly half of new PTB cases. ER -