Low diagnostic accuracy of Xpert MTB/RIF assay for extrapulmonary tuberculosis: A multicenter surveillance

Diagnostic accuracy of Xpert MTB/RIF assay for pulmonary tuberculosis (PTB) and extrapulmonary TB (EPTB) has not been investigated in Iran. This study was aimed to assess the diagnostic accuracy of Xpert MTB/RIF assay for both PTB and EPTB. A total of 2111 clinical samples (1218 pulmonary and 838 ex...

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Published in:	Scientific reports Vol. 9; no. 1; pp. 18515 - 6
Main Authors:	Allahyartorkaman, Mohammadreza, Mirsaeidi, Mehdi, Hamzehloo, Gholamreza, Amini, Sirus, Zakiloo, Mona, Nasiri, Mohammad Javad
Format:	Journal Article
Language:	English
Published:	London Nature Publishing Group UK 06-12-2019 Nature Publishing Group
Subjects:	45/23 631/326/2521 692/699/255/1856 Accuracy Antibiotics, Antitubercular - therapeutic use Cross-Sectional Studies Diagnosis Drug Resistance, Bacterial Humanities and Social Sciences Humans Iran - epidemiology Molecular Diagnostic Techniques - methods multidisciplinary Mycobacterium tuberculosis Predictive Value of Tests Reproducibility of Results Rifampin - therapeutic use Science Sensitivity and Specificity Sputum - microbiology Tuberculosis Tuberculosis - diagnosis Tuberculosis, Pulmonary - diagnosis Iran
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Summary:	Diagnostic accuracy of Xpert MTB/RIF assay for pulmonary tuberculosis (PTB) and extrapulmonary TB (EPTB) has not been investigated in Iran. This study was aimed to assess the diagnostic accuracy of Xpert MTB/RIF assay for both PTB and EPTB. A total of 2111 clinical samples (1218 pulmonary and 838 extra-pulmonary) were collected from 16 medical centers during the study period and were analyzed for detection of PTB and EPTB by both Xpert MTB/RIF assay and standard conventional methods (culture and direct smear microscopy). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of Xpert MTB/RIF assay for PTB were found to be 95.5%, 96.7%, 83.8%, and 99.1% respectively. For EPTB, the sensitivity, specificity, PPV and NPV of Xpert MTB/RIF assay counted for 76.5%, 95.9%, 62%, and 97.9% respectively. Xpert MTB/RIF assay found to be highly sensitive, specific and comparable to standard conventional methods for the diagnosis of PTB. However, the sensitivity and specificity of Xpert MTB/RIF for EPTB specimens were highly variable; thus, Xpert MTB/RIF cannot be recommended to replace standard conventional tests for diagnosis of EPTB.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2045-2322 2045-2322
DOI:	10.1038/s41598-019-55112-y