A retrospective study on Xpert MTB/RIF for detection of tuberculosis in a teaching hospital in China

Li, Shuguang; Lin, Li-Yan; Zhang, Feifei; Zhao, Chunjiang; Meng, Han; Wang, Hui

doi:10.1186/s12879-020-05004-8

Cited by 10 publications

(9 citation statements)

References 21 publications

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“…Bronchoscopy can be valuable for these patients as it can obtain suitable specimens from the lower respiratory tract while inspecting all the available airways (Mondoni et al, 2017). Literature regarding the diagnostic accuracy of the Xpert assay on bronchoalveolar lavage fluid (BALF) is limited, and most studies have used small sample sizes (Barnard et al, 2015;Fakey Khan et al, 2019;Kilaru et al, 2019;Li et al, 2020;Lu et al, 2018;Pan et al, 2018;Silva et al, 2019;Theron et al, 2013;Theron et al, 2014). Due to this limited research, no formal recommendation for using the Xpert MTB/RIF assay on BAFL exists.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of the Xpert Mycobacterium tuberculosis/rifampicin assay for diagnosing sputum-smear negative or sputum-scarce pulmonary tuberculosis in bronchoalveolar lavage fluid

Yang

Shen

Wang

et al. 2021

International Journal of Infectious Diseases

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To evaluate he diagnostic performance of the Xpert Mycobacterium tuberculosis/Rifampin (MTB/RIF) assay in bronchoalveolar lavage fluid (BALF). Methods: We retrospectively reviewed the clinical data from 671 sputum-smear negative or sputumscarce adult patients with suspected pulmonary tuberculosis (PTB) who had an Xpert MTB/RIF assay performed on BALF. The diagnostic performance of the Xpert MTB/RIF assay, smear microscopy (SM) and MTB culture was evaluated using MTB culture or final clinical diagnosis as the reference standard. Results: Compared with MTB culture, the sensitivity and specificity were 87.8% and 72.7% for the Xpert MTB/RIF assay and 11.0% and 99.2% for SM, respectively. Compared with final diagnosis, diagnostic performance was 58.9% and 83.9% for the Xpert MTB/RIF assay, 5.0% and 98.3% for SM, and 43.3% and 100% for culture, for sensitivity and specificity respectively. The Xpert MTB/RIF assay had low specificity and high sensitivity. When very low results were re-evaluated and considered MTB-negative, the specificity increased significantly. The sensitivity remained higher than SM and was similar to that of culture. Conclusions: The Xpert MTB/RIF assay adds microbiologic evidence to clinical decisions; however, close attention should be paid to very low semi-quantitative positive results.

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Section: Introductionmentioning

confidence: 99%

Efficacy of the Xpert Mycobacterium tuberculosis/rifampicin assay for diagnosing sputum-smear negative or sputum-scarce pulmonary tuberculosis in bronchoalveolar lavage fluid

Yang

Shen

Wang

et al. 2021

International Journal of Infectious Diseases

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“…Thirdly, the detection limit of Xpert is 131 CFU/ml; any unit lower than this value cannot be detected, resulting in negative results. Moreover, although Xpert shows both high sensitivity and specificity, and suggests its high value in PTB diagnosis; however, the application of pleural fluid is still limited, and should be improved [ 28 ]. Therefore, in some special cases, mNGS can be recognized as an important complement to Xpert in tuberculosis diagnosis.…”

Section: Discussionmentioning

confidence: 99%

The performance of detecting Mycobacterium tuberculosis complex in lung biopsy tissue by metagenomic next-generation sequencing

