Bibliografias temáticas / Xpert MTB

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Literatura científica selecionada sobre o tema "Xpert MTB"

Autor: Grafiati

Publicado: 4 de junho de 2021

Última modificação: 8 de fevereiro de 2022

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Artigos de revistas sobre o assunto "Xpert MTB"

Nicol, Mark, Andrew Whitelaw e Wendy Stevens. "Using Xpert MTB/RIF". Current Respiratory Medicine Reviews 9, n.º 3 (1 de setembro de 2013): 187–92. http://dx.doi.org/10.2174/1573398x113099990015.

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Yin, Qing-Qin, Wei-Wei Jiao, Rui Han, An-Xia Jiao, Lin Sun, Jian-Ling Tian, Yu-Yan Ma et al. "Rapid Diagnosis of Childhood Pulmonary Tuberculosis by Xpert MTB/RIF Assay Using Bronchoalveolar Lavage Fluid". BioMed Research International 2014 (2014): 1–6. http://dx.doi.org/10.1155/2014/310194.

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In order to evaluate the diagnostic accuracy of the Xpert MTB/RIF assay on childhood pulmonary tuberculosis (PTB) using bronchoalveolar lavage fluid (BALF), we evaluated the sensitivity, specificity, positive predictive value, and negative predictive value of Xpert MTB/RIF assay using BALF in comparison with acid-fast bacilli (AFB) microscopy andMycobacterium tuberculosis(MTB) culture for diagnosing childhood PTB using Chinese “composite clinical reference standard” (CCRS) as reference standard. Two hundred fifty-five children with suspected PTB were enrolled at Beijing Children’s Hospital from September 2010 to July 2013. Compared with Chinese CCRS, the sensitivity of AFB microscopy, MTB culture, and Xpert MTB/RIF assay was 8.4%, 28.9%, and 53.0%, respectively. The specificity of three assays was all 100%. Xpert MTB/RIF assay could detect 33.9% of cases with negative MTB culture, and 48.7% of cases with negative AFB microscopy. Younger age (<3 years), absence of BCG scar, and contact with TB patient were found significantly associated with a positive result of Xpert MTB/RIF assay. In conclusion, Xpert MTB/RIF assay using BALF can assist in diagnosing childhood PTB much faster when fiberoptic bronchoscopy is necessary according to the chest radiograph.

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Cuong, Nguyen Kim, Nguyen Bao Ngoc, Nguyen Binh Hoa, Vu Quoc Dat e Nguyen Viet Nhung. "GeneXpert on patients with human immunodeficiency virus and smear-negative pulmonary tuberculosis". PLOS ONE 16, n.º 7 (6 de julho de 2021): e0253961. http://dx.doi.org/10.1371/journal.pone.0253961.

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Objectives Vietnam is a high-prevalence country for tuberculosis (TB). Xpert MTB/RIF is a novel PCR-based diagnostic test that is substantially more sensitive for detecting M. tuberculosis than traditional smear-based techniques. However, locally-derived evidence of Xpert MTB/RIF in HIV-infected people is limited. This study evaluates the performance of the Xpert MTB/RIF in HIV-infected patients with smear-negative pulmonary TB (SNTB). Methods This was a cross-sectional study in 3 hospitals. The performance of Xpert MTB/RIF was compared with the reference standard of liquid culture and phenotypic drug-susceptibility testing for rifampicin (RIF) resistance. Results Out of 123 patients, the median age was 37.0 (IQR: 32.0–41.0) and 81.3% were male. The area under the receiver operating characteristic curve, sensitivity (Se) and specificity (Sp) of Xpert MTB/RIF for pulmonary TB diagnosis were 0.72 (95% confidence interval [CI]: 0.63–0.81), 66.7% (95%CI: 54.8–77.1) and 77.1% (95%CI: 62.7–88.0), respectively, while Se and Sp of Xpert MTB/RIF in detecting RIF resistance were 50.0 (11.8–88.2) and 86.4% (95%CI: 72.7–94.8). Conclusion The performance of Xpert MTB/RIF in HIV-infected patients with SNTB for the diagnosis of TB and RIF-resistance was low. Further studies are required to evaluate the results of Xpert MTB/RIF assay in HIV-infected patients with SNTB and the role of Xpert repetition on the same specimens.

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Chhajed, Prashant N., Preyas J. Vaidya, Neha P. Mandovra, Vinod B. Chavhan, Tejashree T. Lele, Rekha Nair, Jörg D. Leuppi e Avinandan Saha. "EBUS-TBNA in the rapid microbiological diagnosis of drug-resistant mediastinal tuberculous lymphadenopathy". ERJ Open Research 5, n.º 4 (outubro de 2019): 00008–2019. http://dx.doi.org/10.1183/23120541.00008-2019.

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This study aimed to examine the use of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the rapid diagnosis of mediastinal tuberculous lymphadenitis and drug-resistant mediastinal tuberculous lymphadenitis.A diagnosis of TB was confirmed by a positive Xpert MTB/RIF test or Mycobacterium tuberculosis culture. Rifampicin-resistant TB (RR-TB) or multidrug-resistant TB (MDR-TB) was diagnosed upon the detection of rifampicin resistance by Xpert MTB/RIF or resistance to rifampicin and isoniazid by phenotypic drug susceptibility testing (DST).Xpert MTB/RIF was positive in 43 of 56 patients (77%) and TB culture was positive in 31 of 56 patients (55%). Of these 56 patients, 25 (45%) were Xpert MTB/RIF positive and TB culture negative, 13 (23%) were Xpert MTB/RIF negative and TB culture positive, and 18 (32%) were Xpert MTB/RIF positive and TB culture positive. 11 patients (20%) had drug-resistant TB: seven with RR/MDR-TB, one with pre-extensively drug-resistant (XDR) TB, two with XDR-TB and one with isoniazid mono-resistance.An Xpert MTB/RIF assay carried out on EBUS-TBNA specimens provides rapid diagnosis of TB. Xpert MTB/RIF testing appears to have additional and more rapid sensitivity compared with culture alone. Culture-based DST provides an additional exclusive yield and the full resistance profile in addition to or instead of rifampicin resistance.

