Evaluation of GeneXpert MTB/RIF for the detection of Mycobacterium tuberculosis and resistance to rifampin in clinical specimens

Bunsow, Eleonora; Ruiz‐Serrano, María Jesús; Roa, Paula López; Kestler, Martha; Viedma, Darı́o Garcı́a de; Bouza, Emilio

doi:10.1016/j.jinf.2013.11.012

Cited by 47 publications

(55 citation statements)

References 21 publications

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“…Every effort should be made to make a confirmatory microbiological diagnosis but this is often not possible. New technologies such as Genexpert (Cepheid, California, USA) can expedite diagnosis while providing early information on rifampicin sensitivity 161. Anti‐TB treatment should always be started at TB diagnosis.…”

Section: Coinfectionsmentioning

confidence: 99%

Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV‐1 infection 2015: optimizing health in preparation for adult life

et al. 2015

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The 2015 Paediatric European Network for Treatment of AIDS (PENTA) guidelines provide practical recommendations on the management of HIV‐1 infection in children in Europe and are an update to those published in 2009. Aims of treatment have progressed significantly over the last decade, moving far beyond limitation of short‐term morbidity and mortality to optimizing health status for adult life and minimizing the impact of chronic HIV infection on immune system development and health in general. Additionally, there is a greater need for increased awareness and minimization of long‐term drug toxicity. The main updates to the previous guidelines include: an increase in the number of indications for antiretroviral therapy (ART) at all ages (higher CD4 thresholds for consideration of ART initiation and additional clinical indications), revised guidance on first‐ and second‐line ART recommendations, including more recently available drug classes, expanded guidance on management of coinfections (including tuberculosis, hepatitis B and hepatitis C) and additional emphasis on the needs of adolescents as they approach transition to adult services. There is a new section on the current ART ‘pipeline’ of drug development, a comprehensive summary table of currently recommended ART with dosing recommendations. Differences between PENTA and current US and World Health Organization guidelines are highlighted and explained.

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Section: Coinfectionsmentioning

confidence: 99%

Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV‐1 infection 2015: optimizing health in preparation for adult life

et al. 2015

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“…In recent years, the GeneXpert MTB/RIF assay (Cepheid, Sunnyvale, CA, USA) was introduced as a semiautomated and semiquantitative nested real-time PCR (RT-PCR) assay for the simultaneous detection of M. tuberculosis and resistance to rifampin (RIF) directly from clinical specimens (6,7). Given its excellent performance in several clinical studies and easy handling (7)(8)(9), the GeneXpert assay received a strong endorsement from the World Health Organization (WHO) (1). However, there are some issues related to increased use of the GeneXpert assay in high-and low-income countries, including the cost, the inability to detect nontuberculous mycobacteria (NTM), and problems associated with the detection of rifampin-resistant strains (10).…”

mentioning

confidence: 99%

Multicenter Evaluation of Anyplex Plus MTB/NTM MDR-TB Assay for Rapid Detection of Mycobacterium tuberculosis Complex and Multidrug-Resistant Isolates in Pulmonary and Extrapulmonary Specimens

et al. 2016

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The rapid diagnosis of tuberculosis (TB) and the detection of drug-resistant Mycobacterium tuberculosis strains are critical for successful public health interventions. Therefore, TB diagnosis requires the availability of diagnostic tools that allow the rapid detection of M. tuberculosis and drug resistance in clinical samples. Here, we performed a multicenter study to evaluate the performance of the Seegene Anyplex MTB/NTM MDR-TB assay, a new molecular method based on a multiplex real-time PCR system, for detection of Mycobacterium tuberculosis complex (MTBC), nontuberculous mycobacteria (NTM), and genetic determinants of drug resistance. In total, the results for 755 samples (534 pulmonary and 221 extrapulmonary samples) were compared with the results of smears and cultures. For pulmonary specimens, the sensitivities of the Anyplex assay and acid-fast bacillus smear testing were 86.4% and 75.0%, respectively, and the specificities were 99% and 99.4%. For extrapulmonary specimens, the sensitivities of the Anyplex assay and acid-fast bacillus smear testing were 83.3% and 50.0%, respectively, and the specificities of both were 100%. The negative and positive predictive values of the Anyplex assay for pulmonary specimens were 97% and 100%, respectively, and those for extrapulmonary specimens were 84.6% and 100%. The sensitivities of the Anyplex assay for detecting isoniazid resistance in MTBC strains from pulmonary and extrapulmonary specimens were 83.3% and 50%, respectively, while the specificities were 100% for both specimen types. These results demonstrate that the Anyplex MTB/NTM MDR-TB assay is an efficient and rapid method for the diagnosis of pulmonary and extrapulmonary TB and the detection of isoniazid resistance.

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“…31 Bunsow E et al support the accuracy and rapidity of the test, but suggest other confirmatory tests for drug resistant mycobacteria. 32 Centre for disease control too recommends combination of tests, in particular for smear negative cases. 33 This technique is not free from drawbacks.…”

Section: Discussionmentioning

confidence: 99%

GeneXpert: a game changer in the detection and diagnosis of childhood tuberculosis

Gandra¹,

Gali²

2017

Int J Contemp Pediatr

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Background: Battling against tuberculosis (TB) is still a major challenge in India, despite measures undertaken by the government and medical fraternity. Delay in diagnosing tuberculosis is a challenge, causing hurdle in the prevention of spread of the disease.Methods: This retrospective study analysed the samples by geneXpert assay. Samples (n=403, from 359 children) included pulmonary (sputum and gastric aspirate, 359), extrapulmonary (lymph node aspirate (LNA), 41) cerebrospinal fluid (CSF, 03) pus from the lesion at the elbow joint (01). Only sputum was analysed for 315 children, both sputum and LNA for 41.Results: Mean age of patients was 9.08±2.85 years, range 3-15 years. There were 221 (61.56%) males and 138 (38.44%) females. Fever (71, 19.78%), fever with cough (87, 24.23%), fever with weight loss (41,11.42%) were the main symptoms. There were three patients with high fever, headache and seizures with neck rigidity, clinically diagnosed as Tuberculous meningitis. There was history of contact with Tuberculosis in 15 (4.18%) patients. Mean ESR was 112.09mm/1st Hr±56.05 (range 54 -750 mm/1st Hr). Mantoux test was positive in 270 (75.42%). Chest X-ray was normal in 33 (9.19%); consolidation in 189 (52.65%), mild pleural effusion in 94 (26.18%) mild pleural effusion associated with consolidation in 43 (11.98%) were reported. Positive GeneXpert assay (106 samples, 27.39%; sputum (87, 24.23% %), pus (01), CSF (03), LNA (15, 57.69%) was reported in 87 patients. Results were obtained ≤36 hours, mean 2 hours± 2.34 (range 6- 36 hours).Conclusions: GeneXpert is an effective tool for rapid detection of tuberculosis. Present study supports its inclusion in the battery of routine investigations. It can revolutionise the scenario in prevention and management of tuberculosis.

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Evaluation of GeneXpert MTB/RIF for the detection of Mycobacterium tuberculosis and resistance to rifampin in clinical specimens

Cited by 47 publications

References 21 publications

Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV‐1 infection 2015: optimizing health in preparation for adult life

Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV‐1 infection 2015: optimizing health in preparation for adult life

Multicenter Evaluation of Anyplex Plus MTB/NTM MDR-TB Assay for Rapid Detection of Mycobacterium tuberculosis Complex and Multidrug-Resistant Isolates in Pulmonary and Extrapulmonary Specimens

GeneXpert: a game changer in the detection and diagnosis of childhood tuberculosis

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