Cao

Xia

et al. 2022

BMC Pulm Med

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Background Tuberculosis (TB) is a chronic infectious disease caused by the Mycobacterium tuberculosis complex (MTBC), which is the leading cause of death from infectious diseases. The rapid and accurate microbiological detection of the MTBC is crucial for the diagnosis and treatment of TB. Metagenomic next-generation sequencing (mNGS) has been shown to be a promising and satisfying application of detection in infectious diseases. However, relevant research about the difference in MTBC detection by mNGS between bronchoalveolar lavage fluid (BALF) and lung biopsy tissue specimens remains scarce. Methods We used mNGS to detect pathogens in BALF and lung biopsy tissue obtained by CT-guide percutaneous lung puncture (CPLP) or radial endobronchial ultrasound transbronchial lung biopsy (R-EBUS-TBLB) from 443 hospitalized patients in mainland China suspected of pulmonary infections between May 1, 2019 and October 31, 2021. Aim to evaluate the diagnostic performance of mNGS for detecting MTBC and explore differences in the microbial composition in the 2 specimen types. Results Among the 443 patients, 46 patients finally were diagnosed with TB, of which 36 patients were detected as MTBC positive by mNGS (8.93%). Striking differences were noticed in the higher detection efficiency of lung biopsy tissue compared with BALF (P = 0.004). There were no significant differences between the 2 specimen types in the relative abundance among the 27 pathogens detected by mNGS from the 36 patients. Conclusions This study demonstrates that mNGS could offer an effective detection method of MTBC in BALF or lung tissue biopsy samples in patients suspected of TB infections. When it comes to the situations that BALF samples have limited value to catch pathogens for special lesion sites or the patients have contraindications to bronchoalveolar lavage (BAL) procedures, lung biopsy tissue is an optional specimen for MTBC detection by mNGS. However, whether lung tissue-mNGS is superior to BALF-mNGS in patients with MTBC infection requires further prospective multicenter randomized controlled studies with more cases.

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“…In 2017, the WHO endorsed the new-generation Xpert technology, named Xpert MTB/RIF Ultra (Xpert-Ultra), to replace Xpert for HIV patients, children, or EPTB ( Park and Kon, 2021 ). Several studies found that when pleural fluid was used to diagnose TP, the Xpert assay had high specificity (100%) for the diagnosis of TP-related pleural effusion, indicating its value in confirming a TP diagnosis; however, the low sensitivity (14–34%) indicates that the Xpert assay is of limited value for TP screening ( Maynard-Smith et al., 2014 ; Huo and Peng, 2018 ; Li et al., 2020 ). Low sensitivity may be attributed to the presence of Polymerase Chain Reaction (PCR) inhibitors in pleural fluid, or the loading of MTB is too low that the detection limit cannot be reached even by centrifugation ( Huo and Peng, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Global trends of research on tuberculous pleurisy over the past 15 years: A bibliometric analysis

Bian

Deng

Zhang

et al. 2022

Front. Cell. Infect. Microbiol.

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Tuberculous pleurisy (TP) is a common type of extrapulmonary tuberculosis (EPTB). With the development of research and changes in TP patient characteristics, an increasing number of studies have revealed the prevalence, risk factors, and novel diagnosis techniques. Thus, this bibliometric analysis was performed to identify global scientific output characteristics and research hotspots and frontiers for TP over the past 15 years. We searched the Web of Science Core Collection (WoSCC) Science Citation Index Expanded (SCI-expanded) for literature published between 2007 and 2021 and recorded their information. The Bibliometrix software package was used for bibliometric indicator analysis, and VOSviewer was used to visualize the trends of and hotspots in TP research. A total of 1,464 original articles were reviewed, and the results indicated that the annual number of publications (Np) focusing on TP has increased over the past 15 years. China had the largest number of papers and the highest H-index, and the United States ranked first for number of citations (Nc). EGYPTIAN KNOWLEDGE BANK and PLOS ONE were the most prolific unit and journal, respectively. The use of the Xpert assay and immune-related biomarker detection to diagnose TP appears to be a recent research hotspot. This bibliometric study demonstrated that the number of publications related to TP have tended to increase. China is a major producer, and the United States is an influential country in this field. Research in the past 15 years has been predominantly clinical research. The diagnosis of TP was the focus of research, and the exploration of novel diagnostic techniques, verification of diagnostic markers, and combination of diagnostic methods have been recent research hotspots. Immune-related biomarkers should be given more attention in the field of TP diagnosis.

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A retrospective study on Xpert MTB/RIF for detection of tuberculosis in a teaching hospital in China

Cited by 10 publications

References 21 publications

Efficacy of the Xpert Mycobacterium tuberculosis/rifampicin assay for diagnosing sputum-smear negative or sputum-scarce pulmonary tuberculosis in bronchoalveolar lavage fluid

Efficacy of the Xpert Mycobacterium tuberculosis/rifampicin assay for diagnosing sputum-smear negative or sputum-scarce pulmonary tuberculosis in bronchoalveolar lavage fluid

The performance of detecting Mycobacterium tuberculosis complex in lung biopsy tissue by metagenomic next-generation sequencing

Global trends of research on tuberculous pleurisy over the past 15 years: A bibliometric analysis

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