Xpert&lt;SUP&gt;®&lt;/SUP&gt; MTB/RIF for improved case detection of extra-pulmonary TB in a tertiary care setting in urban India

Nataraj, Gita; Kanade, Swapna; Mehta, Preeti

doi:10.5588/ijtld.15.0849

Cited by 14 publications

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“…While the performance of Xpert MTB/RIF in the detection of MTB complex in respiratory samples is well described, its performance in extra-pulmonary clinical specimens has not been well characterized with lower sensitivity and specificity in some studies. 6 , 7 Extra-pulmonary MTB infection remains a diagnostic challenge not only due to the low number of bacteria, but also due to invasive procedures often required for sample collection. Recent studies focusing on diagnosis of extra-pulmonary MTB revealed that Xpert MTB/RIF detection rate was variable with lower sensitivity in different extra-pulmonary tissues; lymph node (sensitivity 83%), cerebrospinal fluid (CSF) (sensitivity 80%), and pleural fluid (sensitivity 46%).…”

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confidence: 99%

Evaluation of GeneXpert MTB/RIF for detection of Mycobacterium tuberculosis complex and rpo B gene in respiratory and non-respiratory clinical specimens at a tertiary care teaching hospital in Saudi Arabia

Somily

Barry

Habib

et al. 2016

SMJ

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ObjectivesTo assess the performance of Xpert MTB/RIF, an automated molecular test for Mycobacterium tuberculosis (MTB) and resistance to rifampin (RIF), against smear microscopy and culture method for diagnosis of MTB infection.MethodsThis is a retrospective analysis of 103 respiratory and 137 non-respiratory patient specimens suspected of tuberculosis at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia performed between April 2014 and March 2015. Each sample underwent smear microscopy, mycobacterial culture, and GeneXpert MTB/RIF test.ResultsFifteen out of 103 respiratory samples were smear and culture positive, whereas 9 out of 137 non-respiratory samples were smear positive. Out of 9 smear positive specimens, 8 were also culture positive. All 15 culture positive respiratory samples were detected by Xpert MTB/RIF (sensitivity and positive predictive value [PPV]=100%). Similarly, all 8 culture positive non-respiratory specimens were identified by Xpert MTB/RIF (sensitivity 100%; PPV 88.8%). The Xpert MTB/RIF detected only one false positive result in 88 smear negative respiratory specimens (specificity 98.9%; negative predictive value [NPV]= 100%). All 125 smear negative non-respiratory specimens tested negative by culture and Xpert MTB/RIF (sensitivity, specificity, PPV, NPV= 100%).ConclusionThe performance of Xpert MTB/RIF was comparable to the gold standard culture method for identification of MTB in both respiratory and non-respiratory clinical specimens.

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confidence: 99%

Evaluation of GeneXpert MTB/RIF for detection of Mycobacterium tuberculosis complex and rpo B gene in respiratory and non-respiratory clinical specimens at a tertiary care teaching hospital in Saudi Arabia

Somily

Barry

Habib

et al. 2016

SMJ

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“…Next, we screened the title, abstract, and conclusion of the research. Finally, we conducted a full-text review and meta-analysis of 27 articles [ 3 , 8 – 33 ] ( S1 , Table 1 ). The sample number of each article ranged from 25 to 348.…”

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confidence: 99%

“…Some researchers pointed out that this situation may be due to the presence of PCR inhibitors in the extrapulmonary samples, which prevented the test from being performed [ 15 ]. In another study, the researchers believed that the sample reagent buffer used in the Xpert analysis was originally designed for liquefaction of mucus-like sputum specimens, which may not be suitable for a variety of extrapulmonary specimens, resulting in detection errors [ 33 ]. Obviously, for extrapulmonary samples, the most common type of error is B.…”

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confidence: 99%

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Evaluation of Xpert MTB/RIF for the Diagnosis of Lymphatic Tuberculosis