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Diel, Roland, Albert Nienhaus, Doris Hillemann e Elvira Richter. "Cost–benefit analysis of Xpert MTB/RIF for tuberculosis suspects in German hospitals". European Respiratory Journal 47, n.º 2 (2 de dezembro de 2015): 575–87. http://dx.doi.org/10.1183/13993003.01333-2015.

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Our objective was to assess the cost–benefit of enhancing or replacing the conventional sputum smear with the real-time PCR Xpert MTB/RIF method in the inpatient diagnostic schema for tuberculosis (TB).Recent data from published per-case cost studies for TB/multidrug-resistant (MDR)-TB and from comparative analyses of sputum microscopy, mycobacterial culture, Xpert MTB/RIF and drug susceptibility testing, performed at the German National Reference Center for Mycobacteria, were used. Potential cost savings of Xpert MTB/RIF, based on test accuracy and multiple cost drivers, were calculated for diagnosing TB/MDR-TB suspects from the hospital perspective.Implementing Xpert MTB/RIF as an add-on in smear-positive and smear-negative TB suspects saves on average €48.72 and €503, respectively, per admitted patient as compared with the conventional approach. In smear-positive and smear-negative MDR-TB suspects, cost savings amount to €189.56 and €515.25 per person, respectively. Full replacement of microscopy by Xpert MTB/RIF saves €449.98. In probabilistic Monte-Carlo simulation, adding Xpert MTB/RIF is less costly in 46.4% and 76.2% of smear-positive TB and MDR-TB suspects, respectively, but 100% less expensive in all smear-negative suspects. Full replacement by Xpert MTB/RIF is also consistently cost-saving.Using Xpert MTB/RIF as an add-on to and even as a replacement for sputum smear examination may significantly reduce expenditures in TB suspects.

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Yu, Guocan, Fangming Zhong, Yanqin Shen e Hong Zheng. "Diagnostic accuracy of the Xpert MTB/RIF assay for tuberculous pericarditis: A systematic review and meta-analysis". PLOS ONE 16, n.º 9 (10 de setembro de 2021): e0257220. http://dx.doi.org/10.1371/journal.pone.0257220.

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Objective The purpose of this study was to evaluate the diagnostic efficacy of Xpert MTB/RIF for tuberculous pericarditis (TBP). Methods We searched relevant databases for Xpert MTB/RIF for TBP diagnosis until April 2021 and screened eligible studies for study inclusion. We evaluated the effectiveness of Xpert MTB/RIF when the composite reference standard (CRS) and mycobacterial culture were the gold standards, respectively. We performed meta-analyses using a bivariate random-effects model, and when the heterogeneity was obvious, the source of heterogeneity was further discussed. Results We included seven independent studies comparing Xpert MTB/RIF with the CRS and six studies comparing it with culture. The pooled sensitivity, specificity, and area under the curve of Xpert MTB/RIF were 65% (95% confidence interval, 59–72%), 99% (97–100%), and 0.99 (0.97–0.99) as compared with the CRS, respectively, and 75% (53–88%), 99% (90–100%), and 0.94 (0.92–0.96) as compared with culture, respectively. There was no significant heterogeneity between studies when CRS was the gold standard, whereas heterogeneity was evident when culture was the gold standard. Conclusions The sensitivity of Xpert MTB/RIF for diagnosing TBP was moderate and the specificity was good; thus, Xpert MTB/RIF can be used in the initial diagnosis of TBP.

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Tadesse, Mulualem, Gemeda Abebe, Danie Yilma, Ludwig Apers, Bouke De Jong e Leen Rigouts. "PO 8168 CLINICAL UTILITY OF XPERT MTB/RIF ASSAY FOR THE DIAGNOSIS OF EXTRAPULMONARY TUBERCULOSIS IN ETHIOPIA". BMJ Global Health 4, Suppl 3 (abril de 2019): A20.2—A20. http://dx.doi.org/10.1136/bmjgh-2019-edc.50.

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BackgroundThe diagnosis of extrapulmonary tuberculosis (EPTB) is often made on clinical suspicion alone, and many people receive the wrong diagnosis leading to unnecessary TB treatment or poor outcomes from untreated EPTB. In this study, we evaluated the clinical utility of the Xpert MTB/RIF assay on routinely collected extra-pulmonary specimens in Ethiopia.MethodsThis study was carried out at Jimma University Specialized Hospital, Southwest Ethiopia from September 2015 to June 2017. Extra-pulmonary specimens were collected from 572 patients clinically suspected of suffering from EPTB. All specimens were tested for TB by smear-microscopy, culture and Xpert MTB/RIF. The diagnostic accuracy of Xpert MTB/RIF was calculated compared to a composite reference standard (CRS), composed of liquid culture and anti-TB treatment response.ResultsIn total, 572 extra-pulmonary specimens (279 lymph node, 159 pleural, 80 peritoneal, 45 cerebrospinal and 9 pericardial fluids) were tested. The pooled sensitivity and specificity of Xpert MTB/RIF were calculated to be 91% and 90.6% respectively when compared to culture. The pooled sensitivity of Xpert MTB/RIF was decreased to 75% and the specificity was improved to 98% when Xpert MTB/RIF was compared to the CRS. The sensitivities among the specimen types differed markedly. The highest sensitivity was documented for lymph node (90%), moderate sensitivity for cerebrospinal (53%), while the sensitivity was lowest for pleural (30%) and peritoneal (32%) fluids. Xpert MTB/RIF, in addition, detected rifampicin resistance in 13 patients in perfect agreement with line probe assay.ConclusionOur study showed that Xpert MTB/RIF is likely to be of greatest utility when testing lymph node specimens. A negative Xpert MTB/RIF result on fluid specimens does not exclude the diagnosis of EPTB and patients with a high clinical probability of EPTB should be started on anti-TB treatment.

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Lee, Han Na, Jung Im Kim e Yee Hyung Kim. "Clinical and CT characteristics of Xpert MTB/RIF-negative pulmonary tuberculosis". PLOS ONE 16, n.º 5 (3 de maio de 2021): e0250616. http://dx.doi.org/10.1371/journal.pone.0250616.

