Usefulness of Xpert MTB/RIF Ultra for rapid diagnosis of extrapulmonary tuberculosis in Tunisia.

Publication date: Jan 26, 2024

Extrapulmonary tuberculosis (EPTB) remains a challenging diagnosis. The purpose of this study was to assess the accuracy of Xpert MTB/RIF Ultra (Cepheid, USA) for rapid diagnosis of EPTB in Tunisia. Eight hundred and forty-seven extrapulmonary samples collected from 2017 to 2021, were subjected to Xpert MTB/RIF Ultra. Microscopy and culture were performed for all the specimens. The accuracy of Xpert Ultra was evaluated in comparison to the culture. Xpert Ultra diagnosed EPTB with a global sensitivity of 80. 66% (74. 3-85. 75) and specificity of 70. 87% (67. 31-74. 20). The molecular test was most accurate when performed in cerebrospinal fluids, bones and joints and cutaneous specimens showing a sensitivity of 100% and a specificity ranging from 70. 60 to 91. 11%. In lymph node samples comprising aspirates and biopsies, the sensitivity of Xpert Ultra was high 87. 50% (77. 23-93. 53), however, the specificity was 51. 08% (44. 67-57. 46). For pleural samples, the Xpert Ultra sensitivity was 77. 50% (68. 34-84. 68) ranging from 71. 43 to 80% in pleural biopsies and fluids respectively. The specificity in all pleural specimens was 79. 56% (74. 40-83. 91). Xpert Ultra showed promise in the diagnosis of EPTB. The performances varied according to the site of the disease. The test may be more valuable if used in combination with other diagnostic modalities.

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Concepts Keywords
Biopsies Culture
Tuberculosis Diagnosis
Tunisia Eptb
Valuable Extrapulmonary


Type Source Name
disease MESH extrapulmonary tuberculosis
drug DRUGBANK Coenzyme M
disease MESH Tuberculosis
pathway KEGG Tuberculosis
disease MESH HIV infection
pathway REACTOME HIV Infection
disease MESH lymphadenitis
drug DRUGBANK Rifampicin
drug DRUGBANK L-Cysteine
disease MESH Tuberculous meningitis
disease MESH morbidity
drug DRUGBANK Sodium hydroxide
disease MESH Pleural tuberculosis
disease MESH peritoneal fluids
drug DRUGBANK Dihydrostreptomycin
drug DRUGBANK Diethylstilbestrol
disease MESH lymph node tuberculosis
disease MESH restriction fragment length polymorphism
drug DRUGBANK Isoniazid
drug DRUGBANK Rifabutin
drug DRUGBANK Rifapentine
disease MESH pulmonary tuberculosis
disease MESH pleural effusion
disease MESH osteoarticular tuberculosis

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