Diagnostic Accuracy of Xpert MTB/RIF in Sputum Smear-Negative Pulmonary Tuberculosis

Rasheed, Waqas; Rao, Nisar Ahmed; Adel, Hatem; Baig, Mirza Saifullah; Adil, Syed Omair

doi:10.7759/cureus.5391

Cited by 14 publications

(16 citation statements)

References 18 publications

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“…Results of this study revealed that the GeneXpert assay is highly specific for the PTB diagnosis, in accordance with other earlier studies that have also reported this high specificity (Scott et al, 2011;Geleta et al, 2015). On the other hand, we currently recorded high specificity of the GeneXpert with regard to CN-SN pulmonary samples, in contrast to several recent studies which reported lower specificity among smear-negative PTB cases (Kawkitinarong et al, 2017;Ullah et al, 2017;Rasheed et al, 2019). This high specificity of GeneXpert assay suggests that it acts as a rapid test for the diagnosis of PTB in SN specimens, compared to the traditional methods in resource-limited settings.…”

Section: Discussioncontrasting

confidence: 59%

“…On using culture as the reference standard, results of the present study showed that the overall sensitivity, specificity, PPV, and NPV of the GeneXpert assay for the pulmonary samples were higher than other previous studies from China (Ou et al, 2015) and Ethiopia (Geleta et al, 2015). Moreover, the sensitivity for CP-SN was also higher than that recently reported by the study of Rasheed et al, (2019). This detected variation in sensitivities between the different studies could be attributed to the population studied, genetic differences, and the relative different prevalence of TB among the various populations.…”

Section: Discussionmentioning

confidence: 51%

“…Furthermore, the deficiency of diagnostic infrastructure, experienced staff and specialized laboratories interfere with proper patients care and outcomes, and exacerbate the dilemma of EPTB diagnosis. Thus, recent studies conduct by Bankar et al, (2018), Rasheed et al, (2019) highlighted that rapid and early detection of Mycobacterium tuberculosis (MTB), and the multidrug resistance/rifampicin-resistant (MDR/RIF-R) strains is an obligation. The WHO.…”

Section: Introductionmentioning

confidence: 99%

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Utility of GeneXpert MTB/RIF assay for the diagnosis of pulmonary and extra-pulmonary tuberculosis, A report from Egypt

Hefzy¹,

Ahmed²,

Ahmed³

et al. 2021

Novel Research in Microbiology Journal

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Early diagnosis of tuberculosis continues to be a challenge for clinicians. The World Health Organization (WHO) guidelines recommend the application of GeneXpert MTB/RIF in extra-pulmonary tuberculosis (EPTB) diagnosis. This study aimed to test and compare the accuracy of the GeneXpert MTB/RIF assay to diagnose pulmonary tuberculosis (PTB) and EPTB, compared to bacterial culture and to composite reference standard (CRS). The GeneXpert assay diagnosed tuberculosis (TB) in 19.5 % of patients. With reference to bacterial culture, the sensitivity of this assay for detection of the pulmonary and extra-pulmonary specimens was perfect. For pulmonary specimens, on using CRS; the detected sensitivity and specificity of the GeneXpert assay were 78.3 % and 99.1 %, respectively. However, for extra-pulmonary specimens, the sensitivity and specificity of the GeneXpert assay were 37.1 % and 99 %, respectively. In the current study, the GeneXpert assay showed almost perfect agreement with the bacterial culture for TB diagnosis. The diagnostic accuracy of the GeneXpert assay was high in ruling in, but not in ruling out of EPTB.

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Section: Discussioncontrasting

confidence: 59%

Section: Discussionmentioning

confidence: 51%

Section: Introductionmentioning

confidence: 99%

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Utility of GeneXpert MTB/RIF assay for the diagnosis of pulmonary and extra-pulmonary tuberculosis, A report from Egypt

Hefzy¹,

Ahmed²,

Ahmed³

et al. 2021

Novel Research in Microbiology Journal

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“…In this study, the case detection rate of GeneXpert was compared with the conventional smear microscopy and revealed that it showed almost two-fold case detection rate. All patients who turned positive for smear AFB were also positive for GeneXpert, implying that it can replace the conventional smear AFB microscopy in the clinical care of TB [ 9 , 12 , 13 ]. GeneXpert detected additional 31.6% among smear AFB negative cases which is congruent with the finding of the study from north-western part of Ethiopia and other multicenter studies [ 1 , 4 , 7 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic performance of GeneXpert in tuberculosis–HIV co–infected patients at Asella Teaching and Referral Hospital, Southeastern Ethiopia: A cross sectional study