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Purpose To determine the diagnostic accuracy of the Xpert MTB/RIF assay in patients with smear-negative pulmonary tuberculosis (TB) and to assess clinical and CT characteristics of Xpert-negative pulmonary TB. Material and methods We retrospectively reviewed the records of 1,400 patients with suspected pulmonary TB for whom the sputum Xpert MTB/RIF assay was performed between September 1, 2014 and February 28, 2020. Clinical and CT characteristics of smear-negative pulmonary TB patients with negative Xpert MTB/RIF results were compared with positive results. Results Of 1,400 patients, 365 (26.1%) were diagnosed with pulmonary TB and 190 of 365 patients (52.1%) were negative for sputum acid-fast bacilli. The diagnosis of pulmonary TB was based on a positive culture, positive Xpert MTB/RIF or the clinical diagnoses of patients treated with an anti-TB medication. The sensitivity, specificity, positive predictive and negative predictive values of sputum Xpert MTB/RIF for smear-negative pulmonary TB were 41.1%, 100%, 100%, and 90.1%, respectively. Finally, 172 patients with smear-negative pulmonary TB who underwent chest CT within 2 weeks of diagnosis were included to compare Xpert-positive (n = 66) and Xpert- negative (n = 106) groups. Patients with sputum Xpert-negative TB showed lower positive rates for sputum culture (33.0% vs. 81.8%, p<0.001) and bronchoalveolar lavage culture (53.3% vs. 84.6%, p = 0.042) than in Xpert-positive TB. Time to start TB medication was longer in patients with Xpert-negative TB than in Xpert-positive TB (11.3±16.4 days vs. 5.0±8.7 days, p = 0.001). On chest CT, sputum Xpert-negative TB showed significantly lower frequency of consolidation (21.7% vs. 39.4%, p = 0.012), cavitation (23.6% vs. 37.9%, p = 0.045), more frequent peripheral location (50.9% vs. 21.2 p = 0.001) with lower area of involvement (4.3±4.3 vs. 7.6±6.4, p<0.001). Multivariate analysis revealed peripheral location (odds ratios, 2.565; 95% confidence interval: 1.157–5.687; p = 0.020) and higher total extent of the involved lobe (odds ratios, 0.928; 95% confidence interval: 0.865–0.995; p = 0.037) were significant factors associated with Xpert MTB/RIF-negative TB. Regardless of Xpert positivity, more than 80% of all cases were diagnosed of TB on chest CT by radiologists. Conclusion The detection rate of sputum Xpert MTB/RIF assay was relatively low for smear negative pulmonary TB. Chest CT image interpretation may play an important role in early diagnosis and treatment of Xpert MTB/RIF-negative pulmonary TB.

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McMillen, Tracy, Shauna C. Usiak, Liang Hua Chen, Luz Gomez, Peter Ntiamoah, Meera R. Hameed, Indre Budvytiene, Niaz Banaei, Mini Kamboj e N. Esther Babady. "Evaluation of the Xpert MTB/RIF Performance on Tissues: Potential Impact on Airborne Infection Isolation at a Tertiary Cancer Care Center". Infection Control & Hospital Epidemiology 39, n.º 4 (15 de fevereiro de 2018): 462–66. http://dx.doi.org/10.1017/ice.2018.7.

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OBJECTIVESIn this study, we sought to evaluate the performance of the Xpert MTB/RIF (Cepheid) assay for the detection of Mycobacterium tuberculosis (MTB) complex DNA on fresh and formalin-fixed, paraffin-embedded (FFPE) tissue specimens from oncology patients in an area with a low prevalence of tuberculosis. We also aimed to retrospectively assess the potential impact of Xpert MTB/RIF on the duration of airborne infection isolation (AII).SETTINGA 473-bed, tertiary-care cancer center in New York City.DESIGNA total of 203 tissue samples (101 FFPE and 102 fresh) were tested using Xpert MTB/RIF, including 133 pulmonary tissue samples (65.5%) and 70 extrapulmonary tissue samples (34.5%). Acid-fast bacilli (AFB) culture was used as the diagnostic gold standard. The limit of detection (LOD) and reproducibility were also evaluated for both samples types using contrived specimens. The potential impact of the Xpert MTB PCR assay on tissue samples from AII patients on AII duration was retrospectively assessed.RESULTSUsing the Xpert MTB/RIF for fresh tissue specimens, the sensitivity was 50% (95% CI, 1.3%–98.7%) and the specificity was 99% (95% CI, 94.5%–99.9%). For FFPE tissue specimens, the sensitivity was 100% (95% CI, 63.1%–100%) and the specificity was 98.3% (95% CI, 95.5%–100%. The LOD was 103 colony-forming units (CFU)/mL for both fresh and FFPE tissue specimens, and the Xpert MTB/RIF was 100% reproducible at concentrations 10 times that of the LOD. With an expected turnaround time of 24 hours, the Xpert MTB PCR could decrease the duration of AII from a median of 8 days to a median of 1 day.CONCLUSIONSThe Xpert MTB/RIF assay offers a valid option for ruling out Mycobacterium tuberculosis complex (MTBC) on tissue samples from oncology patients and for minimizing AII resource utilization.Infect Control Hosp Epidemiol 2018;39:462–466

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Fakey Khan, Dilshaad, Moosa Suleman, Prinita Baijnath, Rubeshan Perumal, Vedanthi Moodley, Zoey Mhlane, Taryn Naidoo, Thumbi Ndung'u e Emily B. Wong. "Multiple microbiologic tests for tuberculosis improve diagnostic yield of bronchoscopy in medically complex patients". AAS Open Research 2 (16 de julho de 2019): 25. http://dx.doi.org/10.12688/aasopenres.12980.1.

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Background: Bronchoalveolar lavage (BAL) is indicated for medical evaluation of complex cases of lung disease. There is limited data on the performance of tuberculosis (TB) microbiologic tests on BAL in such patients, particularly in human immunodeficiency virus (HIV) and TB endemic areas. Methods: We evaluated the performance of Mycobacterium tuberculosis (Mtb) culture and up to two simultaneous Xpert MTB/RIF tests on BAL fluid against a consensus clinical diagnosis in 98 medically complex patients undergoing bronchoscopy over a two-year period in Durban, South Africa. Results: TB was the most frequently diagnosed lung disease, found in 19 of 98 participants (19%) and was microbiologically proven in 14 of these (74%); 9 (47%) were culture positive and 5 were positive on at least one Xpert MTB/RIF assay. Immunosuppression prevalence was high (26% HIV-infected, 29% on immunosuppressive therapy and 4% on chemotherapy). Xpert MTB/RIF had low sensitivity (45%) and high specificity (99%) when assessed against the consensus clinical diagnosis. Compared to TB culture, a single Xpert MTB/RIF increased the diagnostic yield by 11% and a second Xpert MTB/RIF by a further 16%. Conclusion: Although Xpert MTB/RIF had a low sensitivity, sending two tests improved the microbiologically-proven diagnostic yield of bronchoscopy from 47% to 74% compared to culture alone.

