Diagnostic Accuracy of Xpert MTB/RIF Assay in Extrapulmonary Tuberculosis

Bankar, Sheetal; Set, Reena; Sharma, Deepak; Shah, Daksha; Shastri, Jayanthi

doi:10.4103/ijmm.ijmm_18_173

Cited by 17 publications

(5 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Finally, we evaluated the performance of different assays in smear-negative samples, and Xpert still had higher sensitivity (92.7% [80.6-97.5]) and specificity (100% [95.7-100]) compared to culture. This was slightly higher than the reported sensitivity (70-85%) ( Bankar et al., 2018 ; Rakotoarivelo et al., 2018 ; Horne et al., 2019 ), perhaps due to the different choice of the reference standard (culture and Xpert were used in this study).…”

Section: Discussioncontrasting

confidence: 65%

Diagnosis of extrapulmonary tuberculosis by ultrasound-guided biopsy: A retrospective comparison study

Shi

et al. 2023

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

ObjectiveTo compare the diagnostic performance of laboratory assays on the ultrasound-guided core needle biopsy samples for diagnosis of extra-pulmonary tuberculosis (EPTB) in HIV-positive and HIV-negative patients.MethodsA total of 217 patients suspected to have EPTB underwent lesion biopsy from 2017 to 2020. Results of laboratory tests on the biopsy and non-biopsy samples were collected with clinical data for retrospective analysis of test utility. The calculated diagnostic accuracy of the tests was stratified according to the specimen types and HIV status.ResultsThe cohort contained 118 patients with a final positive diagnosis of extrapulmonary tuberculosis (EPTB group, 54.4%) and 99 finally diagnosed as without TB (non-EPTB group, 45.6%). The risk factor for EPTB was HIV co-infection (OR 2.22, 95% CI 1.17-4.28, p = 0.014). In biopsy samples, GeneXpert (Xpert) showed higher sensitivity (96.6% [91.6-98.7], p < 0.0001) than culture (56.1% [47.0-64.9]). Regardless of HIV status, Xpert had the highest sensitivity (>95%) and specificity (nearly 100%) of any methods. In non-biopsy samples, only T-SPOT.TB (T-SPOT) showed higher sensitivity than culture (90.9% [62.3-99.5] vs 35.3% [17.3-58.7], p = 0.0037). Furthermore, the sensitivities of Xpert were lower in non-biopsy samples (60.0% [23.1-92.9], p = 0.022) than in biopsy samples (100% [86.7-100]). Even in smear-negative biopsy samples, Xpert still had higher sensitivity than culture and retained high specificity (100% [95.7-100]).ConclusionSuperior performance of Xpert in diagnosing EPTB was observed regardless of HIV status and specimen types. Nevertheless, the biopsy samples still substantially facilitated the accurate diagnosis of extrapulmonary tuberculosis.

show abstract

Section: Discussioncontrasting

confidence: 65%

Diagnosis of extrapulmonary tuberculosis by ultrasound-guided biopsy: A retrospective comparison study

Shi

et al. 2023

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

show abstract

“…Ten investigators thawed cryopreserved fluid samples for their tests [ 23 , 31 , 35 , 42 , 60 , 66 , 73 , 78 , 80 , 84 ]. Pleural fluid was concentrated by centrifugation in 32 studies prior to Xpert/Ultra assay [ 23 – 25 , 27 , 30 , 33 – 35 , 37 , 38 , 43 , 44 , 46 , 48 – 51 , 53 , 58 , 59 , 65 , 72 – 74 , 76 , 78 , 85 , 88 , 89 , 91 , 94 , 95 ]. Most investigators (51, 68.9%) used mycobacterial culture as reference standard for diagnosing TPE, while 33 used a composite reference standard ( S1 Table of online supplement).…”

Section: Resultsmentioning

confidence: 99%

Xpert MTB/RIF Ultra versus Xpert MTB/RIF for diagnosis of tuberculous pleural effusion: A systematic review and comparative meta-analysis

et al. 2022

View full text Add to dashboard Cite

Objective We compared diagnostic accuracy of pleural fluid Xpert MTB/RIF (Xpert) and Xpert MTB/RIF Ultra (Ultra) assays for diagnosing tuberculous pleural effusion (TPE), through systematic review and comparative meta-analysis. Methods We searched PubMed and Embase databases for publications reporting diagnostic accuracy of Xpert or Ultra for TPE. We used bivariate random-effects modeling to summarize diagnostic accuracy information from individual studies using either mycobacterial culture or composite criteria as reference standard. We performed meta-regression through hierarchical summary receiver operating characteristic (HSROC) modeling to evaluate comparative performance of the two tests from studies reporting diagnostic accuracy of both in the same study population. Results We retrieved 1097 publications, and included 74 for review. Summary estimates for sensitivity and specificity for Xpert were 0.52 (95% CI 0.43–0.60, I2 82.1%) and 0.99 (95% CI 0.97–0.99, I2 85.1%), respectively, using culture-based reference standard; and 0.21 (95% CI 0.17–0.26, I2 81.5%) and 1.00 (95% CI 0.99–1.00, I2 37.6%), respectively, using composite reference standard. Summary estimates for sensitivity and specificity for Ultra were 0.68 (95% CI 0.55–0.79, I2 80.0%) and 0.97 (95% CI 0.97–0.99, I2 92.1%), respectively, using culture-based reference standard; and 0.47 (95% CI 0.40–0.55, I2 64.1%) and 0.98 (95% CI 0.95–0.99, I2 54.8%), respectively, using composite reference standard. HSROC meta-regression yielded relative diagnostic odds ratio of 1.28 (95% CI 0.65–2.50) and 1.80 (95% CI 0.41–7.84) respectively in favor of Ultra, using culture and composite criteria as reference standard. Conclusion Ultra provides superior diagnostic accuracy over Xpert for diagnosing TPE, mainly because of its higher sensitivity.

show abstract

“…More than 95% of rifampicinresistant strains exhibit rpoB variation ( Thirumurugan et al, 2015 ). The Xpert MTB/RIF assay can detect MTB and rifampicin resistance simultaneously within 2 hours; it has been proven to have good efficacy in the diagnosis of extrapulmonary TB ( Bankar et al, 2018 ;Penz et al, 2015 ). Kohli et al . reported that the pooled sensitivity and specificity of the Xpert MTB/RIF assay against a CRS were 42.3% (32.1-52.8%) and 99.8% (99.3-100.0%) for cerebrospinal fluid specimens and 18.9% (11.5-27.9%) and 99.3% (98.1-99.8%) for pleural fluid specimens, respectively ( Kohli et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Application of core needle biopsy in the diagnosis of epididymal tuberculosis: a retrospective analysis of 41 cases

Gu¹,

Liu²,

Qin³

2022

International Journal of Infectious Diseases

View full text Add to dashboard Cite

Diagnostic Accuracy of Xpert MTB/RIF Assay in Extrapulmonary Tuberculosis

Cited by 17 publications

References 16 publications

Diagnosis of extrapulmonary tuberculosis by ultrasound-guided biopsy: A retrospective comparison study

Diagnosis of extrapulmonary tuberculosis by ultrasound-guided biopsy: A retrospective comparison study

Xpert MTB/RIF Ultra versus Xpert MTB/RIF for diagnosis of tuberculous pleural effusion: A systematic review and comparative meta-analysis

Application of core needle biopsy in the diagnosis of epididymal tuberculosis: a retrospective analysis of 41 cases

Contact Info

Product

Resources

About