Comparative Study of GeneXpert with ZN Stain and Culture in Samples of Suspected Pulmonary Tuberculosis

Agrawal, Manindra; Bajaj, Ashish; Bhatia, Vinay; Dutt, Sarjana

doi:10.7860/jcdr/2016/18837.7755

Cited by 113 publications

(134 citation statements)

References 19 publications

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“…Furthermore, Singh et al, 2016, demonstrated a sensitivity of 100% and specificity of 100% for pulmonary samples by using GeneXpert assay. In addition, Agrawal et al, 2016, reported that the sensitivity and specificity of GeneXpert in sputum were 100% and 90% that is compatible with the study of Sharma et al, 2015who found a sensitivity of 96.9% and a specificity of 99.8%.…”

Section: Resultssupporting

confidence: 78%

“…Similar results were demonstrated by Agrawal et al, 2016, Bajrami et al, 2016 and Tang et al, 2017. This discordance between GeneXpert and MGIT culture was also reported by Agrawal et al, 2016 found that 9,6and 19 samples were GeneXpert positive and culture negative respectively. Also, the same previous authors found that 2, 2 and 13 samples were negative by GeneXpert and positive by culture respectively.…”

Section: Resultssupporting

confidence: 76%

“…In India, Raj et al, (2012) and Sajed et al, (2014), found that positive cases represent 51.7% (out of 547 suspected patient) and 37% (out of 100 suspected patients) respectively. This high percentage of TB in these studies compared to our study could be explained by the fact that South Korea and Turkey were considered as countries with intermediate burden of TB (Kim et al, 2012), while the world's largest burden of TB was found in India (Agrawal et al, 2016).…”

Section: Resultsmentioning

confidence: 57%

“…Higher percentage of TB around 25% was demonstrated by Nakwon et al, (2013), Arzu et al, (2011) and Agrawal et al, (2016). In India, Raj et al, (2012) and Sajed et al, (2014), found that positive cases represent 51.7% (out of 547 suspected patient) and 37% (out of 100 suspected patients) respectively.…”

Section: Resultsmentioning

confidence: 83%

See 3 more Smart Citations

GeneXpert MTB/RIF Assay: A Revolutionizing Method for Rapid Molecular Detection of Mycobacterium Tuberculosis in Comparison to Other Conventional Methods

Rakha¹,

Hakeem²

2017

Int.J.Curr.Microbiol.App.Sci

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Section: Resultssupporting

confidence: 78%

Section: Resultssupporting

confidence: 76%

Section: Resultsmentioning

confidence: 57%

Section: Resultsmentioning

confidence: 83%

See 2 more Smart Citations

GeneXpert MTB/RIF Assay: A Revolutionizing Method for Rapid Molecular Detection of Mycobacterium Tuberculosis in Comparison to Other Conventional Methods

Rakha¹,

Hakeem²

2017

Int.J.Curr.Microbiol.App.Sci

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“…Similar results of very high sensitivity of CBNAAT in smear positive cases have been reported by most of the studies, but sensitivity of CBNAAT in smear negative cases varied between 35%-79.1% among several studies [ Table 5]. [12,15,[16][17][18][19][20] Specificity of CBNAAT was 100% (95% CI-92.89%-100%) in this study in both smear positive and smear negative group and is in line with other studies which have also demonstrated a very high specificity of CBNAAT in diagnosis of pulmonary tuberculosis [ Table 5]. [12,15,[16][17][18][19][20] Sensitivity of sputum smear microscopy was even lower in this study in patients infected with HIV, all of the TB-HIV co-infected patients were sputum smear negative in comparison to 38 out of 195 immunocompetent patients being sputum smear-positive on microscopy (p-0.01).…”

Section: Discussionsupporting

confidence: 72%

Evaluation of Cartridge Based Nucleic Acid Amplification Test in Diagnosis of Pulmonary Tuberculosis