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Teses / dissertações sobre o assunto "Xpert MTB"

Pereira, Giovana Rodrigues. "Impacto do teste Xpert MTB/RIF no diagnóstico da tuberculose". reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2018. http://hdl.handle.net/10183/179848.

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Introdução: O teste Xpert MTB / RIF está sendo cada vez mais utilizado em muitos países como diagnóstico inicial para a tuberculose (TB). Poucos estudos avaliaram o impacto do Xpert no diagnóstico em rotinas de programas de controle de TB no Brasil. O objetivo do presente estudo foi avaliar o impacto da introdução do Xpert MTB / RIF no diagnóstico de TB em uma cidade com alta incidência de TB no Brasil. Métodos: Incluímos pacientes avaliados com testes diagnósticos convencionais durante um ano antes da introdução do Xpert (grupo pré-Xpert) e pacientes avaliados usando Xpert durante um ano após a introdução do teste (grupo pós-Xpert). Resultados: 620 pacientes preencheram os critérios de inclusão (208 no grupo pré-Xpert e 412 no grupo pós-Xpert) e foram incluídos na análise. O tempo até o diagnóstico de TB foi menor no grupo pós-Xpert (0,7 dias, IQR: 0,5-1,0 dias) do que no grupo pré-Xpert (2,0 dias, IQR: 2,0-2,0 dias) (p <0,0001). Características atípicas da doença, como menor perda de peso, febre, dispneia, sudorese noturna e hemoptise; baciloscopia de escarro negativa; cultura negativa e radiografia de tórax atípica de TB foram mais comuns no grupo pós-Xpert do que no grupo pré-Xpert (p <0,0001 para todos). Conclusões: Observamos que a implementação do ensaio Xpert MTB / RIF, em rotinas de programas de controle de TB, melhora e facilita o diagnóstico de tuberculose, especialmente nos casos com manifestações da doença atípica. Esses resultados podem provavelmente ser generalizados para locais com incidência de TB similar.
Introduction: The receptor for advanced glycation end products (RAGE) is expressed in normal lungs and is upregulated during inflammation and infection. The interaction between AGEs and RAGE on the plasma membrane causes oxidative stress and apoptosis in lung cells. The objective of this study is to evaluate plasma levels of AGEs and its soluble receptor (sRAGE) in patients with active TB and healthy controls, and to investigate their relationship with food intake and nutritional status. Methods: Case-control study. AGE (carboxymethil lysine, CML) and RAGE were measured by Elisa. Nutritional assessment was performed by body mass index, triceps skin-fold thickness, mid-arm circumference, mid-arm muscle circumference, bioelectrical impedance analysis, and food frequency questionnaire. Results: 35 TB patients and 35 controls were included in the study. The mean S-RAGE levels were higher in TB patients than in controls (68.5 ± 28.1 vs 57.5 ± 24.0, p=0.046). Among cases that were current smokers, lower S-RAGE levels were associated with mortality (S-RAGE levels= 58.0 ± 36.5 [non-survivors] vs 71.3 ± 25.6 [survivors], p=0.006), and with weight loss (S-RAGE levels= 65.6 ± 27.4 [weight loss] vs 98.6 ± 16.7 [no weight loss], p=0.034). There was no statistically significant difference in CML levels and diet CML content between cases and controls. Malnutrition was more frequent in cases than in controls, but there was no correlation between nutritional parameters and CML or S-RAGE levels. Conclusions: TB patients had higher S-RAGE levels than controls. S-RAGE may play a role in disease manifestations and outcomes, being associated with weight loss and mortality.

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Held, Michael. "Evaluation of diagnostic advances in musculoskeletal tuberculosis; the automated xpert MTB/RIF assay". Doctoral thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/20495.

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The aim of this thesis was to investigate the diagnostic accuracy of Xpert for musculoskeletal TB and for rifampicin resistance against a gold standard of culture or histology. Site of disease, HIV status, and age of patients, and accuracy in spinal compared to extraspinal TB were investigated as secondary objectives. The overarching hypothesis was that Xpert is more accurate and would provide results faster than the gold standard for musculoskeletal TB, and that it would have a higher yield in HIV infected patients, adult patients, and patients with spinal disease.

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Held, Michael. "Evaluation of diagnostic advances in Musculoskeletal Tuberculosis; the automated xpert MTB/RIF assay". Doctoral thesis, Faculty of Health Sciences, 2019. http://hdl.handle.net/11427/30373.

