Performance of the Xpert MTB/RIF assay for the diagnosis of pulmonary tuberculosis and rifampin resistance in a low-incidence, high-resource setting
Publication Date
October 09, 2017
Authors
Jason P. Rice, Marva Seifert, Kathleen S. Moser & Timothy C. Rodwell
Volume
12
Issue
10
Pages
e0186139
DOI
https://dx.plos.org/10.1371/journal.pone.0186139
Publisher URL
http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0186139
Scopus
85031038055
Mendeley
http://www.mendeley.com/research/performance-xpert-mtbrif-assay-diagnosis-pulmonary-tuberculosis-rifampin-resistance-lowincidence-hig-2
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Mendeley | Further Information

{"title"=>"Performance of the Xpert MTB/RIF assay for the diagnosis of pulmonary tuberculosis and rifampin resistance in a low-incidence, high-resource setting", "type"=>"journal", "authors"=>[{"first_name"=>"Jason P.", "last_name"=>"Rice", "scopus_author_id"=>"57196022821"}, {"first_name"=>"Marva", "last_name"=>"Seifert", "scopus_author_id"=>"56573567500"}, {"first_name"=>"Kathleen S.", "last_name"=>"Moser", "scopus_author_id"=>"35496806000"}, {"first_name"=>"Timothy C.", "last_name"=>"Rodwell", "scopus_author_id"=>"6603200869"}], "year"=>2017, "source"=>"PLoS ONE", "identifiers"=>{"pui"=>"618656915", "pmid"=>"29016684", "doi"=>"10.1371/journal.pone.0186139", "issn"=>"19326203", "scopus"=>"2-s2.0-85031038055", "sgr"=>"85031038055", "isbn"=>"1932-6203"}, "id"=>"b5e4992b-4a00-323b-a051-695709ef0dbf", "abstract"=>"Performance of the Xpert MTB/RIF assay, designed to simultaneously detect Mycobacterium tuberculosis complex (MTBC) and rifampin (RIF) resistance, has been well documented in low-resource settings with high TB-incidence. However, few studies have assessed its accuracy in low TB incidence settings. We evaluated the performance of Xpert MTB/RIF using clinical sputum specimens routinely collected from suspect pulmonary TB patients over a 4-year time period in San Diego County, California. Xpert MTB/RIF results were compared to acid-fast bacilli (AFB) smear microscopy, mycobacterial culture, and phenotypic drug susceptibility testing (DST). Of 751 sputum specimens, 134 (17.8%) were MTBC culture-positive and 2 (1.5%) were multidrug-resistant (MDR). For the detection of MTBC, Xpert MTB/RIF sensitivity was 89.6% (97.7% and 74.5% in smear-positive and -negative sputa, respectively) and specificity was 97.2%; while AFB smear sensitivity and specificity were 64.9% and 77.8%, respectively. Xpert MTB/RIF detected 35 of 47 smear-negative culture-positive specimens, and excluded 124 of 137 smear-positive culture-negative specimens. Xpert MTB/RIF also correctly excluded 99.2% (121/122) of nontuberculous mycobacteria (NTM) specimens, including all 33 NTM false-positives by smear microscopy. For the detection of RIF resistance, Xpert MTB/RIF sensitivity and specificity were 100% and 98.3%, respectively. Our findings demonstrate that Xpert MTB/RIF is able to accurately detect MTBC and RIF resistance in routinely collected respiratory specimens in a low TB-incidence setting, with comparable performance to that achieved in high-incidence settings; and suggest that under these conditions the assay has particular utility in detecting smear-negative TB cases, excluding smear-positive patients without MTBC disease, and differentiating MTBC from NTM.", "link"=>"http://www.mendeley.com/research/performance-xpert-mtbrif-assay-diagnosis-pulmonary-tuberculosis-rifampin-resistance-lowincidence-hig-2", "reader_count"=>8, "reader_count_by_academic_status"=>{"Student > Doctoral Student"=>1, "Student > Master"=>5, "Student > Postgraduate"=>2}, "reader_count_by_user_role"=>{"Student > Doctoral Student"=>1, "Student > Master"=>5, "Student > Postgraduate"=>2}, "reader_count_by_subject_area"=>{"Nursing and Health Professions"=>1, "Medicine and Dentistry"=>4, "Physics and Astronomy"=>1, "Social Sciences"=>1, "Economics, Econometrics and Finance"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>4}, "Social Sciences"=>{"Social Sciences"=>1}, "Physics and Astronomy"=>{"Physics and Astronomy"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}}, "group_count"=>0}

Scopus | Further Information

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