ArticleThorax2013
Accuracy and impact of Xpert MTB/RIF for the diagnosis of smear-negative or sputum-scarce tuberculosis using bronchoalveolar lavage fluid.
Article in Thorax, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
45 citing papers in PubMed, 3 syntheses or guidelines pooled it, 104 citations in OpenAlex.
- Value of Xpert MTB/RIF Using Bronchoalveolar Lavage Fluid for the Diagnosis of Pulmonary Tuberculosis: a Systematic Review and Meta-analysis.Journal of clinical microbiology · 2021Pooled it
- Which sample type is better for Xpert MTB/RIF to diagnose adult and pediatric pulmonary tuberculosis?Bioscience reports · 2020Pooled it
- Xpert MTB/RIF and Xpert MTB/RIF Ultra for pulmonary tuberculosis and rifampicin resistance in adults.The Cochrane database of systematic reviews · 2019Pooled it
- Diagnosing tuberculosis in hospitalized HIV-infected individuals who cannot produce sputum: is urine lipoarabinomannan testing the answer?BMC infectious diseases · 2017Trial
- Development and evaluation of a multiplex PCR for simultaneous detection of Mycobacterium tuberculosis complex, Mycobacterium avium complex, and Burkholderia pseudomallei in clinical specimens.PLoS neglected tropical diseases · 2026Article
- Clinical Evaluation of a Tandem qPCR-CRISPR Assay for Multidrug-Resistant or Rifampicin-Resistant Tuberculosis: A Prospective Diagnostic Accuracy Study.Microorganisms · 2026Article
- Complementary effects of acid-fast staining, culture, and Xpert MTB/RIFBMC infectious diseases · 2026Article
- Bronchoalveolar Lavage in Immunocompetent Patients with Pneumonia: A Retrospective Cohort Study Shows No Survival Benefit.Journal of clinical medicine · 2025Article
- Xpert MTB/RIF Ultra performance on bronchial specimens in diagnosing pulmonary tuberculosis in Vancouver, Canada.Journal of medical microbiology · 2025Article
- Performance of Xpert MTB/RIF and acid-fast bacilli smear microscopy for the diagnosis of pulmonary tuberculosis using bronchoalveolar lavage samples in negative or sputum-scarce adults in Colombia: a retrospective diagnostic accuracy study.BMC infectious diseases · 2025Article
- Diagnostic Accuracy of BD MAX MDR-TB Assay Performed on Bronchoscopy Specimens in Patients with Suspected Pulmonary Tuberculosis.Tuberculosis and respiratory diseases · 2025Article
- Evaluating a Dual-Gene qPCR Melting Curve Assay for Rapid Detection of Tuberculosis in Suspected Pulmonary Cases.Infection and drug resistance · 2025Article
- Accuracy of Xpert® MTB/RIF Ultra test for posterior oropharyngeal saliva for the diagnosis of paucibacillary pulmonary tuberculosis: a prospective multicenter study.Emerging microbes & infections · 2023Article
- Utility of multimodal sampling and testing during advanced bronchoscopy for diagnosing atypical respiratory infections in aJournal of thoracic disease · 2023Article
- A cross-sectional study: a breathomics based pulmonary tuberculosis detection method.BMC infectious diseases · 2023Article
- The diagnostic performance of endobronchial ultrasound with Xpert MTB/RIF Ultra in smear-negative pulmonary tuberculosis.BMC infectious diseases · 2023Article
- The role of Xpert MTB/RIF using bronchoalveolar lavage fluid in active screening: insights from a tuberculosis outbreak in a junior school in eastern China.Frontiers in public health · 2023Article
- Biodiagnostics in an era of global pandemics-From biosensing materials to data management.View (Beijing, China) · 2022Review
- Dependence of Xpert MTB/RIF Accuracy for Detecting Rifampin Resistance in Bronchoalveolar Lavage Fluid on Bacterial Load: A Retrospective Study in Beijing, China.Infection and drug resistance · 2021Article
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13 authors at 3 institutions in 2 countries.
Funding
Abstract
rationaleThe accuracy and impact of new tuberculosis (TB) tests, such as Xpert MTB/RIF, when performed on bronchoalveolar lavage fluid (BALF) obtained from patients with sputum-scarce or smear-negative TB is unclear.
methodsSouth African patients with suspected pulmonary TB (n=160) who were sputum-scarce or smear-negative underwent bronchoscopy. MTB/RIF was performed on uncentrifuged BALF (1 ml) and/or a resuspended pellet of centrifuged BALF (∼10 ml). Time to TB detection and anti-TB treatment initiation were compared between phase one, when MTB/RIF was performed as a research tool, and phase two, when it was used for patient management.
results27 of 154 patients with complete data had culture-confirmed TB. Of these, a significantly lower proportion were detected by smear microscopy compared with MTB/RIF (58%, 95% CI 39% to 75% versus 93%, 77% to 98%; p<0.001). Of the 127 patients who were culture negative, 96% (91% to 98%) were MTB/RIF negative. When phase two was compared with phase one, MTB/RIF reduced the median days to TB detection (29 (18-41) to 0 (0-0); p<0.001). However, more patients initiated empirical therapy (absence of a positive test in those commencing treatment) in phase one versus phase two (79% (11/14) versus 28% (10/25); p=0.026). Consequently, there was no detectable difference in the overall proportion of patients initiating treatment (26% (17/67; 17% to 37%) versus 36% (26/73; 26% to 47%); p=0.196) or the days to treatment initiation (10 (1-49) versus 7 (0-21); p=0.330). BALF centrifugation, HIV coinfection and a second MTB/RIF did not result in detectable changes in accuracy.
conclusionsMTB/RIF detected TB cases more accurately and more rapidly than smear microscopy and significantly reduced the rate of empirical treatment.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.