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Background Xpert MTB/RIF (Xpert) is a rapid, automated, onsite nucleic acid amplification test for tuberculosis (TB). It is effective for the diagnosis of pulmonary TB but there is limited evidence for its usefulness in extrapulmonary TB, particularly musculoskeletal TB. Aims and hypothesis The aim of this thesis was to investigate the diagnostic accuracy of Xpert for musculoskeletal TB and for rifampicin resistance against a gold standard of culture or histology. Site of disease, HIV status, and age of patients, and accuracy in spinal compared to extraspinal TB were investigated as secondary objectives. The overarching hypothesis was that Xpert is more accurate and would provide results faster than the gold standard for musculoskeletal TB, and that it would have a higher yield in HIV infected patients, adult patients, and patients with spinal disease. Methods Prospective studies of patients with suspected musculoskeletal TB, at the tertiary care hospitals Groote Schuur and Red Cross Children’s Hospital in Cape Town, South Africa, were undertaken from June 2013 to March 2015. The diagnostic accuracy of Xpert was compared to culture or histopathology. Findings 206 biopsies of 201 patients older than 13 years of age (23% HIV positive) were analysed. The sensitivity and specificity of Xpert was 92.3% and 99.1% respectively. Xpert detected 8 cases more than culture (p = 0.069) and positive results were available 17 days earlier (<0.001). The sensitivity of Xpert in HIV positive patients was 96.9% (31/32) versus 89.6% (43/48) in HIV negative patients (p=0.225). The sensitivity of Xpert for spinal biopsies was 93.8% (95% CI 86.0-97.9) with specificity of 97.6% (95% CI 87.4 – 99.9), compared to extraspinal biopsies with a sensitivity of 81.8% (95% CI 48.2 – 99.7, p=0.164) and specificity of 100% (95% CI 95.1 – 100%, p=0.186). 109 osteoarticular samples of children 12 years of age or younger, with a median age of 5.6 years (IQR 2.2 – 8.7) were analysed. Xpert provided a sensitivity of 73.9% (95% CI 51.6-89.8) with a specificity of 100% (95% CI 95.7 - 100) and was available at a mean of 0.8 days (0.46- 1.4) compared to 21 days (19 – 30) for culture (p< 0.001). All rifampicin resistant cases were correctly diagnosed. A trend towards higher sensitivity in spinal tissue as well as HIV infected patients was observed. This study also provides evidence that Xpert has a lower sensitivity in children than in adults, yet, still detects more cases of paediatric musculoskeletal TB and is faster than culture. Histology was a useful test for the diagnosis of musculoskeletal TB, especially in children, and should be used alongside Xpert to provide the highest yield possible to detect TB. Conclusion: These first large studies on the accuracy of Xpert for musculoskeletal TB provide evidence for the usefulness of Xpert in the diagnosis of spinal TB, extraspinal TB, in HIV positive patients, and in childhood musculoskeletal TB. Based on these results, Xpert should be recommended as the initial test for diagnosis as it is more sensitive and faster than the gold standard of liquid culture.

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Neto, Wilson Oliveira Ezequiel. "Associação dos achados radiológicos com o teste Xpert MTB/RIF em pacientes com suspeita de tuberculose pulmonar". reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2017. http://hdl.handle.net/10183/179752.

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Introdução: O tratamento da tuberculose (TB) geralmente é realizado de forma empírica, baseado nos achados clínicos e radiológicos. O raio-x (RX) do tórax tem boa sensibilidade, mas uma baixa especificidade para o diagnóstico de tuberculose. O Xpert MTB/RIF está sendo usado cada vez mais em diversos países como teste inicial para diagnóstico de TB.O objetivo deste estudo foi de avaliar a associação dos achados radiológicos com o teste Xpert MTB/RIF em pacientes com suspeita de TB pulmonar. Métodos: Estudo transversal com pacientes de um ambulatório de TB. Foram realizados testes de baciloscopia no escarro, Xpert MTB/RIF e RX de tórax em pacientes com suspeita de TB pulmonar. Resultados: Durante o período do estudo, 312 pacientes preencheram os critérios de inclusão e incluídos na análise. Dentre os pacientes com Xpert MTB/RIF positivo, os padrões radiológicos foram classificados como típico de TB, compatível com TB e normal em 78 (70,3%), 31 (27,9%) e 2 (1,8%) dos pacientes, respectivamente. Os RX de tórax foram considerados típico de TB, compatível com TB e normal em 20 (10,0%), 25 (12,4%) e 152 (75,6%) dos pacientes, respectivamente, em casos Xpert MTB/RIF negativos. Conclusões: Foi encontrada uma associação entre os padrões radiológicos e os resultados do Xpert MTB/RIF em pacientes com suspeita de tuberculose pulmonar. O RX de tórax ainda é uma ferramenta diagnóstica útil e sensível, mas o seu papel nos algoritmos diagnósticos em lugares onde o Xpert MTB/RIF está disponível requer uma discussão mais aprofundada.
Background: Tuberculosis (TB) treatment is often carried out empirically, based on clinical and radiological findings. Chest X-ray (CXR) has good sensitivity but poor specificity in TB diagnosis. Xpert MTB/RIF is increasingly used in many countries as the initial diagnostic test for TB. The aim of the present study was to evaluate the association of radiological findings with the Xpert MTB/RIF test in patients with suspected pulmonary TB. Methods: Cross-sectional study in an outpatient TB clinic. Sputum AFB smear, culture, Xpert MTB/RIF and CXR were collected in patients with suspected pulmonary TB. Results: During the study period, 312 patients met the inclusion criteria and were included in the analysis. Among Xpert MTB/RIF positive cases, the radiographic patterns were classified as typical of TB, compatible of TB, and normal in 78 (70.3%), 31 (27.9%), and 2 (1.8%) patients, respectively. CXRs were classified as typical of TB, compatible of TB, and normal in 20 (10.0%), 25 (12.4%), and 152 (75.6%) patients, respectively, in Xpert MTB/RIF negative cases. Conclusions: We found an association between radiographic patterns and Xpert MTB/RIF results in patients with suspected pulmonary TB. CXR is still a useful and sensitive diagnostic tool, but its place at the diagnostic algorithms in the context of Xpert MTB/RIF availability warrants further discussion.

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Lessells, R. J. "Impact of the Xpert MTB/RIF tuberculosis diagnostic system in individuals at high risk of mortality in rural South Africa". Thesis, London School of Hygiene and Tropical Medicine (University of London), 2015. http://researchonline.lshtm.ac.uk/2222113/.

