Diagnostic accuracy of Xpert MTB/RIF ultra for detection of
            <i>Mycobacterium tuberculosis</i>
            in children: a prospective cohort study

Yadav, Rakesh; Vaidya, Pankaj C; Mathew, Joseph L; Khaneja, Rajiv; Agarwal, Priyanka; Singh, Meenu; Sethi, Sunil

doi:10.1111/lam.13402

Cited by 7 publications

(12 citation statements)

References 10 publications

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“…Table summarizes the characteristics of the included studies. Regarding PTB, we calculated Ultra‐pooled sensitivity and specificity of all specimens (95% CI) against culture were 78% (73%–82%) and 92% (91%–94%), respectively (Figure ) 4–13 . A high heterogeneity emerged.…”

Section: Resultsmentioning

confidence: 99%

“…The difference was not statistically significant. Ultra‐pooled sensitivity against CRS was considerably lower (95% CI, 35%, 32–38), but specificity was higher (95% CI, 99%, 99–100) (Figure ) 4–13 …”

Section: Resultsmentioning

confidence: 99%

“…Eight studies compared Ultra and Xpert MTB/RIF 4–10,12 . Ultra‐pooled sensitivity (95% CI) tended toward higher values (73%, 67%–78%) compared with Xpert MTB/RIF (66%, 60%–72%), but Ultra‐pooled specificity was lower (Ultra: 95%, 94%–96% vs. Xpert MTB/RIF: 99%, 98%–99%) (Figure ).…”

Section: Resultsmentioning

confidence: 99%

“…Ultra‐pooled sensitivity (95% CI) tended toward higher values (73%, 67%–78%) compared with Xpert MTB/RIF (66%, 60%–72%), but Ultra‐pooled specificity was lower (Ultra: 95%, 94%–96% vs. Xpert MTB/RIF: 99%, 98%–99%) (Figure ). Eight studies focused on Ultra for the detection of rifampicin resistance, 4,6–9,11–13 but we exclusively included three of them, 6,11,13 because the others had no cases of rifampicin resistance or did not report data relating to the reference standard. Ultra‐pooled sensitivity and specificity (95% CI) were 100% (40%–100%) and 100% (95%–100%) (Figure ).…”

Section: Resultsmentioning

confidence: 99%

“…Regarding PTB, we calculated Ultra-pooled sensitivity and specificity of all specimens (95% CI) against culture were 78% (73%-82%) and 92% (91%-94%), respectively (Figure S2). [4][5][6][7][8][9][10][11][12][13] A high heterogeneity emerged. Therefore, we created subgroups based on different samples and ages to assign statistical significance to the data.…”

Section: Re Sultsmentioning

confidence: 99%

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Diagnostic accuracy of Xpert ultra for childhood tuberculosis: A preliminary systematic review and meta‐analysis

Signorino

Votto

Filippo

et al. 2022

Pediatric Allergy Immunology

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Diagnosis of childhood tuberculosis (TB) is challenging. Xpert MTB/RIF and the new version Xpert MTB/RIF Ultra (Ultra) are molecular tests currently used to rapidly identify the infection. We reviewed the literature for the accuracy of Ultra assay in the diagnosis of tuberculosis and rifampicin resistance in children. We conducted a full search in PubMed, Web of Science (WOS), Embase, and Scopus, up to April 2021. A bivariate random‐effects model was used to determine the pooled sensitivity and specificity of Ultra, with a 95% confidence interval (CI), compared with culturing and the composite reference standard (CRS). In the ten included studies (2,427 participants), the pooled Ultra sensitivity and specificity, in diagnosing pulmonary tuberculosis (PTB), were 78% (95% CI, 73–82) and 92% (95% CI, 91–94), respectively, against culture. Since a high heterogeneity was found between studies, we created subgroups based on different samples and ages. Ultra‐pooled sensitivity was consistently lower against CRS (95% CI, 35%, 32–38). Compared to Xpert MTB/RIF, Ultra sensitivity tended toward higher values (Ultra: 73%, 67%–78% vs. Xpert MTB/RIF: 66%, 60%–72%), but specificity was lower (Ultra: 95%, 94%–96% vs. Xpert MTB/RIF: 99%, 98%–99%). Ultra has improved the definitive diagnosis of PTB, particularly in subjects with paucibacillary TB, including children. The lower specificity could be due to the fact that culture is an imperfect reference standard. Further studies are needed to evaluate the accuracy of Ultra in the diagnosis of childhood TB.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Re Sultsmentioning

confidence: 99%

See 3 more Smart Citations

Diagnostic accuracy of Xpert ultra for childhood tuberculosis: A preliminary systematic review and meta‐analysis

