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Diagnosing Pulmonary Tuberculosis with the Xpert MTB/RIF Test
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Diagnosing Pulmonary Tuberculosis with the Xpert MTB/RIF Test

Published on: April 9, 2012

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Detection of pulmonary tuberculosis in children using the Xpert MTB/RIF Ultra assay on sputum: a multicenter study

Xiaoshan Peng1,2, Qiong Liao1,2, Min Fang3

  • 1Department of Pediatrics Infectious Diseases, West China Second Hospital, Sichuan University, No.20, 3Rd Section of Renmin South Road, Chengdu, 610041, China.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|November 4, 2021
PubMed

Insights

Accurate diagnosis of childhood tuberculosis is challenging. The Xpert MTB/RIF Ultra assay shows improved sensitivity for detecting pediatric pulmonary tuberculosis compared to the standard Xpert MTB/RIF test.

Area of Science:

  • Pediatric Infectious Diseases
  • Microbiology
  • Respiratory Medicine

Background:

  • Microbiological confirmation of active tuberculosis in children is often difficult.
  • Accurate diagnostic tools are crucial for timely and effective treatment of pediatric pulmonary tuberculosis.
  • The World Health Organization recommends the Xpert MTB/RIF Ultra assay for childhood tuberculosis diagnosis in high-burden settings.

Purpose of the Study:

  • To evaluate the diagnostic utility of the Xpert MTB/RIF Ultra assay for pulmonary tuberculosis in children.
  • To compare the performance of Xpert MTB/RIF Ultra with the standard Xpert MTB/RIF assay and MTB culture.

Main Methods:

  • A multicenter study enrolled children with symptoms suggestive of tuberculosis in China.
  • Sputum samples were tested using Xpert MTB/RIF Ultra, Xpert MTB/RIF, and Mycobacterium tuberculosis (MTB) culture.
  • Sensitivity and specificity of the Ultra assay were calculated, and performance was compared against MTB culture and the Xpert assay.

Main Results:

  • The Xpert MTB/RIF Ultra assay demonstrated a sensitivity of 42.1% and specificity of 99.0% for active pulmonary tuberculosis in children.
  • Ultra sensitivity was significantly higher in culture-positive cases (68.4%) compared to culture-negative cases (28.9%).
  • The Ultra assay showed higher sensitivity (41.4%) than the standard Xpert assay (24.1%) in a direct comparison.

Conclusions:

  • The Xpert MTB/RIF Ultra assay offers improved diagnostic performance for pediatric pulmonary tuberculosis compared to the standard Xpert assay.
  • Implementing the Xpert MTB/RIF Ultra assay can lead to higher confirmation rates for childhood tuberculosis.
  • Further research may explore optimizing its use in combination with MTB culture for enhanced detection.

Keywords:
Childhood tuberculosisDiagnosisSputumXpert MTB/RIF Ultra

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