Diagnostic utility of GeneXpert MTB/RIF assay versus conventional methods for diagnosis of pulmonary and extra-pulmonary tuberculosis

Elbrolosy, Asmaa M.; Helbawy, Rana Helmy El; Mansour, Osama M.; Latif, Reda Abdel

doi:10.1186/s12866-021-02210-5

Cited by 34 publications

(26 citation statements)

References 30 publications

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“…However, 34 false positive cases were detected by GeneXpert MTB/RIF in this study. It may be because sputum samples of patients display a low MTB burden, which is in line with the research results of Elbrolosy et al[8]. For these reasons, the GeneXpert MTB/RIF and gene chip technology can be combined for joint diagnosis to further enhance the performance in diagnosis of MTB, which is conducive to the evaluation of false positive diagnostic results.…”

supporting

confidence: 66%

Performance Comparison of GeneXpert MTB/RIF, Gene Chip Technology, and Modified Roche Culture Method in Detecting Mycobacterium tuberculosis and Drug Susceptibility in Sputum

Xie

Liu

et al. 2022

Contrast Media & Molecular Imaging

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Our aim of this study was to observe and analyze the performance of the real-time fluorescence quantitative nucleic acid amplification detection of Mycobacterium tuberculosis/rifampicin resistance (GeneXpert MTB/RIF), gene chip technology, and modified Roche culture method in detecting MTB in sputum submitted for inspection and drug susceptibility. Patients with smear-negative suspected pulmonary TB (n = 120) in our hospital were enrolled in this study using a random number table, and sputum samples submitted for inspection were tested by the GeneXpert MTB/RIF, gene chip technology, and modified Roche culture method. With clinical diagnosis as the gold standard, the performance (mainly sensitivity and specificity) of the above three detection methods in the diagnosis of MTB was compared. Next, the drug susceptibility test (DST) was carried out on sputum samples, tested positive by the three methods. With the solid culture results as the evaluation criteria, the performance of the three detection methods in the diagnosis MTB and DST was compared. When compared with the modified Roche culture method, the GeneXpert MTB/RIF had the highest positive rate and a shorter overall test duration ( P < 0.05 ). In contrast with the gene chip technology, the GeneXpert MTB/RIF exhibited higher sensitivity and negative predictive value (NPV) and lower specificity, accuracy, positive predictive value (PPV), and Kappa value ( P < 0.05 ). According to analysis of the diagnostic performance of the three detection methods, GeneXpert MTB/RIF displayed the highest diagnostic sensitivity, ideal predictive values, and the highest similarity with clinical diagnosis in results ( P < 0.05 ). The detection of susceptibility to isoniazid (INH) and RIF showed that the GeneXpert MTB/RIF and gene chip technology performed ideally in DST of MTB. In comparison with the modified Roche culture method, the GeneXpert MTB/RIF and gene chip technology have more prominent performance in detecting MTB and drug susceptibility. Besides, to further improve the accuracy of clinical diagnosis, various molecular biology detection methods can be combined to avoid delaying of the best time for the diagnosis and treatment of the disease.

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supporting

confidence: 66%

Performance Comparison of GeneXpert MTB/RIF, Gene Chip Technology, and Modified Roche Culture Method in Detecting Mycobacterium tuberculosis and Drug Susceptibility in Sputum

Xie

Liu

et al. 2022

Contrast Media & Molecular Imaging

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“…Furthermore, studies in patients with colonic TB indicate that positive culture can be found in only one-third of patients or even less [ 9 , 10 ]. Although the advanced investigations like polymerase chain reaction and Gene X-pert play a promising role in the diagnosis of pulmonary TB, it has shown poor sensitivity and specificity for the detection of abdominal TB from ascitic fluid samples [ 11 ] compared with sputum [ 12 ] and cerebrospinal fluid [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Intestinal tuberculosis masquerading as carcinoma colon: a case report of diagnostic quandary in low-resource setting

Panthi

Khatiwada

Adhikari

et al. 2022

Journal of Surgical Case Reports

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Intestinal tuberculosis (TB) is a rare condition comprising a majority of the extra-pulmonary TB cases. Owing to a similar clinical presentation, ultrasonographic and biopsy findings of intestinal TB with that of other abdominal pathologies such as carcinoma colon, their clinical delineation is very difficult unless aided with other modalities of investigations such as colonoscopy, culture of the biopsy material, etc. and even advanced methods such as polymerase chain reaction and gene X-pert of the biopsy material. Having all these investigations may not even lead to a correct diagnosis of intestinal TB as evidenced in the reported cases in the literature, advocating the need of diagnostic laparoscopy in the diagnosis of intestinal TB to eliminate extensive and unnecessary surgeries. Here, we present a case of intestinal TB in a 51-year-gentleman who got diagnosed in the course of treatment for a suspected carcinoma colon.

