Xpert MTB/RIF ultra for rapid diagnosis of extrapulmonary tuberculosis in a high-income low-tuberculosis prevalence setting

Hoel, Ida Marie; Syre, Heidi; Skarstein, Ingerid; Mustafa, Tehmina

doi:10.1038/s41598-020-70613-x

Cited by 29 publications

(19 citation statements)

References 31 publications

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“…In patients of different ages and in different clinical specimens, Ultra sensitivities ranged from 90 to 95%, and specificities ranged from 86 to 99% [7][8][9] . We did not perform a comparison between Xpert and Ultra, as Xpert is no longer available in Brazil.…”

Section: Resultsmentioning

confidence: 99%

Gene-Xpert Ultra for the diagnosis of extrapulmonary tuberculosis in children and adolescents

Aurílio

Ferreira

Parente

et al. 2022

Rev. Inst. Med. trop. S. Paulo

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This prospective study describes the use of Gene-Xpert Ultra for the diagnosis of extrapulmonary tuberculosis (EPTB) in children and adolescents, in Rio de Janeiro, Brazil. Eighteen patients were studied; the final diagnosis of EPTB was established in 13 (72%). Gene-Xpert Ultra results showed detection in 10/13 (77%) of EPTB cases (7 of these 10 with trace-positive results). Gene-Xpert Ultra proved to be a promising method for the diagnosis of childhood EPTB.

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Section: Resultsmentioning

confidence: 99%

Gene-Xpert Ultra for the diagnosis of extrapulmonary tuberculosis in children and adolescents

Aurílio

Ferreira

Parente

et al. 2022

Rev. Inst. Med. trop. S. Paulo

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“…Despite the software cannot provide information about RIF resistance, it is relevant in the clinical context of the patient. The Global Laboratories Initiative (guidelines), and the working group of Stop TB Partnership, states that "trace category should be considered as a true-positive result for use in clinical decisions and patient follow-up in case of extrapulmonary samples 22 ." However, there is also uncertainty surrounding the interpretation of this category.…”

Section: Discussionmentioning

confidence: 99%

Performance of Real-Time Semi-Quantitative Polymerase Chain Reaction Assay for Optimum Diagnosis of Extrapulmonary Tuberculosis and Sensitivity to Rifampin in a Tertiary Care Center

Peñata-Bedoya¹,

Zuluaga-Avendaño²,

Castaño-Sepúlveda³

et al. 2021

RIC

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Background: Tuberculosis represents a public health problem, with extrapulmonary disease occurring in 15% of incident cases annually. Early diagnosis is a challenge due to its paucibacillary nature. Recently, a molecular real-time semi-quantitative assay (GeneXpert Ultra) was developed to overcome limitations of the previous assay version (Xpert MTB/RF). Objective: The objective of the study was to assess the usefulness of the novel next-generation GeneXpert assay in extrapulmonary samples from different anatomic sites under routine diagnostic conditions at a university medical center. Methods: A total of 519 samples from patients with presumptive diagnosis of extrapulmonary TB were subjected to smear microscopy, culture, and molecular assay. Univariate analyses for demographic and microbiological characteristics were performed. The sensitivity, specificity, and Kappa index with a 95% confidence interval were determined. Results: Molecular assay was positive in 53 samples (10.2%), of which 38 (71.6%) belonged to the "low" and "trace" semi-quantitative categories. The overall sensitivity and specificity were 86.4% (95% confidence intervals [CI]: 74.1-98.8) and 95.6% (95% CI: 93.7-97.6), respectively. Phenotypic drug susceptibility testing for rifampin was 100% concordant. Conclusions: Molecular assay showed significant results when compared to other standard tests, making it a useful tool that could lead in the improvement to a rapid diagnosis of extrapulmonary disease.

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“…In low TB prevalent settings, even a small reduction in specificity could increase the rate of false positive cases. For this reason, Ultra should be performed on pre-selected samples with a high clinical suspect of TB disease [18]. In other studies, it has been reported that the increase in sensitivity with Ultra respect Xpert, specifically in patients with a history of TB [12] [22] and patients with meningitis [23] came at the expense of a decrease in specificity.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Xpert MTB/RIF Ultra for Diagnosis of Extrapulmonary Tuberculosis: A Retrospective Analysis in a Low-Tuberculosis Prevalence Setting

Giudice¹,

Perna²,

Baldoni³

et al. 2021

JTR

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Background: Extrapulmonary tuberculosis (EPTB) remains difficult to diagnose because the clinical specimens to be examined are often paucibacillary and obtained with difficulty from inaccessible sites. An updated Xpert ® MTB/RIF Ultra (Ultra) test has been designed and licensed to improve sensitivity in the detection of Mycobacterium tuberculosis complex. The aim of the present study is to evaluate the performance of Ultra assay for the clinical diagnosis of EPTB in a low tuberculosis prevalence country. Methods: A retrospective analysis was performed at "A. O dei Colli" of Naples on consecutive extrapulmonary specimens for EPTB across a three-year period. All different types of extrapulmonary specimens were tested for EPTB by smear microscopy, culture and Ultra assay in accordance with relevant guidelines. Results: A total of 606 EPTB samples, 561 culture negative EPTB and 45 culture positive EPTB were included. Using culture as reference standard, the overall sensitivities and specificities of Ultra assay were 95.6% (95% CI 84.8 -99.5) and 97.5% (95% CI 95.8 -98.6) respectively. Sensitivity and specificity of Ultra for individual category of specimens were also performed. Conclusion: In a low-tuberculosis prevalence setting, Ultra assay confirms to have a good performance in the diagnosis of EPTB for all different extrapulmonary samples.

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Xpert MTB/RIF ultra for rapid diagnosis of extrapulmonary tuberculosis in a high-income low-tuberculosis prevalence setting

Cited by 29 publications

References 31 publications

Gene-Xpert Ultra for the diagnosis of extrapulmonary tuberculosis in children and adolescents

Gene-Xpert Ultra for the diagnosis of extrapulmonary tuberculosis in children and adolescents

Performance of Real-Time Semi-Quantitative Polymerase Chain Reaction Assay for Optimum Diagnosis of Extrapulmonary Tuberculosis and Sensitivity to Rifampin in a Tertiary Care Center

Evaluation of Xpert MTB/RIF Ultra for Diagnosis of Extrapulmonary Tuberculosis: A Retrospective Analysis in a Low-Tuberculosis Prevalence Setting

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