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This thesis investigates the clinical impact of a point-of-care diagnostic strategy for pulmonary tuberculosis (TB) in a setting at the heart of the TB and human immunodeficiency virus (HIV) epidemics in rural KwaZulu-Natal, South Africa. Although the identification and prompt treatment of active pulmonary TB disease remains the cornerstone of global TB control strategies, weak diagnostic systems contribute to substantial delays and default during the diagnostic process. As new diagnostic technologies are developed, evidence is needed around how best to deliver them within health systems in order to maximize their impact. The impact of positioning of a molecular diagnostic system (Xpert MTB/RIF) was investigated in a cluster randomised trial. Clusters (two-week time periods) were randomised to one of two strategies: centralised laboratory Xpert MTB/RIF testing or point-of-care Xpert MTB/RIF at the clinic. The trial enrolled 1297 adults with symptoms of pulmonary TB who were HIV infected and/or at high risk of drugresistant TB. There was some evidence that point-of-care placement shortened the time to initiation of treatment but there was no difference in the overall proportion of culture-positive pulmonary TB cases initiated on appropriate anti-TB treatment within 30 days. Overall mortality was lower than anticipated and, although it was higher with the point-of-care strategy, this effect was not maintained after adjusting for the presence of TB disease and CD4+ T-cell count. Further analysis suggested that the point-of-care strategy increased the proportion of valid Xpert results from the initial sputum specimen, increased the proportion of individuals receiving test results and allowed same-day treatment initiation for half of all culture-positive cases that tested positive with Xpert. The diagnostic performance of the Xpert MTB/RIF system was comparable under both strategies. However, delays in initiation of treatment for drug-resistant TB cases and for Xpertnegative/ culture-positive cases occurred similarly with both strategies, reducing the potential to detect a real impact on outcomes. Although not a primary focus of the study, the results highlighted deficiencies in the performance of sputum culture, which raise questions about its place as the gold standard diagnostic test. The development of simple, rapid diagnostics suitable for point-of-care use remains important for TB control in high burden settings. The findings will improve understanding of the key requirements for successful diagnostic strategies and the lessons learnt will help to inform future diagnostic clinical trials. Further research is needed to evaluate how different diagnostic strategies might impact on TB transmission in health care facilities and more broadly in the community.

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Norin, Johanna. "A retrospective evaluation study of diagnostic accuracy of Xpert® MTB/RIF assay, used for detection of Mycobacterium tuberculosis in Greece". Thesis, Örebro universitet, Institutionen för hälsovetenskap och medicin, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-44978.

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Birungi, Francine Mwayuma. "An evaluation of Isoniazid prophylaxis treatment and the role of Xpert MTB/RIF test in improving the diagnosis and prevention of tuberculosis in children exposed to index cases with pulmonary tuberculosis in Kigali, Rwanda". University of the Western Cape, 2018. http://hdl.handle.net/11394/6880.

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Philosophiae Doctor - PhD
Background: Tuberculosis (TB) is a major cause of morbidity and mortality among children (<15 years) in resource-limited countries. The World Health Organization (WHO) identified active contact screening and isoniazid preventive therapy (IPT) as essential actions for detecting and preventing childhood TB. Despite their benefits and inclusion in the policy of most National TB Programme (NTP) guidelines of the resource-limited countries, there is still a wide gap between policy and implementation. The implementation of contact screening for active case finding might be improved by the decentralised use of the Xpert MTB/RIF test in gastric lavage (GL) specimens, but this has not been previously assessed. Furthermore, although the provision of IPT to eligible child contacts has been a focus for implementation by the NTP of Rwanda since 2005, implementation has not previously been evaluated. The assessment of IPT uptake and adherence as well as associated factors could be informative for the programme. Therefore, we aimed to assess the diagnostic yield of Xpert MTB/RIF in GL among child contacts with suspected pulmonary tuberculosis (PTB) and the uptake of and adherence to IPT by eligible child contacts to make recommendations towards strengthening TB diagnostic and prevention in children in Kigali, Rwanda. Methods: The proposed study setting Kigali, the capital city of Rwanda, was the location for 30% of the national PTB case notifications in 2013-14.A conceptual framework based on ecological theory was used in this study. Quantitative, qualitative and mixed (using both quantitative and qualitative research methods in one study) research methods were applied, and various research designs were used depending on the research questions. The study involved a cross-sectional analysis of the diagnostic yield of Xpert MTB/RIF in GL among all child contacts with suspected TB. Across-sectional and prospective cohort study design was used to assess the uptake and adherence of IPT among eligible child contacts.

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Mendonça, Tiago João Carvalho. "Xpert MTB/RIF®, um método diagnóstico rápido para a tuberculose?" Master's thesis, 2014. http://hdl.handle.net/10451/24488.

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Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014
Despite the availability of effective treatment, tuberculosis still accounts for millions of cases of active disease and deaths worldwide. Sub-Saharan Africa has the highest incidence of tuberculosis, where the deficient laboratory capacity remains a serious obstacle towards a rapid diagnosis and correct treatment of tuberculosis. One of the solutions proposed, to improve the diagnosis of tuberculosis, is the use of molecular techniques, like the Xpert MTB/RIF, that detect Mycobacterium tuberculosis and mutations associated with drug resistance. Xpert MTB/RIF is an automated self-contained platform that can be used with minimal technical skills and was endorsed by the World Health Organization in 2010. It is one of the most advanced new generation automated molecular diagnostics platforms available at the moment. My experience in Cape Verde, during the implementation of Xpert MTB/RIF motivated a review of available clinical data. Sputum analysis by the Xpert MTB/RIF is a rapid and highly sensitive (87% globally and 80% in patients co-infected by HIV) direct test. However, conventional drug susceptibility testing continues to be necessary in selected clinical cases. More data would be desirable to evaluate the real clinical impact of Xpert MTB/RIF.
Apesar da disponibilidade de tratamento eficaz, a tuberculose é responsável por milhões de casos de doença activa e mortes em todo o mundo. A incidência mais alta de tuberculose encontra-se na África subsariana onde a fraca capacidade laboratorial mantém-se como um sério impedimento ao diagnóstico e tratamento da tuberculose. Uma das soluções para melhorar o diagnóstico de tuberculose é o uso de técnicas moleculares rápidas, como o Xpert MTB/RIF, que detectam Mycobacterium tuberculosis e mutações associadas a resistências. O Xpert MTB/RIF é uma plataforma automática e auto contida que pode ser usada com habilidade técnica mínima, aprovada pela OMS em 2010, e neste momento é uma das ferramentas de diagnóstico da tuberculose da nova geração cujo desenvolvimento está mais avançado. A experiência vivida em Cabo Verde durante a implementação do Xpert MTB/RIF levou à revisão dos dados disponíveis. Confirmou-se: a análise da expectoração pelo Xpert MTB/RIF é um método directo rápido com alta sensibilidade para o diagnóstico de tuberculose pulmonar (87% global e 80% em doentes co-infectados por VIH); contudo não elimina a necessidade de realizar testes de susceptibilidade convencionais em casos seleccionados; são necessários mais estudos para avaliar o impacto clínico real do Xpert MTB/RIF.

