ArticlePloS one2014
Evaluation of Cepheid's Xpert MTB/Rif test on pleural fluid in the diagnosis of pleural tuberculosis in a high prevalence HIV/TB setting.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 7 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 7 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Efficacy of Xpert in tuberculosis diagnosis based on various specimens: a systematic review and meta-analysis.Frontiers in cellular and infection microbiology · 2023Pooled it
- Accuracy of Xpert MTB/RIF assay for the diagnosis of tuberculous pleural effusion.Journal of clinical laboratory analysis · 2022Pooled it
- Pooled it
- Xpert MTB/RIF Ultra and Xpert MTB/RIF assays for extrapulmonary tuberculosis and rifampicin resistance in adults.The Cochrane database of systematic reviews · 2021Pooled it
- XpertThe Cochrane database of systematic reviews · 2018Pooled it
- Is Xpert MTB/RIF appropriate for diagnosing tuberculous pleurisy with pleural fluid samples? A systematic review.BMC infectious diseases · 2018Pooled it
- Diagnostic Performance of Xpert MTB/RIF in Tuberculous Pleural Effusion: Systematic Review and Meta-analysis.Journal of clinical microbiology · 2016Pooled it
- Application of Venn's diagram in the diagnosis of pleural tuberculosis using IFN-γ, IP-10 and adenosine deaminase.PloS one · 2018Trial
- A proof of concept study on the diagnostic utility of in vivo expressed mycobacterial transcripts in tuberculous pleuritis.Scientific reports · 2026Article
- Diagnostic accuracy and microbial profiles of tuberculous pleurisy: a comparative study of metagenomic next generation sequencing and GeneXpertFrontiers in cellular and infection microbiology · 2023Article
- Bayesian latent class analysis produced diagnostic accuracy estimates that were more interpretable than composite reference standards for extrapulmonary tuberculosis tests.Diagnostic and prognostic research · 2022Article
- Diagnostic value of Xpert MTB/RIF assay on pleural tissue obtained via closed pleural biopsy among persons with presumptive tuberculous pleuritis.African journal of thoracic and critical care medicine · 2021Article
- Diagnostic accuracy of GeneXpert MTB/RIF assay for detection of tubercular pleural effusion.PloS one · 2021Article
- Article
- An improved algorithm for rapid diagnosis of pleural tuberculosis from pleural effusion by combined testing with GeneXpert MTB/RIF and an anti-LAM antibody-based assay.BMC infectious diseases · 2019Article
- Increased Diagnostic Yield of Tuberculous Serositis by Using Serous Fluid Drainage Flocky Precipitate (SFDFP) as a Testing Sample.Scientific reports · 2019Article
- Evaluation of the Xpert MTB/RIF Ultra Assay for Direct Detection of Mycobacterium tuberculosis Complex in Smear-Negative Extrapulmonary Samples.Journal of clinical microbiology · 2018Article
- Reduction in extrapulmonary tuberculosis in context of antiretroviral therapy scale-up in rural South Africa.Epidemiology and infection · 2017Article
- Tuberculosis in Infants and Children.Microbiology spectrum · 2017Review
- Diagnosis of opportunistic infections: HIV co-infections - tuberculosis.Current opinion in HIV and AIDS · 2017Review
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundDiagnosis of pleural tuberculosis (TB) using routinely available diagnostic methods is challenging due to the paucibacillary nature of the disease. Histopathology and pleural tissue TB culture involves an invasive procedure which requires expertise and appropriate equipment, both often unavailable in many health units. Xpert MTB/Rif test has been widely evaluated in sputum specimens but data on its performance in pleural TB is scarce. We evaluated the accuracy of Cepheid's Xpert MTB/Rif test on pleural fluid in the diagnosis of pleural TB in Uganda.
methodsConsenting adult patients with exudative pleural effusions underwent pleural biopsy and the tissue obtained subjected to Lowenstein-Jensen and mycobacterial growth indicator tube MTB cultures and histopathology. Pleural fluid for Xpert MTB/Rif testing was also collected. Data on socio-demographic characteristics, clinical symptoms, HIV status and CD4 count were also collected. Sensitivity, specificity, positive and negative predictive values of Xpert MTB/Rif test on pleural fluid in pleural TB diagnosis were calculated using pleural tissue MTB culture and/or histopathology as the reference standard.
resultsOf the 116 participants [female 50%, mean age 34 (SD ±13], 87/116 (75%) had pleural TB confirmed on pleural tissue culture and/or histopathology. The Xpert MTB/Rif test identified 25 (28.7%) of the 87 confirmed pleural TB cases. The sensitivity and specificity of Xpert MTB/Rif test were 28.7% and 96.6% respectively while the positive and negative predictive values were 96.1% and 31.1% respectively.
conclusionXpert MTB/Rif test on pleural fluid does not accurately diagnose pleural TB and therefore cannot be used as an initial evaluation test in patients with suspected pleural TB. New, rapid and accurate tests for the diagnosis of pleural TB are still warranted.
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