Liang

et al. 2020

BioMed Research International

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Background. The World Health Organization approved the use of Xpert MTB/RIF for the detection of Mycobacterium tuberculosis DNA, which has significantly improved the diagnosis of tuberculosis. In this study, our main objective was to evaluate the diagnostic efficacy of Xpert MTB/RIF for lymphoid tuberculosis to determine whether Xpert MTB/RIF could be used as a routine detection method. Materials and Methods. We searched four databases for the relevant literature published from May 2007 to December 2019. The quality of the literature was evaluated with reference to the evaluation criteria. Data that were extracted from the literature on Xpert MTB/RIF diagnosis of lymphatic tuberculosis were used to plot the summary receiver operating characteristic (SROC) curve, after which the software was used to combine and analyze the accuracy of these data. Results. A total of 27 studies were included. The sensitivity of Xpert MTB/RIF for detecting lymphatic tuberculosis was 0.79 (95% CI (0.77, 0.81)), the specificity was 0.88 (95% CI (0.87, 0.90)), and the positive likelihood ratio (PLR) was 7.21 (95% CI (4.93, 10.55)). In addition, the negative likelihood ratio (NLR) was 0.25 (95% CI (0.19, 0.32)) and the diagnostic odds ratio (DOR) was 40.23 (95% CI (24.53, 65.98)). At the same time, we used the extracted data to make the SROC curve, obtaining the following parameters: area under the curve AUC=0.9144, Q=0.8470 (SE=0.0163). Conclusion. Xpert MTB/RIF has high accuracy in detecting lymphatic tuberculosis, and it can be used to quickly and easily diagnose lymphatic tuberculosis at an early stage as a general method.

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“…Most studies published on PTB have used ascitic fluid for the Xpert® MTB/RIF assay. The yield of Xpert® MTB/RIF assay in the ascitic fluid was poor from 4%-28% [15][16][17][18][19][20][21]. Although this yield may be higher in HIV patients, only limited data are available [19].…”

Section: Discussionmentioning

confidence: 99%

Tissue Xpert® MTB/RIF Assay in Peritoneal Tuberculosis: To be (Done) or Not to be (Done)

Dahale¹,

Puri²,

Kumar³

et al. 2019

Cureus

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Introduction Peritoneal tuberculosis (PTB) is a paucibacillary disease with poor mycobacterial yield in ascitic fluid. The Xpert® MTB/RIF assay (Gene Xpert) is a new tool for the diagnosis of tuberculosis (TB) and has not yet been studied on peritoneal tissue. The present study aimed to investigate the yield of the Xpert® MTB/RIF assay on peritoneal tissue obtained at peritoneoscopy. Methods This is a retrospective study and the data were collected from hospital records. The patients who underwent peritoneoscopy along with Xpert® MTB/RIF assay on peritoneal tissue were included in this study. Those with proven PTB were considered as cases while those with other diagnoses as controls. Using the reference standard of TB diagnosis, sensitivity, specificity, and accuracy of Xpert® MTB/RIF assay were calculated. Results Total of 36 patients was analyzed in this study: 28 as cases and eight as controls. Peritoneoscopy was carried out for diagnosis and biopsy. Histopathology in cases revealed caseating granulomas in 16 while 11 had non-caseating granulomas. Nine patients showed acid-fast bacillus positivity on peritoneal tissue. The most common finding on peritoneoscopy was tubercles with adhesions (n = 14, 50%), followed by tubercles only (n = 12, 42.9%). Xpert® MTB/RIF assay was positive in 17 (60.7%) patients with a sensitivity of 60.71%, specificity of 100%, and an accuracy of 69.44%. Two patients expressed rifampicin resistance. Conclusion Xpert® MTB/RIF assay on peritoneal tissue has fair sensitivity and excellent specificity. The multidrug resistance and the ability to provide results rapidly make it clinically useful.

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Xpert<SUP>®</SUP> MTB/RIF for improved case detection of extra-pulmonary TB in a tertiary care setting in urban India

Abstract: The ability of the Xpert assay to rapidly detect a significantly greater number of bacteriologically confirmed EPTB cases, including RMP-resistant cases, makes it an important diagnostic tool in a TB-endemic country.

Cited by 14 publications

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Evaluation of GeneXpert MTB/RIF for detection of Mycobacterium tuberculosis complex and rpo B gene in respiratory and non-respiratory clinical specimens at a tertiary care teaching hospital in Saudi Arabia

Evaluation of GeneXpert MTB/RIF for detection of Mycobacterium tuberculosis complex and rpo B gene in respiratory and non-respiratory clinical specimens at a tertiary care teaching hospital in Saudi Arabia

Evaluation of Xpert MTB/RIF for the Diagnosis of Lymphatic Tuberculosis

Tissue Xpert® MTB/RIF Assay in Peritoneal Tuberculosis: To be (Done) or Not to be (Done)

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