Mukherjee¹,

Biswas²,

Begum³

et al. 2017

jemds

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BACKGROUNDTuberculosis still continues to be one of the commonest cause of infectious disease related morbidity in the developing world. Diagnosis of pulmonary tuberculosis is mostly relied on sputum smear microscopy and sputum for mycobacterial culture. In recent years, cartridge based nucleic acid amplification test (CBNAAT) has been recommended by World Health Organization as a rapid diagnostic test for detection of tuberculosis and rifampicin resistance.The aim of this study is to determine the diagnostic yield of CBNAAT in pulmonary tuberculosis (PTB) and to compare its efficacy between sputum smear-positive and sputum smear-negative pulmonary tuberculosis. MATERIALS AND METHODSA prospective observational study was conducted in the Department of Respiratory Medicine in a teaching hospital in eastern India for a period of one year. All re-treatment cases of PTB, newly detected smear-negative PTB and all human immunodeficiency virus-PTB co-infected cases were recruited for the study and sputum for CBNAAT was performed in all of them. Results were analysed in light of diagnostic yield of CBNAAT with special emphasis on comparing CBNAAT results between different subgroups-sputum smear-positive, sputum smear-negative PTB and immunocompromised patients. RESULTSOut of 228 cases of PTB, 190 were sputum smear negative and 38 cases were sputum smear positive. Mean age of the study population was 33 ± 17.13 years. Sensitivity of sputum smear for AFB was 16.67% (CI-12.07%-22.15%) with a negative predictive value (NPV) of 20.83% (CI-19.89%-21.81%). Sputum smear negativity was found to be more common in females. CBNAAT was positive in 111 cases. Overall, sensitivity of CBNAAT was 48.68% (95% CI-42.03%-55.37%). Sensitivity of CBNAAT varied significantly between sputum smear-positive PTB (100%, CI-92.89%-100%) and sputum smear-negative PTB (38.42%; CI-31.47%-45.74%) (p-<0.0001). Sensitivity of CBNAAT was 33.33% (CI-17.96%-51.83%) in PTB-HIV co-infected patients. Rifampicin resistance was detected in five (2.2%) patients with 100% sensitivity and specificity. CONCLUSIONCBNAAT adds significantly to the diagnostic yield of PTB in comparison to sputum smear microscopy, but its sensitivity is lower in sputum smear-negative cases. It has additional advantage of identifying rifampicin resistance with high sensitivity and specificity.

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Xpert MTB/RIF and Xpert MTB/RIF Ultra for pulmonary tuberculosis and rifampicin resistance in adults

Horne

Kohli

Zifodya

et al. 2019

Cochrane Database of Systematic Reviews

184

157

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Background Xpert MTB/RIF (Xpert MTB/RIF) and Xpert MTB/RIF Ultra (Xpert Ultra), the newest version, are the only World Health Organization (WHO)‐recommended rapid tests that simultaneously detect tuberculosis and rifampicin resistance in persons with signs and symptoms of tuberculosis, at lower health system levels. A previous Cochrane Review found Xpert MTB/RIF sensitive and specific for tuberculosis ( ). Since the previous review, new studies have been published. We performed a review update for an upcoming WHO policy review. Objectives To determine diagnostic accuracy of Xpert MTB/RIF and Xpert Ultra for tuberculosis in adults with presumptive pulmonary tuberculosis (PTB) and for rifampicin resistance in adults with presumptive rifampicin‐resistant tuberculosis. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register, MEDLINE, Embase, Science Citation Index, Web of Science, Latin American Caribbean Health Sciences Literature, Scopus, the WHO International Clinical Trials Registry Platform, the International Standard Randomized Controlled Trial Number Registry, and ProQuest, to 11 October 2018, without language restriction. Selection criteria Randomized trials, cross‐sectional, and cohort studies using respiratory specimens that evaluated Xpert MTB/RIF, Xpert Ultra, or both against the reference standard, culture for tuberculosis and culture‐based drug susceptibility testing or MTBDR plus for rifampicin resistance. Data collection and analysis Four review authors independently extracted data using a standardized form. When possible, we also extracted data by smear and HIV status. We assessed study quality using QUADAS‐2 and performed meta‐analyses to estimate pooled sensitivity and specificity separately for tuberculosis and rifampicin resistance. We investigated potential sources of heterogeneity. Most analyses used a bivariate random‐effects model. For tuberculosis detection, we first estimated accuracy using all included studies and then only the subset of studies where participants were unselected, i.e. not selected based on prior microscopy testing. Main results We identified in total 95 studies (77 new studies since the previous review): 86 studies (42,091 participants) evaluated Xpert MTB/RIF for tuberculosis and 57 studies (8287 participants) for rifampicin resistance. One study compared Xpert MTB/RIF and Xpert Ultra on the same participant specimen. Tuberculosis detection Of the total 86 studies, 45 took place in high tuberculosis burden and 50 in high TB/HIV burden countries. Most studies had low risk of bias. Xpert MTB/RIF pooled sensitivity and specificity (95% credible Interval (CrI)) were 85% (82% to 88%) and 98% (97% to 98%), (70 studies, 37,237 unselected participants; high‐certainty evidence). We found similar accuracy when ...

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Comparative Study of GeneXpert with ZN Stain and Culture in Samples of Suspected Pulmonary Tuberculosis

Cited by 113 publications

References 19 publications

GeneXpert MTB/RIF Assay: A Revolutionizing Method for Rapid Molecular Detection of Mycobacterium Tuberculosis in Comparison to Other Conventional Methods

GeneXpert MTB/RIF Assay: A Revolutionizing Method for Rapid Molecular Detection of Mycobacterium Tuberculosis in Comparison to Other Conventional Methods

Evaluation of Cartridge Based Nucleic Acid Amplification Test in Diagnosis of Pulmonary Tuberculosis

Xpert MTB/RIF and Xpert MTB/RIF Ultra for pulmonary tuberculosis and rifampicin resistance in adults

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