Evaluación de la técnica Xpert® MTB/RIF para la detección de Mycobacterium tuberculosis complex en muestras extra-pulmonares

García, Patricia; Balcells, María Elvira; Castillo, Claudia; Miranda, Carolina; Geoffroy, Enrique; Román, Juan C; Wozniak, Aniela

doi:10.4067/s0716-10182017000400333

Cited by 7 publications

(4 citation statements)

References 16 publications

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“…We excluded one other article that reported on the specificity only [33], without reporting any sensitivity. We excluded five articles written in languages other than Chinese or English [34][35][36][37][38]. The specimens used in the article were pericardial effusion, pericardial tissue, or both.…”

Section: Identification Of Studies and Study Characteristicsmentioning

confidence: 99%

Diagnostic accuracy of the Xpert MTB/RIF assay for tuberculous pericarditis: A systematic review and meta-analysis

Zhong

Shen

et al. 2021

PLoS ONE

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Objective The purpose of this study was to evaluate the diagnostic efficacy of Xpert MTB/RIF for tuberculous pericarditis (TBP). Methods We searched relevant databases for Xpert MTB/RIF for TBP diagnosis until April 2021 and screened eligible studies for study inclusion. We evaluated the effectiveness of Xpert MTB/RIF when the composite reference standard (CRS) and mycobacterial culture were the gold standards, respectively. We performed meta-analyses using a bivariate random-effects model, and when the heterogeneity was obvious, the source of heterogeneity was further discussed. Results We included seven independent studies comparing Xpert MTB/RIF with the CRS and six studies comparing it with culture. The pooled sensitivity, specificity, and area under the curve of Xpert MTB/RIF were 65% (95% confidence interval, 59–72%), 99% (97–100%), and 0.99 (0.97–0.99) as compared with the CRS, respectively, and 75% (53–88%), 99% (90–100%), and 0.94 (0.92–0.96) as compared with culture, respectively. There was no significant heterogeneity between studies when CRS was the gold standard, whereas heterogeneity was evident when culture was the gold standard. Conclusions The sensitivity of Xpert MTB/RIF for diagnosing TBP was moderate and the specificity was good; thus, Xpert MTB/RIF can be used in the initial diagnosis of TBP.

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Section: Identification Of Studies and Study Characteristicsmentioning

confidence: 99%

Diagnostic accuracy of the Xpert MTB/RIF assay for tuberculous pericarditis: A systematic review and meta-analysis

Zhong

Shen

et al. 2021

PLoS ONE

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“… 28 , 29 The accuracy of Xpert MTB/RIF in TBP diagnosis in pericardial effusions is moderate, and it can be recommended as a method for rapid TBP diagnosis. 30 In pericardial tissues, NAATs are still indicated. 16 The tests currently used for TBP diagnosis are DNA-based tests, 29 and there have been no studies on the role of RNA-based tests in TBP diagnosis, which is the purpose of our study.…”

Section: Discussionmentioning

confidence: 99%

Clinical Application of the Mycobacterium tuberculosis-RNA Assay of Pericardial Tissue Specimens in the Diagnosis of Tuberculous Pericarditis

Zhang¹,

Bu²,

Yao³

et al. 2023

IDR

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Purpose To assess the accuracy of the Mycobacterium tuberculosis (MTB)-RNA assay using pericardial tissue specimens for tuberculous pericarditis (TBP) diagnosis. Methods MTB culture and MTB-RNA assay were performed for patients with suspected TBP. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) of these two assays were analyzed. Results This study included 79 patients. The sensitivity, specificity, PPV, NPV, and AUC were 28.1% (18/64), 100.0% (15/15), 100.0% (18/18), 24.6% (15/61), and 0.64 for the MTB culture and 37.5% (24/64), 100.0% (15/15), 100.0% (24/24), 27.3% (15/55), and 0.69 for the MTB-RNA assay, respectively. Patients with positive pericardial tissue culture were defined as having definite TBP; in other words, culture was the gold standard for this group of patients and had a sensitivity, specificity, PPV, and NPV of 100% and an AUC of 1.00. However, these values were found to be 72.2% (13/18), 100.0% (15/15), 100.0% (13/13), 75.0% (15/20), and 0.86 for the MTB-RNA assay, respectively. Among patients with probable TBP (culture-negative patients), the sensitivity, specificity, NPV, and AUC of MTB culture were 0.0% (0/46), 100.0% (15/15), 24.6% (15/61), and 0.50, respectively, but the PPV could not be determined. These values were found to be 23.9% (11/46), 100.0% (15/15), 100.0% (11/11), 30.0% (15/50), and 0.62 for the MTB-RNA assay, respectively. Conclusion MTB-RNA assay using pericardial tissues had limited diagnostic efficacy for TBP. In culture-positive TBP, the diagnostic accuracy of MTB-RNA was good. In contrast, in culture-negative TBP, its diagnostic accuracy was unsatisfactory.

