title: Availability and use of molecular microbiological and immunological tests for the diagnosis of tuberculosis in europe.
abstract: BACKGROUND
  Currently only limited data exist regarding the availability and clinical use of molecular and immunological tests for tuberculosis (TB) in the European setting.
  
  
  METHODS
  Web-based survey of Paediatric-Tuberculosis-Network-European-Trialsgroup (ptbnet) and Tuberculosis-Network-European-Trialsgroup (TBnet) members conducted June to December 2013. Both networks comprise clinicians, microbiologists, epidemiologists and researchers predominately based in Europe.
  
  
  RESULTS
  191 healthcare professionals from 31 European countries participated. Overall, 26.8% of respondents did not have access to the Xpert MTB/RIF assay; only 44.6% had access to the assay in-house. However, a substantial proportion had access to other commercial and/or non-commercial PCR-based assays for TB (68.8% and 31.8%, respectively). Only 6.4% did not have access to any PCR-based assays for TB. A large proportion of participants with access to the Xpert MTB/RIF assay had used it for the analysis of non-respiratory samples [pleural fluid: 36.5%, gastric aspirates: 34.7%, cerebrospinal fluid: 34.7%, stool samples: 4.3%, blood/serum: 2.6%, 'other samples' (which included biopsy/tissue samples, lymph node aspirates, joint aspirates and urine samples): 16.5%]. Regarding interferon-gamma release assays, a greater proportion of respondents had access to the QuantiFERON-TB Gold assay (84.7%) than to the T-SPOT.TB assay (52.2%).
  
  
  CONCLUSIONS
  Both immunological and molecular TB tests are widely available across Europe. The QuantiFERON-TB Gold assay is more widely used than the T-SPOT.TB assay, which may reflect the difficulties of integrating an ELISPOT assay into the routine laboratory setting. Although Xpert MTB/RIF assays are optimised and solely licensed for the analysis of sputum samples, in clinical practice they are commonly used for non-respiratory samples. Further research is needed to establish how current molecular TB tests impact on patient care and outcome in the routine clinical setting.
authors.affiliation: Academic Unit of Clinical & Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; Department of Paediatric Infectious Diseases & Immunology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom; Institute for Life Sciences, University of Southampton, Southampton, United Kingdom; Department of Paediatrics, The University of Melbourne, Parkville, Australia.
authors.forename: Marc
authors.initials: M
authors.lastname: Tebruegge
authors.affiliation: Department of Paediatrics, The University of Melbourne, Parkville, Australia; Infectious Diseases Unit, University Children's Hospital Basel, Basel, Switzerland.
authors.forename: Nicole
authors.initials: N
authors.lastname: Ritz
authors.affiliation: Department of Paediatrics, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Karsten
authors.initials: K
authors.lastname: Koetz
authors.affiliation: Department of Paediatrics, Hospital Sant Joan de Déu - Universitat de Barcelona, Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Noguera-Julian
authors.affiliation: Academic Department of Paediatrics, Faculty of Medicine, Imperial College, London, United Kingdom.
authors.forename: James A
authors.initials: JA
authors.lastname: Seddon
authors.affiliation: Birmingham Chest Clinic, Heart of England NHS Foundation Trust, Birmingham, United Kingdom.
authors.forename: Steven B
authors.initials: SB
authors.lastname: Welch
authors.affiliation: Second University Department of Pediatrics, National and Kapodistrian University of Athens School of Medicine, ''P. & A. Kyriakou'' Children's Hospital, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Tsolia
authors.affiliation: Academic Department of Paediatrics, Faculty of Medicine, Imperial College, London, United Kingdom; Medical Research Council (MRC) Unit The Gambia, Banjul, The Gambia.
authors.forename: Beate
authors.initials: B
authors.lastname: Kampmann
mesh_terms: D005060:Europe; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D007159:Immunologic Tests / Q000706:statistics & numerical data*; D025202:Molecular Diagnostic Techniques / Q000706:statistics & numerical data*; D016133:Polymerase Chain Reaction / Q000706:statistics & numerical data; D014376:Tuberculosis / Q000175:diagnosis*