Use of Xpert MTB/RIF and Xpert Ultra in extrapulmonary tuberculosis

Park, Mirae; Kon, Onn Min

doi:10.1080/14787210.2020.1810565

Cited by 36 publications

(24 citation statements)

References 96 publications

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“…In our cohort, the Xpert improved bacteriological diagnoses of LNTB by eleven folds compared to microscopy (124 MTB + ve vs.11AFB + ve) but still could diagnose less than 60% of all TB cases. Xpert Ultra is expected to improve sensitivity in such paucibacillary specimens 31 , 32 . Ultra is reported to have higher sensitivity and lower specificity than Xpert, but the certainty of the evidence is low as the number of studies and patients tested are small 17 .…”

Section: Discussionmentioning

confidence: 99%

The value of histological examination in the diagnosis of tuberculous lymphadenitis in the era of rapid molecular diagnosis

Tahseen

Ambreen²,

Ishtiaq³

et al. 2022

Sci Rep

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Extrapulmonary tuberculosis often poses a diagnostic challenge. This study aimed to assess the value of histological examination in diagnosing tuberculous lymphadenitis (LNTB) when performed simultaneously with rapid molecular assay (Xpert MTB/RIF) testing. People presumed to have LNTB were prospectively enrolled in a tertiary care hospital. Excision biopsy was performed and tested by histology, Xpert, and culture. Of 390 lymph nodes, 11 (2.8%) were positive by AFB microscopy, 124 (31.8%) by Xpert, 137 (35.1%) by culture, and histopathology was consistent with TB in 208 (53.3%). Altogether, LNTB was diagnosed in 228 and bacteriologically confirmed TB in 178 cases. Against culture, histopathology versus Xpert had higher sensitivity (93 vs. 62%) but lower specificity (68 vs. 83%). In patients with short clinical history, a significantly higher number of Xpert-positive specimens were culture-positive. Among patients with histology suggestive of TB, no difference was seen in response to treatment between bacteriology positive and negative, but a significant slow response was noted in bacteriology confirmed TB with nonspecific histology. In a country like Pakistan, with high TB and low HIV prevalence, diagnosis is possible for more than 95% of LNTB when Xpert and histopathology examination is used in combination, compared to less than 60% by Xpert alone.

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Section: Discussionmentioning

confidence: 99%

The value of histological examination in the diagnosis of tuberculous lymphadenitis in the era of rapid molecular diagnosis

Tahseen

Ambreen²,

Ishtiaq³

et al. 2022

Sci Rep

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“…The Xpert MTB/RIF (Xpert, Cepheid, Sunnyvale, CA, USA) has greatly contributed to the early and rapid diagnosis of TB and has been recommended by the World Health Organization for diagnosing TBL. 12 , 13 Other molecular tests have emerged, including the CapitalBio Mycobacterium real-time polymerase chain reaction test (CapitalBio test, CapitalBio Technology Inc., Beijing, China), which can detect both TB and nontuberculous mycobacterial infections. 14 In PTB and EPTB, the CapitalBio test exhibited similar diagnostic accuracy to Xpert MTB/RIF.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Accuracy of Two Different Molecular Tests for the Diagnosis of Tuberculous Lymphadenitis Using Core Needle Biopsy Specimens: A Diagnostic Accuracy Study

Yao¹,

Xu²,

Chen³

et al. 2022

IJGM

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Purpose To evaluate the diagnostic accuracy of the CapitalBio Mycobacterium real-time polymerase chain reaction assay (CapitalBio test) testing of core needle biopsy (CNB) specimens for tuberculous lymphadenitis (TBL) and to compare it with Xpert MTB/RIF. Methods We retrospectively analyzed the medical data on patients with suspected peripheral TBL. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) of the CapitalBio test, Xpert MTB/RIF, and parallel test (positive result for either of these two tests) were calculated to evaluate their diagnostic efficacy compared with the final clinical diagnosis. Results The study included 114 patients. For diagnosing TBL using CNB samples, the sensitivity, specificity, PPV, NPV, and AUC were 65.0%, 100.0%, 100.0%, 28.6%, and 0.83, respectively, for the CapitalBio test; 72.0%, 100.0%, 100.0%, 33.3%, and 0.86, respectively, for Xpert MTB/RIF; and 82.0%, 100.0%, 100.0%, 43.8%, and 0.91, respectively, for the parallel test. Conclusion The accuracy of the CapitalBio test and Xpert MTB/RIF for diagnosing TBL using CNB specimens was moderate, while the sensitivity and NPV of these two tests were relatively low. The diagnostic accuracy of the CapitalBio test was slightly lower than that of Xpert MTB/RIF, but the difference between the two was not statistically significant. Parallel test might improve the diagnostic accuracy but not substantially over a single test.

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“…Research on extrapulmonary tuberculosis is mostly reported in developed countries, with fewer studies conducted in developing and undeveloped nations. 20 , 21 Recent studies indicate that extrapulmonary tuberculosis may be rising in China, a phenomenon that should be noted by physicians treating infectious diseases. 4 , 22 , 23 …”

Section: Discussionmentioning

confidence: 99%

Brucellar Knee Arthritis with Knee Joint Tuberculosis: A Case Report and Review of the Literature

Wang¹,

Li²,

Zhang³

2022

IDR

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Brucella and Mycobacterium tuberculosis (MTB) primarily affect the spine and only rarely the knee joint in osteoarticular disease in adults. We present an unusual instance of brucellar knee arthritis combined with knee joint tuberculosis. A 59-year-old man was initially diagnosed with brucellar knee arthritis in the orthopedics department of our hospital, while two weeks of standardized treatment did not improve the joint discomfort and inflammation indexes. Subsequent evaluation of serum tuberculosis interferon-gamma release assays (TB-IGRAs) and the effectiveness of empirical anti-tuberculosis therapy confirmed the mixed infection of tuberculosis. This case report demonstrates that clinical signs and imaging for brucellar knee arthritis and knee joint tuberculosis are similar. Patients with both disorders are more likely to be misdiagnosed or have their diagnosis delayed; clinicians should be aware of this uncommon combination of mixed infections.

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Use of Xpert MTB/RIF and Xpert Ultra in extrapulmonary tuberculosis

Cited by 36 publications

References 96 publications

The value of histological examination in the diagnosis of tuberculous lymphadenitis in the era of rapid molecular diagnosis

The value of histological examination in the diagnosis of tuberculous lymphadenitis in the era of rapid molecular diagnosis

Comparison of the Accuracy of Two Different Molecular Tests for the Diagnosis of Tuberculous Lymphadenitis Using Core Needle Biopsy Specimens: A Diagnostic Accuracy Study

Brucellar Knee Arthritis with Knee Joint Tuberculosis: A Case Report and Review of the Literature

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