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“…Nela mostrou-se que a sensibilidade do teste genotípico variou de acordo com o tipo de amostra, porém a especificidade relatada foi sempre acima de 98,0% (World Health Organization, 2013). Um grupo de autores verificou em 2017 que de um total de 50 amostras de origem extrapulmonar, houve 100,0% de concordância de positividade entre o Xpert ® MTB/RIF e a cultura líquida quanto a positividade e 96,0% de concordância quanto a negatividade (García et al, 2017).…”

Section: Discussionunclassified

Desempenho do teste Xpert® MTB/RIF na detecção laboratorial de tuberculose em amostras pulmonares e extrapulmonares

Dietz¹,

Borges²,

Alves³

et al. 2021

RSD

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Objetivo: Avaliar a performance diagnóstica do Xpert® MTB/RIF na realidade goiana. Metodologia: Estudo transversal formulado a partir de registros arquivados na Seção de Micobactérias de um laboratório referência no diagnóstico de agravos de interesse em saúde pública do Estado de Goiás, Brasil. Foram coletados dados referentes a amostras vinculadas a casos suspeitos de tuberculose processadas no período compreendido entre outubro de 2017 e outubro de 2018. Incluiu-se no estudo amostras pulmonares e extrapulmonares que apresentavam resultados de Xpert® MTB/RIF e cultura. As informações coletadas foram utilizadas para composição de um banco de dados com as seguintes variáveis: espécime clínico, resultado do Xpert® MTB/RIF, resultado da cultura e tipo de cultura (sólida ou líquida). Para cálculo de sensibilidade, especificidade, valor preditivo positivo (VPP) e valor preditivo negativo (VPN), o crescimento em cultura foi tido como referência. Resultados: Foram elegíveis para o estudo 3262 amostras, 3068 de origem pulmonar (94,1%) e 194 de origem extrapulmonar (5,9%). O Xpert® MTB/RIF mostrou sensibilidade e especificidade geral de 87,1% e 97,6% para amostras de origem pulmonar e 80,0% e 97,3% para amostras de origem extrapulmonar. O desempenho do teste variou de acordo com a amostra clínica e o tipo de cultura tomada como referência. Conclusão: O teste Xpert® MTB/RIF demonstrou no presente estudo ser uma importante ferramenta diagnóstica para casos de tuberculose tanto em amostras pulmonares quanto extrapulmonares, apresentando boa sensibilidade e especificidade. Os resultados, como de qualquer outra metodologia, devem ser interpretados com cautela e baseados na associação de critérios clínicos, epidemiológicos e laboratoriais.

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Evaluación de la técnica Xpert® MTB/RIF para la detección de Mycobacterium tuberculosis complex en muestras extra-pulmonares

Cited by 7 publications

References 16 publications

Diagnostic accuracy of the Xpert MTB/RIF assay for tuberculous pericarditis: A systematic review and meta-analysis

Diagnostic accuracy of the Xpert MTB/RIF assay for tuberculous pericarditis: A systematic review and meta-analysis

Clinical Application of the Mycobacterium tuberculosis-RNA Assay of Pericardial Tissue Specimens in the Diagnosis of Tuberculous Pericarditis

Desempenho do teste Xpert® MTB/RIF na detecção laboratorial de tuberculose em amostras pulmonares e extrapulmonares

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