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YU, FANG-LAN, e 余芳蘭. "The Feasibility of Screening Test for Mycobacterium Tuberculosis Using Xpert MTB/RIF". Thesis, 2018. http://ndltd.ncl.edu.tw/handle/c46535.

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碩士
元培醫事科技大學
醫務管理系碩士在職專班
106
Tuberculosis is a chronic infectious disease and it is still common in the world today, especially in untapped and developing countries. Tuberculosis has almost no obvious symptoms in the early stages and it is easily overlooked. Therefore, it is relatively important that TB can be correctly and quickly diagnosed. Mycobacterium tuberculosis is transmitted through the air. Therefore, in laboratory inspection operations, it is necessary to consider how to avoid the negative pressure setting by air spreading and the operator's safety protection. The flood prevention work of the public security in Taiwan is facing many challenges. The correct and rapid inspection of tuberculosis is really an important part. However, the lack of TB inspection hardware facilities and insufficient protective equipment, high risk of TB inspection, and low investment return rate have caused the general hospitals and inspectors' willingness to engage in tuberculosis-related tests to be low, so they are seeking high sensitivity and convenient operation procedures. The inspection method, after screening most of the negative samples, relatively reduces the manpower required for inspection, thereby addressing the high risk of tuberculosis testing and the low willingness of inspectors to engage in tuberculosis-related tests, and on the other hand, evaluating their cost-effectiveness. A total of 36,674 Mycobacterium tuberculosis tests were collected from a medical center from January 2016 to December 2016. The sensitivity, specificity, and PPV were calculated and calculated. The correlations were calculated, together with the timeliness of reports and labor costs. The results showed that although the smear could be reported within 24 hours but the sensitivity was < 50%, the sensitivity of Xpert MTB/RIF was up to 90%, which was reported in about 2 hours, while the RIF drug was tested for its PPV and NPV also reached more than 92%. Xpert MTB/RIF test reagents are simple, fast and have good sensitivity, correctness, and can overcome the space and technical requirements. It is feasible to apply screening, but it is expected that the price is high and sensitive. Improvements and diversification of drugs can be further breakthroughs.

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Ngabonziza, J. C. S., T. Decroo, P. Migambi, Y. M. Habimana, Duen A. Van, Conor J. Meehan, G. Torrea et al. "Prevalence and drivers of false-positive rifampicin-resistant Xpert MTB/RIF results: a prospective observational study in Rwanda". 2020. http://hdl.handle.net/10454/18533.

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Yes
Background: The Xpert MTB/RIF (Xpert) assay is used globally to rapidly diagnose tuberculosis and resistance to rifampicin. We investigated the frequency and predictors of false-positive findings of rifampicin resistance with Xpert. Methods: We did a prospective, observational study of individuals who were enrolled in a Rwandan nationwide diagnostic cohort study (DIAMA trial; NCT03303963). We included patients identified to have rifampicin resistance on initial Xpert testing. We did a repeat Xpert assay and used rpoB Sanger and deep sequencing alongside phenotypic drug susceptibility testing (pDST) to ascertain final rifampicin susceptibility status, with any (hetero)resistant result overriding. We used multivariable logistic regression to assess predictors of false rifampicin resistance on initial Xpert testing, adjusted for HIV status, tuberculosis treatment history, initial Xpert semi-quantitative bacillary load, and initial Xpert probe. Findings: Between May 4, 2017, and April 30, 2019, 175 people were identified with rifampicin resistance at initial Xpert testing, of whom 154 (88%) underwent repeat Xpert assay. 54 (35%) patients were confirmed as rifampicin resistant on repeat testing and 100 (65%) were not confirmed with resistance. After further testing and sequencing, 121 (79%) of 154 patients had a final confirmed status for rifampicin susceptibility. 57 (47%) of 121 patients were confirmed to have a false rifampicin resistance result and 64 (53%) had true rifampicin resistance. A high pretest probability of rifampicin resistance did not decrease the odds of false rifampicin resistance (adjusted odds ratio [aOR] 6·0, 95% CI 1·0–35·0, for new tuberculosis patients vs patients who needed retreatment). Ten (16%) of the 64 patients with true rifampicin resistance did not have confirmed rifampicin resistance on repeat Xpert testing, of whom four had heteroresistance. Of 63 patients with a very low bacillary load on Xpert testing, 54 (86%) were falsely diagnosed with rifampicin-resistant tuberculosis. Having a very low bacillary load on Xpert testing was strongly associated with false rifampicin resistance at the initial Xpert assay (aOR 63·6, 95% CI 9·9–410·4). Interpretation: The Xpert testing algorithm should include an assessment of bacillary load and retesting in case rifampicin resistance is detected on a paucibacillary sputum sample. Only when rifampicin resistance has been confirmed on repeat testing should multidrug-resistant tuberculosis treatment be started. When rifampicin resistance has not been confirmed on repeat testing, we propose that patients should be given first-line anti-tuberculosis drugs and monitored closely during treatment, including by baseline culture, pDST, and further Xpert testing.
The European & Developing Countries Clinical Trials Partnership 2 programme, and Belgian Directorate General for Development Cooperation.

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Livros sobre o assunto "Xpert MTB"

Comunicación rápida: Análisis moleculares como pruebas diagnósticas iniciales de la tuberculosis y la resistencia a la rifampicina. Organización Panamericana de la Salud, 2020. http://dx.doi.org/10.37774/9789275322383.

