Evaluation of direct detection of Mycobacterium tuberculosis complex in respiratory and non-respiratory clinical specimens using the Cepheid Gene Xpert® system
Abstract
OBJECTIVE: To compare the sensitivity and specificity of Cepheid Gene Xpert®, MTB/RIF assay for direct detection of Mycobacterium tuberculosis complex (MTBC) and rifampin (RIF) resistance with conventional methods in respiratory and non-respiratory clinical specimens. METHODS: We used a cross sectional design to evaluate a diagnostic test at the TB Section of the Division of Microbiology, Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia from October 2011 to January 2012. The detection of MTBC and RIF resistance using the Xpert® MTB/RIF assay was assessed in 239 (172 respiratory, and 67 non respiratory) specimens received from 234 patients suspected of TB, and compared with conventional smear microscopy and culture methods. RESULTS: Out of the 239 specimens investigated, 62 (25.9%) were MTBC positive by culture, while 59 (24.6%) were positive by Xpert® assay. Three samples showed false negative Xpert® results. Compared with the culture, the Xpert® assay achieved 95.4% (95% CI: 89-100%) sensitivity, and 100% (95% CI: 93.6-100%) specificity for respiratory samples, while the sensitivity for non-respiratory specimens was 94.4% (95% CI: 90.2-98.5), and the specificity for non-respiratory specimens was 100% (95% CI: 95.8-100%). Overall, a 95.2% (95% CI: 87.6-100) sensitivity, and 100% (95% CI: 92.4-100%) specificity, was observed for the Xpert® MTB/RIF assay compared with conventional methods for MTBC detection. CONCLUSION: The gene Xpert® MTB/RIF assay is a helpful tool for the detection of MTBC and RIF resistance in respiratory and non-respiratory clinical samples with a high sensitivity and specificity within 2 hours as compared with conventional methods, which took a much longer time.
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Mycobacteriological culture and drug susceptibility testing are not always available in resource poor settings like Ethiopia.
“Mycobacteriological culture and drug susceptibility testing are not always available in resource poor settings like Ethiopia [1,9].”
From GeneXpert MTB/RIF Assay for the Diagnosis of Tuberculous Lymphadenitis on Concentrated Fine Needle Aspirates in High Tuberculosis Burden Settings (2015) · cites this paper as [9]
Xpert has a higher sensitivity than smear microscopy.
“In agreement with other studies [9,18,22], Xpert has a higher sensitivity than smear microscopy.”
From GeneXpert MTB/RIF Assay for the Diagnosis of Tuberculous Lymphadenitis on Concentrated Fine Needle Aspirates in High Tuberculosis Burden Settings (2015) · cites this paper as [9]
13 studies (839 samples; 10 with >10 samples, 159 culture positive) evaluated Xpert in CSF against culture.
“13 studies (839 samples; 10 with .10samples, 159 culture positive) evaluated Xpert in CSF against culture [14-16, 19, 20, 22-25, 27-29, 31].”
From Xpert MTB/RIF assay for the diagnosis of extrapulmonary tuberculosis: a systematic review and meta-analysis (2014) · cites this paper as [14]
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- Authors
- Al-Ateah, S. M., Al-Dowaidi, M. M., & El-Khizzi, N. A.
- Affiliations
- Division of Microbiology, TB Section, Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, PO Box 7897 (V898), Riyadh 11159, Kingdom of Saudi Arabia. Tel. +966 (1) 4777714. Ext. 24455. Fax. +966 (1) 4783033. E-mail: suaad.6{at}hotmail.com; satayah{at}rmh.med.sa
- Riyadh Armed Forces Hospital (SA)
- Venue
- Saudi Medical Journal
- Publisher
- Armed Forces Medical Services
- Published
- 2012-10-01
- Volume
- 33
- Issue
- 10
- Pages
- 1100-1105
- ISSN
- 0379-5284 (ISSN-L)
- 1658-3175
- OpenAlex
- W2115312376
- Cited by
- 47
- References
- 18
- Citations by year
- 2026: 1 · 2022: 1 · 2021: 3 · 2020: 4 · 2019: 4 · 2018: 4 · 2017: 8 · 2016: 5 · 2015: 6 · 2014: 9 · 2013: 2
- FWCI
- 3.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Saudi Medical Journal (publishedVersion)
- PubMed (publishedVersion)
- PubMed
- Topics
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Health Sciences › Medicine › Epidemiology › Mycobacterium research and diagnosis
- Health Sciences › Medicine › Surgery › Infectious Diseases and Tuberculosis
- Keywords
- Mycobacterium tuberculosis complex, Xpert MTB/RIF, rifampicin resistance, tuberculosis diagnosis, sensitivity and specificity, smear microscopy, mycobacterial culture, rapid molecular detection
- MeSH terms
- Abscess, Body Fluids, Cerebrospinal Fluid, Culture Media, Female, Genes, Bacterial, Humans, Male, Mycobacterium tuberculosis, Respiratory Tract Infections, Polymerase Chain Reaction
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