The rapid molecular test Xpert MTB/RIF ultra: towards improved tuberculosis diagnosis and rifampicin resistance detection.

Details

Serval ID
serval:BIB_AB65E37DF14D
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
The rapid molecular test Xpert MTB/RIF ultra: towards improved tuberculosis diagnosis and rifampicin resistance detection.
Journal
Clinical microbiology and infection
Author(s)
Opota O., Mazza-Stalder J., Greub G., Jaton K.
ISSN
1469-0691 (Electronic)
ISSN-L
1198-743X
Publication state
Published
Issued date
11/2019
Peer-reviewed
Oui
Volume
25
Number
11
Pages
1370-1376
Language
english
Notes
Publication types: Evaluation Study ; Journal Article ; Review
Publication Status: ppublish
Abstract
Tuberculosis diagnosis has dramatically improved since the introduction of the rapid molecular test Xpert MTB/RIF (Xpert) detecting M. tuberculosis and rifampicin resistance directly from clinical specimens, therefore shortening the turnaround time, reducing patient's isolation period and decreasing the time to start anti-TB drugs. The new version, Xpert MTB/RIF Ultra (Ultra), displays a higher sensitivity and an improved rifampicin resistance detection. Both tests have been endorsed by the World Health Organisation.
Xpert and Ultra rapidly became widespread and paved the way for new approaches and new paradigms as well as for the development of molecular point-of-care tests (POCTs). In this narrative review, we aimed to address their performance in the diagnosis of tuberculosis and to discuss the expectations of these tests as well as their limits and the unmet needs.
Peer-reviewed publications addressing the diagnostic performance of Ultra and Xpert.
We focused on publications that evaluated the performance of Ultra and Xpert on the same group of patients or the same set of specimens in different tuberculosis-burden settings.
The studies published so far reported an increased sensitivity of Ultra when compared to Xpert, which represents a benefit for tuberculosis diagnosis. The fact that such a sensitive assay cannot distinguish between alive and dead bacilli emphasizes that caution should be exercised regarding indications and interpretation of results. Additional studies are needed to determine the true performance for the diagnosis of extrapulmonary tuberculosis because of the great diversity of the specimens.
Keywords
Antibiotics, Antitubercular/pharmacology, Drug Resistance, Bacterial, Humans, Molecular Diagnostic Techniques/methods, Mycobacterium tuberculosis/drug effects, Mycobacterium tuberculosis/isolation & purification, Rifampin/pharmacology, Sensitivity and Specificity, Tuberculosis/diagnosis, Tuberculosis/microbiology, HIV, Molecular diagnostics, Paediatric tuberculosis, Pleural tuberculosis, Point of care test, Rifampicin resistance, Tuberculosis, Tuberculous meningitis, Xpert MTB/RIF, Xpert MTB/RIF Ultra
Pubmed
Web of science
Open Access
Yes
Create date
15/04/2019 9:56
Last modification date
29/01/2021 7:25
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