Rapid Molecular Diagnosis of Extra-Pulmonary Tuberculosis by Xpert/RIF Ultra

Rindi, Laura

doi:10.3389/fmicb.2022.817661

Cited by 15 publications

(9 citation statements)

References 54 publications

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“…A recent review of the diagnosis of extrapulmonary TB with the GeneXpert assay found a sensitivity of 60%–100%, depending on specimen type, and a specificity of 87.5%–100% for bone and joint specimens. 10 We did not diagnose TB in our patient until 5 years after symptom onset, by which time he had considerable destruction of the knee joint. Despite the presence of joint destruction, TB arthritis typically responds well to medical therapy and is usually treated for 6–12 months.…”

Section: Discussionmentioning

confidence: 67%

Tuberculous monoarthritis of the knee joint

Gunton

Losie

Connors

2023

CMAJ

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Section: Discussionmentioning

confidence: 67%

Tuberculous monoarthritis of the knee joint

Gunton

Losie

Connors

2023

CMAJ

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“…A review article has compiled many previous studies on the performance of Xpert Ultra using culture and CRS as the gold standard and has reported highly varied sensitivities as 50%–84% and 37%–61% in pleural fluid, 50%–100% and 27%–70% in lymph node tissue/aspirates, 71%–96% and 33%–95% in CSF samples, and 100% and 18%–34% in urine samples, respectively. [ 20 ]…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Efficacy of New Xpert Ultra for Extrapulmonary Tuberculosis Using Culture and Composite Reference Standard

Chaudhary,

Chawla,

Gupta

et al. 2023

International Journal of Applied &Amp; Basic Medical Research

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Introduction: Xpert Ultra (Cepheid, USA) is recently introduced with an extra category of trace-positive results and higher sensitivity for tuberculosis (TB) diagnosis. Objective: The objective of the study was to assess the diagnostic accuracy of Xpert Ultra for extrapulmonary samples using culture and composite reference standard (CRS) as the gold standard. Materials and Methods: In a 1-year (March 2021–22) prospective observational study, samples of suspected extrapulmonary TB (EPTB) patients were subjected to Ziehl–Neelsen staining, culture, and Xpert Ultra (Cepheid, Sunnyvale, CA) tests. Relevant clinical and treatment information was noted. The diagnostic accuracy of Xpert Ultra compared with culture and CRS was calculated. Results: Out of 1720 suspected patients of EPTB, 223 (13%), predominantly males 135 (60%), with a mean age of 41.46 ± 19.81 years, were diagnosed as TB positive following CRS criteria. The maximum cases were of pleural TB (35.4%), followed by central nervous system TB (17.9%), gastrointestinal TB (17.5%), and lymph node TB (12.1%). Of all samples, 150 (8.7%) were microbiologically confirmed, including 141 detected by Xpert ultra, 67 culture positive, and only 16 smear positive. Among the Xpert Ultra-positive samples, 35 showed trace results, including six false-positive results. Considering culture and CRS as the gold standard, the sensitivity (86.57%, 59.64%) and specificity (94.98%, 99.47%) of Xpert Ultra were calculated, respectively. Rifampicin resistance was detected in 1 (0.70%) sample. Conclusion: Diagnosis of EPTB is a challenge and Xpert Ultra may detect TB at a very early stage. However, it is essential to rule out false-positive results. Additional studies are needed on Xpert Ultra to interpret trace results better.

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“…Le test de dépistage automatisé à base de cartouche GeneXpert MTB/RIF, tout comme le test de nouvelle génération GeneXpert MTB/RIF Ultra, est le test de dépistage fondé sur un test d’amplification de l’acide nucléique le plus étudié et le plus largement accessible, en plus d’être recommandé par l’Organisation mondiale de la santé. Une récente revue des diagnostics de TB extrapulmonaire posés à l’aide du test de dépistage GeneXpert a observé une sensibilité de 60 %–100 %, selon le type d’échantillons, et une spécificité de 87,5 %–100 % pour les échantillons osseux et articulaires 10 . Dans le cas de notre patient, nous n’avons pas été en mesure de diagnostiquer une TB avant 5 ans après l’apparition des symptômes, auquel moment l’articulation de son genou avait subi une destruction considérable.…”

Section: Discussionunclassified