ArticleThe Lancet. Microbe2024
Xpert MTB/RIF Ultra versus mycobacterial growth indicator tube liquid culture for detection of Mycobacterium tuberculosis in symptomatic adults: a diagnostic accuracy study.
Article in The Lancet. Microbe, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 16 citations in OpenAlex.
- Xpert MTB/RIF assay as an initial diagnostic test in pulmonary tuberculosis: a multicenter prospective randomized pragmatic trial.Scientific reports · 2026Trial
- Diagnostic accuracy of GeneReady MTB assay on sputum for detecting pulmonary tuberculosis: a prospective multicenter study in China.Journal of clinical microbiology · 2026Article
- A cartridge-based assay for improved detection of multidrug-resistantJournal of clinical microbiology · 2026Article
- Complementary effects of acid-fast staining, culture, and Xpert MTB/RIFBMC infectious diseases · 2026Article
- Case Report: delayed recognition of pulmonary tuberculosis during immunosuppression for suspected connective tissue disease.Frontiers in medicine · 2026Article
- Plasma exosomal miR-122-5p_R-1, miR-23b-3p_R + 1, and miR-15a-5p_R-1 are associated with multidrug-resistant tuberculosis.BMC infectious diseases · 2025Article
- Electro-impedimetric detection of human anti-mycolate antibody biomarkers of TB before, during, and after treatment.Biomarkers in medicine · 2025Observational
- Prominence of Mycobacterium tuberculosis biomarkers among sputum culture-negative clinic attendees, independent of Ultra status.Journal of infection and public health · 2025Article
- Advances on Electrochemiluminescent Biosensors for TB Biomarkers.ACS sensors · 2025Review
- Persistently high TB prevalence in Nairobi County neighbourhoods, 2015-2022.PLOS global public health · 2025Article
- Recent progress in tuberculosis diagnosis: insights into blood-based biomarkers and emerging technologies.Frontiers in cellular and infection microbiology · 2025Review
- Drug resistance in drug-resistant tuberculosis patients with and without diabetes mellitus: a comparative analysis.BMC infectious diseases · 2024Article
- Evaluating Tuberculosis Screening Tools: A Decade-Long Network Meta-Analysis of Sensitivity and Specificity with Bibliometric Insights.Journal of global infectious diseasesArticle
Corrections and comments
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Authors and funding
25 authors at 14 institutions in 9 countries.
Funding
Abstract
backgroundXpert MTB/RIF Ultra (Ultra) is an automated molecular test for the detection of Mycobacterium tuberculosis in sputum. We compared the sensitivity of Ultra to that of mycobacterial growth indicator tube (MGIT) liquid culture, considered the most sensitive assay in routine clinical use.
methodsIn this prospective, multicentre, cross-sectional diagnostic accuracy study, we used a non-inferiority design to assess whether the sensitivity of a single Ultra test was non-inferior to that of a single liquid culture for detection of M tuberculosis in sputum. We enrolled adults (age ≥18 years) with pulmonary tuberculosis symptoms in 11 countries and each adult provided three sputum specimens with a minimum volume of 2 mL over 2 days. Ultra was done directly on sputum 1, and Ultra and MGIT liquid culture were done on resuspended pellet from sputum 2. Results of MGIT and solid media cultures done on sputum 3 were considered the reference standard. The pre-defined non-inferiority margin was 5·0%.
findingsBetween Feb 18, 2016, and Dec 4, 2019, we enrolled 2906 participants. 2600 (89%) participants were analysed, including 639 (25%) of 2600 who were positive for tuberculosis by the reference standard. Of the 2357 included in the non-inferiority analysis, 877 (37%) were HIV-positive and 984 (42%) were female. Sensitivity of Ultra performed directly on sputum 1 was non-inferior to that of sputum 2 MGIT culture (MGIT 91·1% vs Ultra 91·9%; difference -0·8 percentage points; 95% CI -2·8 to 1·1). Sensitivity of Ultra performed on sputum 2 pellet was also non-inferior to that of sputum 2 MGIT (MGIT 91·1% vs Ultra 91·9%; difference -0·8 percentage points; -2·7 to 1·0).
interpretationFor the detection of M tuberculosis in sputum from adults with respiratory symptoms, there was no difference in sensitivity of a single Ultra test to that of a single MGIT culture. Highly sensitive, rapid molecular approaches for M tuberculosis detection, combined with advances in genotypic methods for drug resistance detection, have potential to replace culture.
fundingUS National Institute of Allergy and Infectious Diseases.
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