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European Journal of Clinical Microbiology & Infectious Diseases

04-01-2025 | Tuberculosis | Research

Diagnostic accuracy of Xpert MTB/RIF Ultra for detecting pulmonary tuberculosis and rifampicin resistance: a systematic review and meta-analysis

Authors: Man-Qing Wang, Ya-Fang Zheng, Yu-Qi Hu, Jin-Xia Huang, Zi-Xin Yuan, Zu-Yan Wu, Lu-Fang Huang, Chu-Ting Tang, Feng-Yi Zhang, Yan Chen, Jin-Ke He, Xu-Guang Guo, Bao-Mei Yan

Published in: European Journal of Clinical Microbiology & Infectious Diseases

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Abstract

Background

Public health issues related to tuberculosis still exist. Because Xpert MTB/RIF Ultra is more effective than conventional TB diagnostic techniques are, it is now regarded as an emerging technology. The diagnostic accuracy of Xpert MTB/RIF Ultra for tuberculosis was assessed in this systematic study.

Methods

We searched the PubMed, Cochrane, EMBASE, and Web of Science databases for pertinent literature published before January 18, 2024. The quality of the collected literature was assessed via Review Manager 5.3 software, which applies the quality assessment of diagnostic accuracy studies criteria. Using Metadisc 1.40 software, the sensitivity, specificity, and summary receiver operating characteristic curves were plotted and examined. Stata 12.0 was the program we utilized to assess publication bias in this investigation. The Prospero prospective register of systematic reviews included this study (reference number CRD42024569674).

Results

Analysis of 187 fourfold tables from 72 studies revealed that Xpert MTB/RIF Ultra demonstrated an overall pooled sensitivity of 76% and specificity of 95% for detecting pulmonary tuberculosis. The positive likelihood ratio (PLR) was 14.91, and the negative likelihood ratio (NLR) was 0.23, with an area under the curve (AUC) of 0.9351 and a diagnostic odds ratio (DOR) of 73.39. For detecting rifampin resistance, the combined sensitivity and specificity were 94% and 97%, respectively. The pooled PLR was 24.94, the NLR was 0.07, and the DOR was 429.05. The area under the summary receiver operating characteristic (SROC) curve was 0.9868.

Conclusion

In conclusion, developing effective laboratory diagnostic tools for identifying Mycobacterium tuberculosis is essential for epidemiological research. This study demonstrated that Xpert MTB/RIF Ultra effectively diagnosed Mycobacterium tuberculosis infection, including pulmonary tuberculosis, as well as rifampin resistance, highlighting its potential as a valuable tool for both diagnosis and resistance detection.
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Metadata
Title
Diagnostic accuracy of Xpert MTB/RIF Ultra for detecting pulmonary tuberculosis and rifampicin resistance: a systematic review and meta-analysis
Authors
Man-Qing Wang
Ya-Fang Zheng
Yu-Qi Hu
Jin-Xia Huang
Zi-Xin Yuan
Zu-Yan Wu
Lu-Fang Huang
Chu-Ting Tang
Feng-Yi Zhang
Yan Chen
Jin-Ke He
Xu-Guang Guo
Bao-Mei Yan
Publication date
04-01-2025
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Clinical Microbiology & Infectious Diseases
Print ISSN: 0934-9723
Electronic ISSN: 1435-4373
DOI
https://doi.org/10.1007/s10096-024-05032-1

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