Evaluation of GeneXpert MTB/RIF for determination of rifampicin resistance among new tuberculosis cases in west and northwest Iran

Atashi, Sara Naybandi; Izadi, Babak; Jalilian, Somayeh; Madani, Seyed Hamid; Farahani, Abbas

doi:10.1016/j.nmni.2017.07.002

Cited by 36 publications

(23 citation statements)

References 23 publications

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“…When comparing the Xpert results of the 103 samples to their pDST results, Xpert had a sensitivity of 91.1%, speci city of 79.2% (Table 3). The agreement rate between pDST and Xpert was 88.3%, which is lower than the previously reported Xpert performance [9,10].…”

Section: Xpert Vs Pdstcontrasting

confidence: 78%

Inquiry into GeneXpert as a complementary MDR-TB diagnostic tool in North Korea: A follow-up study of North Korean TB drug resistance patterns

Lee¹,

Kwon²,

Hwang³

et al. 2021

Preprint

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Background: This study aims to investigate the usefulness of GeneXpert MTB/RIF (Xpert) in diagnosing rifampicin (RIF) resistance among the patients in the secluded sanatoria of North Korea. This article is a follow up of a report that explored the characteristics of drug resistance in North Korean Sanatoria, published in 2017. Xpert is used as a diagnostic tool to check for multidrug-resistant tuberculosis (MDR-TB) in specific areas of North Korea by the Eugene Bell Foundation (EBF). While there are other diagnostic tools are used to test for RIF resistance, there is no other feasible method to consistently test for MDR-TB in North Korea. Currently, EBF exclusively uses Xpert in tuberculosis and RIF resistance diagnosis when providing medical support for tuberculosis patients in North Korea, where there is limited international access. Methods: We performed Xpert using cultured tuberculous bacilli of North Koreans and compared the result to the corresponding phenotypic drug susceptibility tests (pDST) and rifampicin resistant-determining region sequencing (RRDR). All samples were target-sequenced at the rpoB region, where unique RIF resistance related mutations, potentially specific to North Korea, were discovered.Results: Using the RRDR sequencing as the gold standard, Xpert’s sensitivity and specificity was 94.9% and 88.0%, respectively. In addition, we discovered several rare or novel mutations among the North Korean Mycobacterium tuberculosis isolates.Conclusions: RIF detection in North Korea is possible using Xpert as an alternative to pDST, as this research has shown. This research is not only imperative to North Korea, but also in locations where there is limited access to conventional pDST.

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Section: Xpert Vs Pdstcontrasting

confidence: 78%

Inquiry into GeneXpert as a complementary MDR-TB diagnostic tool in North Korea: A follow-up study of North Korean TB drug resistance patterns

Lee¹,

Kwon²,

Hwang³

et al. 2021

Preprint

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“…In this study, conventional drug susceptibility test and Xpert assay were used for characterizing the RIF resistance; however, we did not find any resistant isolates, which limited our ability to evaluate the efficiency of the Xpert assay for the identification of RIF resistance. In a study conducted on ten provinces located in the west and northwest of Iran, the sensitivity and specificity of the Xpert assay for the determination of the RIF resistance were 71% and 100%, respectively (22). As the RIF resistance was uncommon in Golestan Province, 0.5% for new TB cases (8), additional research is recommended with a larger sample size.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Xpert MTB/RIF test accuracy for diagnosis of tuberculosis in areas with a moderate tuberculosis burden

