ArticleBMC infectious diseases2020
Effect of the Xpert MTB/RIF on the detection of pulmonary tuberculosis cases and rifampicin resistance in Shanghai, China.
Article in BMC infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 33 citations in OpenAlex.
- Sputum-negative pulmonary tuberculosis in Shanghai, China: notification, clinical characteristics and outcomes.BMC infectious diseases · 2026Article
- Operationalization of rapid molecular test coverage for tuberculosis in different international contexts: a scoping review.Revista da Escola de Enfermagem da U S P · 2026Article
- Retrospective epidemiological analysis of pulmonary tuberculosis in the older adult and characterization of rifampicin resistance-associatedFrontiers in public health · 2025Article
- Impact of Xpert MTB/RIF implementation in tuberculosis case detection and control in Brazil: a nationwide intervention time-series analysis (2011-2022).Lancet regional health. Americas · 2024Article
- Comparison of microscopic and xpert MTB diagnoses of presumptive mycobacteria tuberculosis infection: retrospective analysis of routine diagnosis at Cape Coast Teaching Hospital.BMC infectious diseases · 2024Article
- New insight in molecular detection of Mycobacterium tuberculosis.AMB Express · 2024Review
- Incomplete tuberculosis reporting and registration to the surveillance system in southwestern China of Yunnan Province: an inventory survey.BMC public health · 2024Article
- Construction of ceRNA regulatory networks for active pulmonary tuberculosis.Scientific reports · 2024Article
- Assessing heterogeneity of patient and health system delay among TB in a population with internal migrants in China.Frontiers in public health · 2024Article
- Changing trend analysis on early detection of rifampicin resistant tuberculosis patients in southwestern area of China, 2016-2020.PloS one · 2023Article
- Construction and application of a heterogeneous quality control library for the Xpert MTB/RIF assay in tuberculosis diagnosis.Frontiers in cellular and infection microbiology · 2023Article
- Effect of mobile health reminders on tuberculosis treatment outcomes in Shanghai, China: A prospective cohort study.Frontiers in public health · 2023Article
- HIV-Negative Rifampicin Resistance/Multidrug-Resistant Extrapulmonary Tuberculosis in China from 2015 to 2019: A Clinical Retrospective Investigation Study from a National Tuberculosis Clinical Research Center.Infection and drug resistance · 2022Article
- Characteristics of rifampicin-resistant tuberculosis detection in China, 2015-2019.Infectious diseases of poverty · 2021Article
- Comparative Performance of Line Probe Assay (Version 2) and Xpert MTB/RIF Assay for Early Diagnosis of Rifampicin-Resistant Pulmonary Tuberculosis.Tuberculosis and respiratory diseases · 2021Article
- Operational research capacity building through the Structured Operational Research Training Initiative (SORT-IT) in China: implementation, outcomes and challenges.Infectious diseases of poverty · 2021Article
- Thin-Layer-Agar-Based Direct Phenotypic Drug Susceptibility Testing on Sputum in Eswatini Rapidly Detects Mycobacterium tuberculosis Growth and Rifampicin Resistance Otherwise Missed by WHO-Endorsed Diagnostic Tests.Antimicrobial agents and chemotherapy · 2021Article
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Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundXpert MTB/RIF (Xpert) is an automated molecular test recommended by World Health Organization (WHO) for diagnosis of tuberculosis (TB). This study evaluated the effect of Xpert implementation on the detection of pulmonary TB (PTB) and rifampicin-resistant TB (RR-TB) cases in Shanghai, China.
methodsXpert was routinely implemented in 2018 for all presumptive PTB patients. All PTB patients above 15 years-old identified within the Provincial TB Control Program during the first half of each of 2017 and 2018, were enrolled to compare the difference in proportions of bacteriological confirmation, patients with drug susceptibility test (DST) results for rifampicin (ie, DST coverage) and RR-TB detection before and after Xpert's implementation.
resultsA total of 6047 PTB patients were included in the analysis with 1691 tested by Xpert in 2018. Percentages of bacteriological confirmation, DST coverage and RR-TB detection in 2017 and 2018 were 50% vs. 59%, 36% vs. 49% and 2% vs. 3%, respectively (all p-values < 0.05). Among 1103 PTB patients who completed sputum smear, culture and Xpert testing in 2018, Xpert detected an additional 121 (11%) PTB patients who were negative by smear and culture, but missed 248 (23%) smear and/or culture positive patients. Besides, it accounted for an increase of 9% in DST coverage and 1% in RR-TB detection. The median time from first visit to a TB hospital to RR-TB detection was 62 days (interquartile range -IQR 48-84.2) in 2017 vs. 9 days (IQR 2-45.7) in 2018 (p-value < 0.001). In the multivariate model, using Xpert was associated with decreased time to RR-TB detection (adjusted hazard ratio = 4.62, 95% confidence interval: 3.18-6.71).
conclusionsIntegrating Xpert with smear, culture and culture-based DST in a routine setting significantly increased bacteriological confirmation, DST coverage and RR-TB detection with a dramatic reduction in the time to RR-TB diagnosis in Shanghai, China. Our findings can be useful for other regions that attempt to integrate Xpert into routine PTB and RR-TB case-finding cascade. Further study should focus on the identification and elimination of operational level challenges to fully utilize the benefit of rapid diagnosis by Xpert.
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