Evidence map›Paper›PMID 25014250›Full record

ArticleScientific reports2014

Determinants of PCR performance (Xpert MTB/RIF), including bacterial load and inhibition, for TB diagnosis using specimens from different body compartments.

Grant Theron, Jonny Peter, Greg Calligaro, Richard Meldau, Colleen Hanrahan, Hoosain Khalfey, Brian Matinyenya, Tapuwa Muchinga, Liezel Smith, Shaheen Pandie and 4 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Scientific reports, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03356925 (Feasibility, Accuracy, and Effect of Point-of-care Xpert MTB/RIF Ultra and Xpert MTB/RIF Ultra Testing in Patients Suspected of Having TB), which is not on this map. Cited by 70 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
70citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

NCT03356925 nacompletednot on this mapstarted 2018, after this paper: background citation

Feasibility, Accuracy, and Effect of Point-of-care Xpert MTB/RIF Ultra and Xpert MTB/RIF Ultra Testing in Patients Suspected of Having TB: a Randomised Controlled Trial

TypeinterventionalSponsorUniversity of StellenboschRan2018 to 2022Enrolled1,549ConditionsTuberculosisArmsXpert Ultra Point of Care testing
3 · Its place in the literature

Who cites it

70 citing papers in PubMed, 9 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. XpertThe Cochrane database of systematic reviews · 2018
    Pooled it
  8. Pooled it
  9. Pooled it
  10. Article
  11. Clinical management of XpertBMC infectious diseases · 2026
    Observational
  12. Development of a Rapid Automated Point-of-Care Test formedRxiv : the preprint server for health sciences · 2026
    Article
  13. Review
  14. Purulent pericarditis caused byFrontiers in cardiovascular medicine · 2025
    Article
  15. Review
  16. Quantum Dot-Based Nanosensors for In Vitro Detection ofNanomaterials (Basel, Switzerland) · 2024
    Review
  17. The tuberculous pleural effusion.Breathe (Sheffield, England) · 2023
    Review
  18. Article
  19. Article
  20. Article

10 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Grant TheronLung Infection and Immunity Unit, Division of Pulmonology & UCT Lung Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Jonny PeterLung Infection and Immunity Unit, Division of Pulmonology & UCT Lung Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Greg CalligaroLung Infection and Immunity Unit, Division of Pulmonology & UCT Lung Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Richard MeldauLung Infection and Immunity Unit, Division of Pulmonology & UCT Lung Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Colleen HanrahanJohns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD, USA.
Hoosain KhalfeyLung Infection and Immunity Unit, Division of Pulmonology & UCT Lung Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Brian MatinyenyaLung Infection and Immunity Unit, Division of Pulmonology & UCT Lung Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Tapuwa MuchingaLung Infection and Immunity Unit, Division of Pulmonology & UCT Lung Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Liezel SmithLung Infection and Immunity Unit, Division of Pulmonology & UCT Lung Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Shaheen PandieDivision of Cardiology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, South Africa.
Laura LendersLung Infection and Immunity Unit, Division of Pulmonology & UCT Lung Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Vinod PatelDepartment of Neurology, University of KwaZulu Natal, South Africa.
Bongani M MayosiDivision of Cardiology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, South Africa.
Keertan Dheda1] Lung Infection and Immunity Unit, Division of Pulmonology & UCT Lung Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa [2] Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The determinants of Xpert MTB/RIF sensitivity, a widely used PCR test for the diagnosis of tuberculosis (TB) are poorly understood. We compared culture time-to-positivity (TTP; a surrogate of bacterial load), MTB/RIF TB-specific and internal positive control (IPC)-specific C(T) values, and clinical characteristics in patients with suspected TB who provided expectorated (n = 438) or induced sputum (n = 128), tracheal aspirates (n = 71), bronchoalveolar lavage fluid (n = 152), pleural fluid (n = 76), cerebral spinal fluid (CSF; n = 152), pericardial fluid (n = 131), or urine (n = 173) specimens. Median bacterial load (TTP in days) was the strongest associate of MTB/RIF positivity in each fluid. TTP correlated with C(T) values in pulmonary specimens but not extrapulmonary specimens (Spearman's coefficient 0.5043 versus 0.1437; p = 0.030). Inhibition affected a greater proportion of pulmonary specimens than extrapulmonary specimens (IPC C(T) > 34: 6% (47/731) versus 1% (4/381; p < 0.0001). Pulmonary specimens had greater load than extrapulmonary specimens [TTPs (interquartile range) of 11 (7-16) versus 22 (18-33.5) days; p < 0.0001]. HIV-infection was associated with a decreased likelihood of MTB/RIF-positivity in pulmonary specimens but an increased likelihood in extrapulmonary specimens. Mycobacterial load, which displays significant variation across different body compartments, is the main determinant of MTB/RIF-positivity rather than PCR inhibition. MTB/RIF C(T) is a poor surrogate of load in extrapulmonary specimens.

Indexed as

AdultAgedAntibiotics, AntitubercularBacterial LoadBronchoalveolar Lavage FluidDrug Resistance, BacterialFemaleHIV InfectionsHumansLungMaleMiddle AgedMycobacterium tuberculosisPredictive Value of TestsPrevalenceReal-Time Polymerase Chain ReactionAntibiotics, Antitubercular

Identifiers

PMID25014250
PMCPMC5375978

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Registered trials

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.