Mansoori

Pahlavanzadeh

Arabmofrad

2020

APMIS

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Mansoori N, Pahlavanzadeh B, Arabmofrad F. Evaluation of the Xpert MTB/RIF test accuracy for diagnosis of tuberculosis in areas with a moderate tuberculosis burden. APMIS 2021; 125: 9-13. The Xpert MTB/RIF assay (Xpert) is a molecular assay used for direct detection of Mycobacterium tuberculosis (MTB) in clinical specimens. In this study, we aimed to assess the accuracy of the Xpert assay for the diagnosis of tuberculosis (TB) in TB suspected patients from the northern region of Iran. The obtained results were compared with the culture method. The sputum specimens were examined using the Xpert assay, smear microscopy, and solid culture media as a reference diagnostic tool. Among 293 presumptive TB cases, 92 (31.4%) were positive according to the culture method. The Xpert method detected 88 (95.7%) cases that were positive according to the culture method, compared with 78 (84.8%) positive cases according to smear microscopy. The overall sensitivity and specificity of the Xpert method for TB diagnosis were 95.7% and 99%, respectively. Also, the sensitivity and specificity for smear microscopy were 84.8% and 97.5%, respectively. The Xpert assay showed high overall sensitivity and specificity; thus, it can be effectively used for the early and accurate diagnosis of MTB in TB endemic areas. In addition, the agreement between semi-quantitative results of Xpert and smear microscopy assays could be helpful in evaluating transmission potential in TB patients.

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“…For example, a study in Indonesia has shown a high sensitivity (89-93%) and specificity (81-92%), suggesting that the Xpert® MTB/RIF could be used as a diagnostic tool for ruling out TB or MDR-TB in Indonesia as one of the countries with a high TB burden.8 An effective TB treatment requires an accurate and early diagnosis as well as screening for drug resistance and HIV, which should be done with a low testing cost per sample. 17 Thus, new TB cases can directly benefit from the use of this Xpert® MTB/RIF examination.…”

Section: Figure Distribution Of Mdr Tb Patients From Various Regions In West Java Indonesiamentioning

confidence: 99%

Performance of Xpert® MTB/RIF in detecting Multidrug-Resistance Tuberculosis in West Java, Indonesia

Sahiratmadja

Mega

Andriyoko

et al. 2020

mkb

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Indonesia is the 2nd country with the highest tuberculosis (TB) caseload in the world. Inappropriate TB treatment may lead to multidrug-resistance tuberculosis (MDR-TB) development. Tuberculosis rapid detection is important, and very much needed, to prevent transmission and deaths due to this disease. The Xpert® MTB/RIF is proposed to address this problem. This study aimed to assess the performance of the Xpert® MTB/RIF test in West Java, Indonesia. This was a cross-sectional study conducted on MDR-TB suspects referred to Dr. Hasan Sadikin General Hospital Bandung, West Java, Indonesia, using data from the eTB Manager. The performance of Xpert® MTB/RIF testing and its validity was tested against conventional drug susceptibility testing (DST). In total, data from 4,452 MDR-TB suspects were retrieved but only 578 data that had both DST and Xpert® MTB/RIF results were included in the study. The Xpert® MTB/RIF showed a sensitivity of 88% (95%CI: 85%-91%), specificity of 66% (95%CI: 60%-72%), positive predictive value of 79% (95%CI: 75%-83%), and negative predictive value of 80% (95%CI: 74%-85%), with a detection accuracy of 79%. Xpert® MTB/RIF test in this study shows a good performance for the diagnosis of MDR-TB when compared to the Mycobacterium tuberculosis culture as the gold standard. Therefore, rapid Xpert® MTB/RIF examination is recommended for MDR-TB screening for countries with a high TB burden as a complementary tool to the reference standard test.

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Evaluation of GeneXpert MTB/RIF for determination of rifampicin resistance among new tuberculosis cases in west and northwest Iran

Cited by 36 publications

References 23 publications

Inquiry into GeneXpert as a complementary MDR-TB diagnostic tool in North Korea: A follow-up study of North Korean TB drug resistance patterns

Inquiry into GeneXpert as a complementary MDR-TB diagnostic tool in North Korea: A follow-up study of North Korean TB drug resistance patterns

Evaluation of the Xpert MTB/RIF test accuracy for diagnosis of tuberculosis in areas with a moderate tuberculosis burden

Performance of Xpert® MTB/RIF in detecting Multidrug-Resistance Tuberculosis in West Java, Indonesia

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