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Performance evaluation of the Xpert MTB/RIF assay according to its clinical application

Overview of attention for article published in BMC Infectious Diseases, November 2014
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Title
Performance evaluation of the Xpert MTB/RIF assay according to its clinical application
Published in
BMC Infectious Diseases, November 2014
DOI 10.1186/s12879-014-0589-x
Pubmed ID
Authors

Hee Jae Huh, Byeong-Ho Jeong, Kyeongman Jeon, Won-Jung Koh, Chang-Seok Ki, Nam Yong Lee

Abstract

BackgroundThe Xpert MTB/RIF assay (Xpert assay; Cepheid, Sunnyvale, CA) is becoming the test of choice for the rapid diagnosis of tuberculosis and rifampin (RIF) resistance. The aim of this study was to evaluate the performance of the Xpert assay with respect to its clinical application at a tertiary care hospital in Korea, a country with an intermediate tuberculosis burden and high-resource.MethodsA total of 303 Xpert assay results from 109 smear-positive and 194 smear-negative respiratory specimens were retrospectively reviewed. Based on patients¿ medical records, four categories of clinical applications of the Xpert assay were identified: (1) the diagnosis of pulmonary tuberculosis in patients with a high probability of pulmonary tuberculosis according to their clinical and radiological features; (2) the exclusion of tuberculosis in clinically indeterminate patients for pulmonary tuberculosis; (3) the differentiation of Mycobacterium tuberculsosis (MTB) from nontuberculous mycobacteria in a smear-positive specimen; and (4) the diagnosis of RIF resistance. Standard culture and drug susceptibility tests were used as reference methods.ResultsThe sensitivity of the Xpert assay for MTB detection in category 1 was 89.8% (95% confidence interval [CI], 78.5-95.8%), but 66.7% (95% CI, 12.5-98.2%) in category 2. The positive predictive values ranged from 33.3% (95% CI, 6.0-75.9%) in category 2 to 91.3% and 91.7% in categories 1 and 3, respectively. The negative predictive values were over 90% in all categories. The Xpert assay correctly detected RIF resistance in six of the seven (85.7%) isolates tested.ConclusionsThe Xpert assay exhibited variable performance according to its clinical application; this finding cautions that careful interpretation for the results of this assay would be needed according to its intended purpose.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 39 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 39 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 6 15%
Student > Master 6 15%
Student > Bachelor 5 13%
Student > Ph. D. Student 5 13%
Student > Postgraduate 3 8%
Other 7 18%
Unknown 7 18%
Readers by discipline Count As %
Medicine and Dentistry 19 49%
Immunology and Microbiology 4 10%
Biochemistry, Genetics and Molecular Biology 2 5%
Nursing and Health Professions 1 3%
Agricultural and Biological Sciences 1 3%
Other 2 5%
Unknown 10 26%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 October 2015.
All research outputs
#18,383,471
of 22,770,070 outputs
Outputs from BMC Infectious Diseases
#5,592
of 7,668 outputs
Outputs of similar age
#184,762
of 258,049 outputs
Outputs of similar age from BMC Infectious Diseases
#124
of 186 outputs
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