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Desde la aprobación por parte de la Organización Mundial de la Salud (OMS) de Xpert® MTB/RIF (Cepheid, Sunnyvale, EUA, en adelante denominado “Xpert MTB/RIF”) en el 2010, se ha generado un cúmulo considerable de evidencia sobre su uso como prueba diagnóstica inicial de la TB y la TB-RR. En los últimos meses también se han obtenido nuevos datos sobre el uso de Xpert® MTB/RIF Ultra (Cepheid, Sunnyvale, EUA, en adelante denominado “Xpert Ultra”) y sobre la última versión del sistema Truenat® MTB y MTB Plus (Molbio Diagnostics, Goa, India, en adelante denominado “Truenat”). La OMS encargó una revisión sistemática de todos los datos existentes en el 2019. Los resultados se evaluaron en la reunión del Grupo de Elaboración de Directrices (GDG) independiente, convocada por la OMS del 3 al 6 de diciembre del 2019. Las recomendaciones detalladas se publicarán en el 2020 en el marco de la actualización de las directrices consolidadas de la OMS sobre el diagnóstico de la TB. El objetivo de esta comunicación rápida es informar a los programas nacionales de tuberculosis y a otros interesados directos acerca de las principales implicaciones de la evidencia más reciente sobre el uso de análisis moleculares específicos como pruebas diagnósticas iniciales de la TB pulmonar y extrapulmonar y de la TB-RR, tanto en adultos como en niños. La actualización de las directrices consolidadas de la OMS del 2020 también incorporará las recomendaciones recientes de la OMS sobre otras pruebas rápidas como los ensayos con sondas en línea, los análisis de flujo lateral de lipoarabinomanano en orina y los análisis moleculares de amplificación isotérmica de ADN mediada por bucles. Versión oficial en español de la obra original en inglés: Molecular assays intended as initial tests for the diagnosis of pulmonary and extrapulmonary TB and rifampicin resistance in adults and children: rapid communication. Policy update. © World Health Organization 2020. ISBN: 978-92-4-000033-9.

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Trabalhos de conferências sobre o assunto "Xpert MTB"

Christopher, Devasahayam Jesudas, Deepa Shankar, Coelho Victor, Ebby Simon e Balamugesh Thangakunam. "Incremental Yield of Xpert MTB/RIF Ultra over Xpert MTB/RIF in the diagnosis of extra-pulmonary tuberculosis". In ERS International Congress 2020 abstracts. European Respiratory Society, 2020. http://dx.doi.org/10.1183/13993003.congress-2020.1554.

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T. V., Rajagopal, Barney Isaac, Devasahayam J. Christopher, Balamugesh Thangakunam, Richa Gupta e Prince James. "The yield of bronchoscopy in sputum Xpert MTB/Rif negative tuberculosis in the Xpert era". In ERS International Congress 2020 abstracts. European Respiratory Society, 2020. http://dx.doi.org/10.1183/13993003.congress-2020.534.

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Isaac, Barney, Devasahayam Christopher, Rajasekar Sekar e Balamugesh Thangakunam. "Is smear microscopy obsolete in the era of Xpert MTB/Rif?" In ERS International Congress 2020 abstracts. European Respiratory Society, 2020. http://dx.doi.org/10.1183/13993003.congress-2020.525.

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Taylor, Rebecca. "Tuberculosis diagnosis in rural Namibia using gene Xpert MTB/RIF testing". In ERS International Congress 2016 abstracts. European Respiratory Society, 2016. http://dx.doi.org/10.1183/13993003.congress-2016.pa2780.

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Lim, T. K., J. S. K. Ng e M. Y. Chew. "Clinical utility of the Xpert MTB/RIF test in induced sputum". In Annual Congress 2015. European Respiratory Society, 2015. http://dx.doi.org/10.1183/13993003.congress-2015.pa1527.

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Van Zyl-Smit, Richard N., Anke Binder, Richard Meldau, Hridesh Mishra, Patricia L. Semple, Grant Theron, Jonathan Peter et al. "Comparison Of Quantitative Techniques Including Xpert MTB/RIF To Evaluate Mycobacterial Burden". In American Thoracic Society 2012 International Conference, May 18-23, 2012 • San Francisco, California. American Thoracic Society, 2012. http://dx.doi.org/10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a4714.

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Chishty, Shazia, Joveria Farooqi, Yusra Shafqat, Samreen Shafiq, Kauser Jabeen e Rumina Hasan. "Performance of XPERT MTB/RIF assay from fluorescent acid fast stained slides". In ERS International Congress 2016 abstracts. European Respiratory Society, 2016. http://dx.doi.org/10.1183/13993003.congress-2016.pa2781.

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Mullerpattan, JB, RB Banka, A. Khillari, S. Ganatra, ZF Udwadia e C. Rodriques. "P11 How expert is the xpert mtb/rif for drug susceptible tuberculosis?" In British Thoracic Society Winter Meeting 2017, QEII Centre Broad Sanctuary Westminster London SW1P 3EE, 6 to 8 December 2017, Programme and Abstracts. BMJ Publishing Group Ltd and British Thoracic Society, 2017. http://dx.doi.org/10.1136/thoraxjnl-2017-210983.153.

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Shabbir, Urvah, Bilal Wajid e Sana Akhtar. "Comparison of Xpert MTB/RIF and GenoType MTBDRplus for rapid diagnosis of tuberculosis". In 2017 7th International Conference on Modeling, Simulation, and Applied Optimization (ICMSAO). IEEE, 2017. http://dx.doi.org/10.1109/icmsao.2017.7934909.

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Clemente, Marta G., Juan Jose Palacios, Ana Penedo, Macarena Alvarez, Z. Velasco, Ana Pando, Isabel Ferrero et al. "Accuracy Of The Xpert MTB/RIF Test For Rapid Diagnosis Of Extrapulmonary Tuberculosis". In American Thoracic Society 2012 International Conference, May 18-23, 2012 • San Francisco, California. American Thoracic Society, 2012. http://dx.doi.org/10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a4717.

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Relatórios de organizações sobre o assunto "Xpert MTB"

Shen, Yanqin, Guocan Yu, Wuchen Zhao e Yazhen Lang. Diagnostic accuracy of Xpert MTB/RIF Ultra for tuberculous meningitis: A protocol of systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, agosto de 2020. http://dx.doi.org/10.37766/inplasy2020.8.0045.

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Yu, Guocan, Yanqin Shen, Pengfei Zhu e Da Chen. Diagnostic accuracy of Xpert MTB/RIF Ultra for tuberculous pleurisy: A protocol of systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, agosto de 2020. http://dx.doi.org/10.37766/inplasy2020.8.0047.

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Yu, Guocan, Fangming Zhong, Yanqin Shen e Hong Zheng. Diagnostic accuracy of the Xpert MTB/RIF assay for tuberculous pericarditis: A protocol of systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, junho de 2020. http://dx.doi.org/10.37766/inplasy2020.6.0045.

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