Diagnostic test accuracy of Xpert MTB/RIF for tuberculous pericarditis: a systematic review and meta-analysis

Andrianto, Andrianto; Mertaniasih, Ni Made; Gandi, Parama; Al-Farabi, Makhyan Jibril; Azmi, Yusuf; Jonatan, Michael; Silahooij, Stevanus Immanuel

doi:10.12688/f1000research.22770.1

Cited by 8 publications

(8 citation statements)

References 26 publications

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“…Although many relevant studies have reported the diagnostic efficacy of Xpert MTB/RIF in TBP [23,46,47], the results were variable. A similar meta-analysis of Xpert for the diagnosis of TBP had been published [48]. However, this study had many shortcomings, such as only assessing the results of comparing with culture and not exploring heterogeneity [48].…”

Section: Plos Onementioning

confidence: 99%

“…A similar meta-analysis of Xpert for the diagnosis of TBP had been published [48]. However, this study had many shortcomings, such as only assessing the results of comparing with culture and not exploring heterogeneity [48]. Thus, we designed this systematic review and meta-analysis to improve the evaluation of the diagnostic efficacy of the test in TBP.…”

Section: Plos Onementioning

confidence: 99%

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Diagnostic accuracy of the Xpert MTB/RIF assay for tuberculous pericarditis: A systematic review and meta-analysis

Zhong

Shen

et al. 2021

PLoS ONE

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Objective The purpose of this study was to evaluate the diagnostic efficacy of Xpert MTB/RIF for tuberculous pericarditis (TBP). Methods We searched relevant databases for Xpert MTB/RIF for TBP diagnosis until April 2021 and screened eligible studies for study inclusion. We evaluated the effectiveness of Xpert MTB/RIF when the composite reference standard (CRS) and mycobacterial culture were the gold standards, respectively. We performed meta-analyses using a bivariate random-effects model, and when the heterogeneity was obvious, the source of heterogeneity was further discussed. Results We included seven independent studies comparing Xpert MTB/RIF with the CRS and six studies comparing it with culture. The pooled sensitivity, specificity, and area under the curve of Xpert MTB/RIF were 65% (95% confidence interval, 59–72%), 99% (97–100%), and 0.99 (0.97–0.99) as compared with the CRS, respectively, and 75% (53–88%), 99% (90–100%), and 0.94 (0.92–0.96) as compared with culture, respectively. There was no significant heterogeneity between studies when CRS was the gold standard, whereas heterogeneity was evident when culture was the gold standard. Conclusions The sensitivity of Xpert MTB/RIF for diagnosing TBP was moderate and the specificity was good; thus, Xpert MTB/RIF can be used in the initial diagnosis of TBP.

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Section: Plos Onementioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

Diagnostic accuracy of the Xpert MTB/RIF assay for tuberculous pericarditis: A systematic review and meta-analysis

Zhong

Shen

et al. 2021

PLoS ONE

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“…A protein-rich lymphocytic exudate that is often grossly hemorrhagic is a typical finding in the pericardial fluid. However, the TP fluid is paucibacillary and the estimated diagnostic accuracy based on the smear is only 5%[ 16 ]. The sensitivity of pericardial fluid culture ranges from 53% to 75%[ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Tuberculous pericarditis-a silent and challenging disease: A case report

Lucero¹,

Bustos²,

Rodríguez³

et al. 2022

WJCC

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BACKGROUND Tuberculous pericarditis (TP) remains a challenge for endemic countries. In developing countries, one to two percent of patients with pulmonary tuberculosis develops TP. CASE SUMMARY A 49-year-old woman presented with dyspnea, chest pain and dry cough. On physical examination, veiled heart sounds were found. The electrocardiogram showed low-voltage complexes and the transthoracic echocardiography revealed a large and free-looking pericardial effusion. The patient was taken for an open pericardiotomy. The pericardial fluid revealed high levels of adenosine deaminase and Ziehl-Neelsen stain showed acid-fast bacilli. Polymerase chain reaction study for Mycobacterium tuberculosis in pericardial fluid was positive. The patient received tetra conjugate management with adequate clinical response after the first week of treatment and resolution of fever and chest pain. CONCLUSION In cases of TP, obtaining pericardial fluid and/or pericardial biopsy is the most efficient strategy to confirm the diagnosis. Early diagnosis of this entity will allow physicians to initiate timely treatment, avoid complications and improve the patient's clinical outcome, so we consider the description of this case pertinent and its review in the literature.

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“…The MTBCs can invade multiple systems and organs, such as the lymph nodes, colon, liver, and spine, with lung infection being the most common form [ 6 ]. Active patients with PTB, the main source of infection, usually expel bacteria by talking, coughing, or sneezing, spreading the pathogen through airborne particles inhaled by others [ 7 ].…”

Section: Introductionmentioning

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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Diagnostic test accuracy of Xpert MTB/RIF for tuberculous pericarditis: a systematic review and meta-analysis

Cited by 8 publications

References 26 publications

Diagnostic accuracy of the Xpert MTB/RIF assay for tuberculous pericarditis: A systematic review and meta-analysis

Diagnostic accuracy of the Xpert MTB/RIF assay for tuberculous pericarditis: A systematic review and meta-analysis

Tuberculous pericarditis-a silent and challenging disease: A case report

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

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