Evidence map›Paper›PMID 31534789›Full record

ArticleSouthern African journal of HIV medicine2019

False rifampicin resistant results using Xpert MTB/RIF on urine samples in hospitalised HIV-infected patients.

Charlotte Schutz, Amy Ward, Rosie Burton, Mark P Nicol, Liz Blumenthal, Graeme Meintjes, Andrew D Kerkhoff

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Southern African journal of HIV medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
0.6field-weighted citation impact, top 33% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
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

7 authors at 2 institutions in 2 countries.

Charlotte SchutzWellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine (IDM) and Department of Medicine, University of Cape Town, Cape Town, South Africa.ORCID https://orcid.org/0000-0001-8329-6158
Amy WardWellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine (IDM) and Department of Medicine, University of Cape Town, Cape Town, South Africa.ORCID https://orcid.org/0000-0001-8430-0999
Rosie BurtonGF Jooste Hospital; Department of Medicine, University of Cape Town, Cape Town, South Africa.ORCID https://orcid.org/0000-0003-1217-8191
Mark P NicolDivision of Medical Microbiology, University of Cape Town and National Health Laboratory Services, Cape Town, South Africa.ORCID https://orcid.org/0000-0002-1366-4805
Liz BlumenthalWellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine (IDM) and Department of Medicine, University of Cape Town, Cape Town, South Africa.ORCID https://orcid.org/0000-0001-8452-6760
Graeme MeintjesWellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine (IDM) and Department of Medicine, University of Cape Town, Cape Town, South Africa.ORCID https://orcid.org/0000-0003-1196-4414
Andrew D KerkhoffDivision of HIV, Infectious Diseases and Global Medicine at Zuckerberg San Francisco General Hospital and Trauma Center, Department of Medicine, University of California, San Francisco, United States.ORCID https://orcid.org/0000-0002-5023-6658
University of Cape Town · ZAUniversity of California, San Francisco · US

Funding

Training in HIV Translational ResearchT32AI060530 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Diane V Havlir · 2005 to 2026
$6.4M
NIAID NIH HHS T32 AI060530
6 · The paper itself

Abstract

backgroundA small proportion of false rifampicin resistant results have previously been reported using GeneXpert MTB/RIF version G4 on sputum samples; however, this has not been investigated for urine samples in HIV-associated tuberculosis (TB).

objectivesWe sought to determine the proportion of false rifampicin resistant results using Xpert MTB/RIF version G4 on urine samples among HIV-infected inpatients investigated for TB.

methodsHospitalised HIV-infected patients undergoing systematic TB testing from two cohorts in Cape Town, South Africa, were enrolled. All patients with ≥1 urine Xpert result available were included. Rifampicin resistant urine Xpert results were classified into three mutually exclusive groups: (1) true rifampicin resistance, (2) false rifampicin resistance or (3) unknown after review of available microbiologic and clinical data.

resultsOverall, 1171 patients were included, from whom a total of 1704 urine Xpert results were available on unconcentrated and/or concentrated urine samples. There were 416 samples positive for TB (24.4% [95% CI 22.4-26.5]), of which 43/413 (10.4% [95% CI 7.6-13.8]) were rifampicin resistant (after excluding three results that were falsely positive due to contamination). Of 43 rifampicin resistant Xpert results (among 40 patients), 30 were classified as true resistance, 11 as false resistance and 2 could not be classified. Excluding unclassifiable results, 30/41 results were confirmed as true-positive urine Xpert rifampicin resistance (positive predictive value: 73.2% [95% CI 57.1-85.8]).

conclusionUrine Xpert testing showed a high proportion of false rifampicin resistance results. Urine Xpert rifampicin resistant results should be interpreted cautiously and confirmed when possible.

Indexed as

AIDSFalse resistanceHIVRifampicin resistanceTuberculosisXpert

Identifiers

PMID31534789
PMCPMC6739559
OpenAlexW2970017185

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.