RT Journal Article SR Electronic T1 EBUS-TBNA in the rapid microbiological diagnosis of drug-resistant mediastinal tuberculous lymphadenopathy JF ERJ Open Research JO erjor FD European Respiratory Society SP 00008-2019 DO 10.1183/23120541.00008-2019 VO 5 IS 4 A1 Prashant N. Chhajed A1 Preyas J. Vaidya A1 Neha P. Mandovra A1 Vinod B. Chavhan A1 Tejashree T. Lele A1 Rekha Nair A1 Jörg D. Leuppi A1 Avinandan Saha YR 2019 UL http://openres.ersjournals.com/content/5/4/00008-2019.abstract AB This study aimed to examine the use of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the rapid diagnosis of mediastinal tuberculous lymphadenitis and drug-resistant mediastinal tuberculous lymphadenitis.A diagnosis of TB was confirmed by a positive Xpert MTB/RIF test or Mycobacterium tuberculosis culture. Rifampicin-resistant TB (RR-TB) or multidrug-resistant TB (MDR-TB) was diagnosed upon the detection of rifampicin resistance by Xpert MTB/RIF or resistance to rifampicin and isoniazid by phenotypic drug susceptibility testing (DST).Xpert MTB/RIF was positive in 43 of 56 patients (77%) and TB culture was positive in 31 of 56 patients (55%). Of these 56 patients, 25 (45%) were Xpert MTB/RIF positive and TB culture negative, 13 (23%) were Xpert MTB/RIF negative and TB culture positive, and 18 (32%) were Xpert MTB/RIF positive and TB culture positive. 11 patients (20%) had drug-resistant TB: seven with RR/MDR-TB, one with pre-extensively drug-resistant (XDR) TB, two with XDR-TB and one with isoniazid mono-resistance.An Xpert MTB/RIF assay carried out on EBUS-TBNA specimens provides rapid diagnosis of TB. Xpert MTB/RIF testing appears to have additional and more rapid sensitivity compared with culture alone. Culture-based DST provides an additional exclusive yield and the full resistance profile in addition to or instead of rifampicin resistance.EBUS-TBNA has value in mediastinal adenopathy, including drug-resistant TB. Combined Xpert MTB/RIF and TB culture testing on EBUS-TBNA specimens helps in diagnosing rifampicin resistance missed by Xpert MTB/RIF. http://bit.ly/2LT2OOD