Signorino

Votto

Filippo

et al. 2022

Pediatric Allergy Immunology

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Xpert MTB/RIF Ultra assay for tuberculosis disease and rifampicin resistance in children

Kay

Ness

Verkuijl

et al. 2022

Cochrane Database of Systematic Reviews

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Background Every year, an estimated one million children and young adolescents become ill with tuberculosis, and around 226,000 of those children die. Xpert MTB/RIF Ultra (Xpert Ultra) is a molecular World Health Organization (WHO)‐recommended rapid diagnostic test that simultaneously detects Mycobacterium tuberculosis complex and rifampicin resistance. We previously published a Cochrane Review 'Xpert MTB/RIF and Xpert MTB/RIF Ultra assays for tuberculosis disease and rifampicin resistance in children'. The current review updates evidence on the diagnostic accuracy of Xpert Ultra in children presumed to have tuberculosis disease. Parts of this review update informed the 2022 WHO updated guidance on management of tuberculosis in children and adolescents. Objectives To assess the diagnostic accuracy of Xpert Ultra for detecting: pulmonary tuberculosis, tuberculous meningitis, lymph node tuberculosis, and rifampicin resistance, in children with presumed tuberculosis. Secondary objectives To investigate potential sources of heterogeneity in accuracy estimates. For detection of tuberculosis, we considered age, comorbidity (HIV, severe pneumonia, and severe malnutrition), and specimen type as potential sources. To summarize the frequency of Xpert Ultra trace results. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register, MEDLINE, Embase, three other databases, and three trial registers without language restrictions to 9 March 2021. Selection criteria Cross‐sectional and cohort studies and randomized trials that evaluated Xpert Ultra in HIV‐positive and HIV‐negative children under 15 years of age. We included ongoing studies that helped us address the review objectives. We included studies evaluating sputum, gastric, stool, or nasopharyngeal specimens (pulmonary tuberculosis), cerebrospinal fluid (tuberculous meningitis), and fine needle aspirate or surgical biopsy tissue (lymph node tuberculosis). For detecting tuberculosis, reference standards were microbiological (culture) or composite reference standard; for stool, we also included Xpert Ultra performed on a routine respiratory specimen. For detecting rifampicin resistance, reference standards were drug susceptibility testing or MTBDR plus . Data collection and analysis Two review authors independently extracted data and, using QUADAS‐2, assessed methodological quality judging risk of bias separately for each target condition and reference standard. For each target condition, we used the bivariate model to estimate summary sensitivity and specificity with 95% confidence intervals (CIs). We stratified all analyses by type of reference standard. We summarized the frequency of Xpert Ultra trace results; trace represents detection of a very low quantity of Mycobacterium tubercul...

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Evaluating the efficacy of stool sample on Xpert MTB/RIF Ultra and its comparison with other sample types by meta-analysis for TB diagnostics

Sharma

Singh

Gaur

et al. 2022

Eur J Clin Microbiol Infect Dis

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Diagnostic accuracy of Xpert MTB/RIF ultra for detection of Mycobacterium tuberculosis in children: a prospective cohort study

Cited by 7 publications

References 10 publications

Diagnostic accuracy of Xpert ultra for childhood tuberculosis: A preliminary systematic review and meta‐analysis

Diagnostic accuracy of Xpert ultra for childhood tuberculosis: A preliminary systematic review and meta‐analysis

Xpert MTB/RIF Ultra assay for tuberculosis disease and rifampicin resistance in children

Evaluating the efficacy of stool sample on Xpert MTB/RIF Ultra and its comparison with other sample types by meta-analysis for TB diagnostics

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