Journal
EXPERT REVIEW OF ANTI-INFECTIVE THERAPY
Volume 10, Issue 6, Pages 631-635Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1586/ERI.12.43
Keywords
diagnosis; extrapulmonary; nucleic acid amplification test; tuberculosis; Xpert (R)
Funding
- Wellcome Trust, London, UK
- EuropeAID, Belgium
- European and Developing Countries Clinical Trials Partnership (EDCTP), The Netherlands
- UK MRC
- UBS Optimus Foundation, Switzerland
- University College London Hospitals Comprehensive Biomedical Research Centre (UCLH-CBRC)
- UCL Hospitals NHS Foundation Trust
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The Xpert (R) MTB/RIF assay has been CE-marked for rapid molecular diagnosis of TB in Europe and has been endorsed by the WHO as a replacement for sputum smear microscopy for diagnosis of pulmonary TB in low-and middle-income countries. However, few data are available to inform recommendations for use of the assay for testing nonsputum clinical samples when investigating suspected extrapulmonary TB (EPTB). We review and discuss the findings of Tortoli and colleagues, who evaluated the assay used for this purpose in a large study of adults and children in Italy. They provide a per-sample analysis of 268 diagnoses of EPTB at a range of anatomic sites (sensitivity: 81.3%; 95% CI: 76.2-85.8) and data for 1206 samples in which EPTB was excluded (specificity: 99.8%; 95% CI: 99.4-100). We discuss how this paper forms an important addition to the growing body of literature demonstrating the utility of Xpert MTB/RIF for EPTB diagnosis when applied to diverse types of clinical samples.
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