Added Value of Xpert MTB/RIF Ultra for Diagnosis of Pulmonary Tuberculosis in a Low-Prevalence Setting.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_7A47A167126E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Added Value of Xpert MTB/RIF Ultra for Diagnosis of Pulmonary Tuberculosis in a Low-Prevalence Setting.
Journal
Journal of clinical microbiology
Author(s)
Opota O., Zakham F., Mazza-Stalder J., Nicod L., Greub G., Jaton K.
ISSN
1098-660X (Electronic)
ISSN-L
0095-1137
Publication state
Published
Issued date
02/2019
Peer-reviewed
Oui
Volume
57
Number
2
Language
english
Notes
Publication types: Evaluation Study ; Journal Article
Publication Status: epublish
Abstract
Xpert MTB/RIF (Xpert) for direct molecular detection of Mycobacterium tuberculosis and rifampin resistance from clinical specimens has dramatically improved the diagnosis of tuberculosis (TB). Xpert MTB/RIF Ultra (Ultra) is proposed as a substitute of Xpert with increased sensitivity and improved rifampin resistance detection. We evaluated the diagnostic performance of Ultra and Xpert for pulmonary TB diagnosis in a low-TB-burden setting. Performance of Ultra and Xpert were compared to culture on respiratory specimens from patients with suspected pulmonary TB (November 2016 to August 2018; n = 196) in Lausanne (Switzerland). Clinical data were used to investigate discrepant results. Correlation between semiquantitative result of Ultra and smear microscopy status for the detection of acid-fast bacilli (AFB) was established. The sensitivities of Xpert and Ultra were 82.9% (39/47) and 95.8% (45/47), respectively, when considering all culture-positive specimens, 100% (23/23) for both assays on smear-positive specimens, and 66.7% (16/24) and 91.7% (22/24) on smear-negative specimens. Using culture as gold standard, the specificities of Xpert and Ultra were 97.3% (145/149) and 96.64% (144/149), respectively. All the patients with Ultra-positive results with the new category "trace" were diagnosed with active TB based on clinical findings and microbiological culture. The semiquantitative results of both Xpert and of Ultra positively correlated with the semiquantitative result of AFB detection. Our data support an increased sensitivity of Ultra compared to Xpert in a low-prevalence setting. Correlation between the Ultra semiquantitative result and AFB burden can help in evaluating a patient's transmission potential.
Keywords
Adolescent, Adult, Aged, 80 and over, Antitubercular Agents/pharmacology, Drug Resistance, Bacterial, Female, Humans, Male, Microbial Sensitivity Tests/methods, Middle Aged, Molecular Diagnostic Techniques/methods, Mycobacterium tuberculosis/drug effects, Mycobacterium tuberculosis/genetics, Mycobacterium tuberculosis/isolation & purification, Rifampin/pharmacology, Sensitivity and Specificity, Switzerland, Tuberculosis, Pulmonary/diagnosis, Young Adult, Mycobacterium tuberculosis, Xpert MTB/RIF, Xpert MTB/RIF Ultra, acid-fast bacilli, airborne isolation, clinical microbiology, diagnostic microbiology, point-of-care test, smear microscopy, tuberculosis
Pubmed
Web of science
Open Access
Yes
Create date
14/01/2019 19:35
Last modification date
30/04/2021 7:12
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