Diagnostic accuracy of the Xpert^® MTB/RIF assay for extra-pulmonary tuberculosis: a meta-analysis

Abstract

Xpert has high specificity but limited sensitivity for the detection of EPTB. Although positive Xpert test results may be useful in rapidly identifying EPTB cases, negative test results provide less certainty for ruling out disease.

Diagnostic accuracy of Xpert MTB/RIF for tuberculosis detection in different regions with different endemic burden: A systematic review and meta-analysis

“…Notably, the impact of sample type,[21,22] age of patients,[12] and status of HIV co-infection [23] and smear-positivity [24] are the main factors studied for their impact on Xpert MTB/RIF’s diagnostic accuracy. In this context, our results showed that Xpert MTB/RIF has higher sensitivity in patients with positive smears (0.99, 95% CI 0.97–0.99), in patients with PTB samples (0.87, 95% CI 0.83–0.90), in adults (0.82, 95% CI 0.76–0.86) and in HIV-positive patients (0.81, 95% CI 0.73–0.87).…”

A diagnostic algorithm for tuberculous pleurisy using the ELISPOT assay on peripheral blood and pleural effusion

“…[31][32][33][34] Recently, a meta-analysis reported the pooled sensitivity and specificity of Xpert MTB/RIF to be 37% and 92%, respectively, in TB pleurisy. [35] The paucibacillary nature of pleural specimens was considered to be the main reason for this. Therefore, we assume that immunologic diagnosis using M. tuberculosis-specific T-cells will play a more important role than molecular or culture-based methods in patients with suspected TB pleurisy.…”

Improved diagnostic sensitivity for tuberculous meningitis with Xpert<SUP>®</SUP> MTB/RIF of centrifuged CSF

“…Data on Xpert performance in CSF in adults are limited to reports of small numbers of meningitis patients in extra-pulmonary TB cohorts 10–18 , multiple meta-analyses 9,19,20 , and two well-conducted TBM cohort studies. 21,22 In South Africa, Patel et al found 67% sensitivity with Xpert in microbiologically proven TBM.…”