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“…Further shorten the judgment time of results. GeneXpert MTB/RIF (GeneXpert) is a semi-quantitative gene detection technology based on nucleic acid amplification (8). It based on the principle of fluorescence quantitative polymerase chain reaction (PCR): Mtb and its drug resistance can be detected directly from the patient's sputum and other specimens at the same time (9).…”

Section: Introductionmentioning

confidence: 99%

GeneXpert MTB/RIF combined with conventional methods for tuberculosis in Shanghai Regional Medical Center: a retrospective diagnostic study

Zhang¹,

Li²,

Tan³

et al. 2022

Ann Transl Med

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Background: At present, the diagnosis of tuberculosis (TB) is still challenging, and improving the efficiency of diagnosis can help prevent and control TB. This retrospective clinical study aimed to assess the diagnostic efficiency of GeneXpert MTB/RIF for pulmonary TB.Methods: A total of 620 newly-diagnosed patients who visited the pulmonary clinic of Shanghai Tongren Hospital between 2018 and 2021 were enrolled in the study. All 620 patients had acid-fast Bacilli (AFB) identified by Ziehl Neelsen staining (ZNS) test, BECTEC MGIT 960 liquid culture (LC), and GeneXpert MTB/RIF assay (GX). A total of 53 patients also underwent interferon-γ release assay (IGRA). The diagnostic efficacy of ZNS, LC, GX alone or in combination in pulmonary TB was evaluated, with clinical diagnosis as the gold standard. Moreover, the IGRA for pulmonary TB diagnosis was preliminarily assessed.Results: Eventually, 185 cases were clinically confirmed (which included 36 etiologically negative cases) in the total enrolled 620 first-diagnosed patients. Overall, the 3 methods ZNS, LC, and GX showed sensitivities of 55.68%, 64.32%, and 68.64%, specificities of 98.39%, 95.40%, and 99.08%, positive predictive values (PPV) of 93.64%, 85.61%, and 96.95%, and negative predictive values (NPV) of 83.92%, 86.28%, and 88.14%, respectively. The GX method showed the highest specificity and PPV for a solitary single method, with 99.08% and 96.95%, respectively. Regarding pairwise combination methods, all showed superior sensitivity to a single test, reaching a maximum of 80.00%. Among them, the LC + GX combination showed both the highest sensitivity (80.00%) and NPV (91.78%), and the corresponding area under the receiver operating characteristic curve (0.875) was the largest. Among the 53 patients who underwent IGRA testing, 42 were positive (including 4 etiologically negative cases), and 11 were negative. The overall sensitivity of IGRA for diagnosing pulmonary TB was 90.00%, specificity was 27.27%, PPV was 42.86%, and NPV was 81.82%. Conclusions:The GX method shows promise as a first-line diagnostic method for pulmonary TB. Furthermore, the sensitivity was significantly improved when combined with LC. This combination will screen out some etiologically negative patients plus IGRA, so their combination is recommended for practice optimization.

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Diagnostic utility of GeneXpert MTB/RIF assay versus conventional methods for diagnosis of pulmonary and extra-pulmonary tuberculosis

Cited by 34 publications

References 30 publications

Performance Comparison of GeneXpert MTB/RIF, Gene Chip Technology, and Modified Roche Culture Method in Detecting Mycobacterium tuberculosis and Drug Susceptibility in Sputum

Performance Comparison of GeneXpert MTB/RIF, Gene Chip Technology, and Modified Roche Culture Method in Detecting Mycobacterium tuberculosis and Drug Susceptibility in Sputum

Intestinal tuberculosis masquerading as carcinoma colon: a case report of diagnostic quandary in low-resource setting

GeneXpert MTB/RIF combined with conventional methods for tuberculosis in Shanghai Regional Medical Center: a retrospective diagnostic study

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