Sorsa¹,

Kaso²

2021

PLoS ONE

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Background GeneXpert is a new introduction in the diagnostic modality to fight tuberculosis (TB) among people living with HIV (PLHIV) under the program of intensified TB case finding. This study aimed to evaluate the diagnostic performance of GeneXpert under the program of intensified TB cases finding among PLHIV. Methods Cross-sectional study was conducted by recruiting individuals attending an HIV clinic from February 2018 to January 2019. Data on clinical parameters were collected using a standardized tool. Two-morning sputum samples were collected and processed for smear microscopy and GeneXpert. SPSS 21 used for data analysis. Proportion, percentage, and mean with SD were used to describe variables. Univariate and multivariable logistic regressions were used to assess factors associated with the GeneXpert. Values for which the 95% CI interval not includes 1 and for which P<0.05 were considered significant. Result A total of 384 presumptive TB-HIV co-infection cases were included, of which 166 (43%) were diagnosed to have TB. Fifty-four (32.5%) TB cases were smear AFB positive while 79 (47.7%) TB cases were GeneXpert positive. The GeneXpert detection rate was almost two-fold of that of smear microscopy and all smear positive TB cases were detected by GeneXpert. Moreover, GeneXpert was able to detect an additional third of TB confirmed cases among smear AFB negative cases. Advanced stage of the disease, high viral load and presence of anemia were significantly associated with TB. The WHO TB screening tool remained least sensitive with the lowest positive predictive value. Conclusion GeneXpert demonstrated two-fold case detection rate compared to the sputum smear microscopy and additional third TB case detection rate among smear AFB negative cases. Clinical screening tool for evaluation of TB-HIV co-infection showed poor performance in TB case notification.

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“…We identified 50 articles: 17 [7,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] in the adult BAL group, 14 [35,[40][41][42][43][44][45][46][47][48][49][50][51][52] in the adult ES group, 7 [35,45,50,[53][54][55][56] in the adult IS group, 2 [57,58] in the pediatric ES group, 6 [57,[59][60][61][62][63] in the pediatric GA group, and 9 [59,[64][65][66][67]…”

Section: Studies' Characteristicsmentioning

confidence: 99%

Which sample type is better for Xpert MTB/RIF to diagnose adult and pediatric pulmonary tuberculosis?

et al. 2020

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Objective: This review aimed to identify proper respiratory-related sample types for adult and pediatric pulmonary tuberculosis (PTB), respectively, by comparing performance of Xpert MTB/RIF when using bronchoalveolar lavage (BAL), induced sputum (IS), expectorated sputum (ES), nasopharyngeal aspirates (NPA) and gastric aspiration (GA) as sample. Methods: Articles were searched in Web of Science, PubMed, and Ovid from inception up to June 29, 2020. Pooled sensitivity and specificity were calculated, each with a 95% confidence interval (CI). Quality assessment and heterogeneity evaluation across included studies were performed. Results: Fifteen articles were included. The respective sensitivity and specificity were 87% (95% CI: 0.84–0.89), 91% (95% CI: 0.90–0.92) and 95% (95% CI: 0.93–0.97) in the adult BAL group, 90% (95% CI: 0.88–0.91), 98% (95% CI: 0.97–0.98) and 97% (95% CI: 0.95–0.99) in the adult ES group, 86% (95% CI: 0.84–0.89) and 97% (95% CI: 0.96–0.98) in the adult IS group, 14% (95% CI: 0.10–0.19) and 99% (95% CI: 0.97–1.00) in the pediatric ES group, 80% (95% CI: 0.72–0.87) and 94% (95% CI: 0.92–0.95) in the pediatric GA group, 67% (95% CI: 0.62–0.72) and 99% (95% CI: 0.98–0.99) in the pediatric IS group, and 54% (95% CI: 0.43–0.64) and 99% (95% CI: 0.97–0.99) in the pediatric NPA group. The heterogeneity across included studies was deemed acceptable. Conclusion: Considering diagnostic accuracy, cost and sampling process, ES was a proper choice for adult PTB. GA might be more suitable than others for pediatric PTB. The actual choice of sample types should consider the needs of specific situations.

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Diagnostic Accuracy of Xpert MTB/RIF in Sputum Smear-Negative Pulmonary Tuberculosis

Cited by 14 publications

References 18 publications

Utility of GeneXpert MTB/RIF assay for the diagnosis of pulmonary and extra-pulmonary tuberculosis, A report from Egypt

Utility of GeneXpert MTB/RIF assay for the diagnosis of pulmonary and extra-pulmonary tuberculosis, A report from Egypt

Diagnostic performance of GeneXpert in tuberculosis–HIV co–infected patients at Asella Teaching and Referral Hospital, Southeastern Ethiopia: A cross sectional study

Which sample type is better for Xpert MTB/RIF to diagnose adult and pediatric pulmonary tuberculosis?

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