High positive predictive value of Xpert in a low rifampicin resistance prevalence setting

Trajman, Anete; Durovni, Betina; Saraceni, Valéria; Cordeiro-Santos, Marcelo; Cobelens, Frank; Hof, Susan van den

doi:10.1183/09031936.00115514

Cited by 7 publications

(6 citation statements)

References 12 publications

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“…Those authors also demonstrated that 82% of the rifampin-resistant cases detected by the Xpert MTB/RIF test were confirmed as cases of multidrug-resistant tuberculosis in a phenotypic sensitivity test. 30 Therefore, although our sample might not have been representative of the true proportion of resistance in the state, the detection of rifampin resistance in 8.8% of the cases indicates that the Xpert MTB/RIF test can facilitate the early identification of cases of multidrug-resistant tuberculosis in Brazil.…”

Section: Discussionmentioning

confidence: 91%

“…The Xpert MTB/RIF test has high specificity for the detection of rifampin resistance (98%), already well established in previous studies. 6 , 29 Trajman et al 30 showed that the test has a high positive predictive value for rifampin resistance (90.2%), even in countries where the prevalence of drug-resistant tuberculosis is relatively low. Those authors also demonstrated that 82% of the rifampin-resistant cases detected by the Xpert MTB/RIF test were confirmed as cases of multidrug-resistant tuberculosis in a phenotypic sensitivity test.…”

Section: Discussionmentioning

confidence: 99%

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Rapid molecular test for tuberculosis: impact of its routine use at a referral hospital

et al. 2018

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Objective:To evaluate the impact of the use of the molecular test for Mycobacterium tuberculosis and its resistance to rifampin (Xpert MTB/RIF), under routine conditions, at a referral hospital in the Brazilian state of Bahia. Methods:This was a descriptive study using the database of the Mycobacteriology Laboratory of the Octávio Mangabeira Specialized Hospital, in the city of Salvador, and georeferencing software. We evaluated 3,877 sputum samples collected from symptomatic respiratory patients, under routine conditions, between June of 2014 and March of 2015. All of the samples were submitted to sputum smear microscopy and the Xpert MTB/RIF test. Patients were stratified by gender, age, and geolocation. Results:Among the 3,877 sputum samples evaluated, the Xpert MTB/RIF test detected M. tuberculosis in 678 (17.5%), of which 60 (8.8%) showed resistance to rifampin. The Xpert MTB/RIF test detected M. tuberculosis in 254 patients who tested negative for sputum smear microscopy, thus increasing the diagnostic power by 59.9%. Conclusions:The use of the Xpert MTB/RIF test, under routine conditions, significantly increased the detection of cases of tuberculosis among sputum smear-negative patients.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Rapid molecular test for tuberculosis: impact of its routine use at a referral hospital

et al. 2018

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“…Quality bacteriological diagnosis includes the WHO-recommended rapid (molecular) assays [12,[41][42][43][44][45][46]; it should be done as early as possible (ideally initiated on the day the presumed patient is identified) within evidence-based diagnostic algorithms and guidelines. Currently available genotypic methods are the automated real-time nucleic acid amplification technology for rapid and simultaneous detection of Mycobacterium tuberculosis and rifampicin resistance (e.g.…”

Section: Notesmentioning

confidence: 99%

ERS/ECDC Statement: European Union standards for tuberculosis care, 2017 update

et al. 2018

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The International Standards for Tuberculosis Care define the essential level of care for managing patients who have or are presumed to have tuberculosis, or are at increased risk of developing the disease. The resources and capacity in the European Union (EU) and the European Economic Area permit higher standards of care to secure quality and timely TB diagnosis, prevention and treatment. On this basis, the European Union Standards for Tuberculosis Care (ESTC) were published in 2012 as standards specifically tailored to the EU setting. Since the publication of the ESTC, new scientific evidence has become available and, therefore, the standards were reviewed and updated.A panel of international experts, led by a writing group from the European Respiratory Society (ERS) and the European Centre for Disease Prevention and Control (ECDC), updated the ESTC on the basis of new published evidence. The underlying principles of these patient-centred standards remain unchanged. The second edition of the ESTC includes 21 standards in the areas of diagnosis, treatment, HIV and comorbidities, and public health and prevention.The ESTC target clinicians and public health workers, provide an easy-to-use resource and act as a guide through all the required activities to ensure optimal diagnosis, treatment and prevention of TB.

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“…Determined by previous study 4 , RMT-TB has high specificity in detecting resistance to rifampicin (98%). Another investigation 27 showed the high positive predictive value for resistance to rifampicin (90.2%) in countries where the prevalence of tuberculosis is low. In addition, it also demonstrated, that 82% of the cases of resistance to rifampin diagnosed using RMT-TB were subsequently confirmed as cases of drug-resistant tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

Impact of the GeneXpert® MTB/RIF rapid molecular test on tuberculosis detection: temporal trends and vulnerable territories

Berra

Bruce

Alves

et al. 2021

Rev. Latino-Am. Enfermagem

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Objective: to assess the impact of the GeneXpert® MTB/RIF rapid molecular test on tuberculosis detection, to analyze the temporal trend of the event and to identify vulnerable territories in a Brazilian municipality. Method: an ecological study carried out in Ribeirão Preto, São Paulo, Brazil, a municipality considered a priority in tuberculosis control due to the high number of cases. To classify the temporal trend, the Prais-Winsten method and the Interrupted Time Series were used to identify changes in the disease incidence. Kernel intensity analysis was applied to identify vulnerable areas. Results: the temporal trend of tuberculosis decreased by 18.1%/year and by 6.9%/year for children under 15 years old. The North District decreased by 6.67%/year and the East District increased by 17.5%/year in the incidence of tuberculosis. Resistant tuberculosis, after the implementation of the Rapid Molecular Test, increased by 0.6% per year. The South and West Districts showed a higher density of cases, with a range from 45 to 79 tuberculosis cases per square kilometer (km2). Conclusion: although resistant tuberculosis is not a problem in the scenario, the study showed an increase in its incidence, which puts it on alert. The use of spatial analysis enabled the identification of priority areas, putting them in evidence for health surveillance actions.

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High positive predictive value of Xpert in a low rifampicin resistance prevalence setting

Cited by 7 publications

References 12 publications

Rapid molecular test for tuberculosis: impact of its routine use at a referral hospital

Rapid molecular test for tuberculosis: impact of its routine use at a referral hospital

ERS/ECDC Statement: European Union standards for tuberculosis care, 2017 update

Impact of the GeneXpert® MTB/RIF rapid molecular test on tuberculosis detection: temporal trends and vulnerable territories

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