Rapid Diagnosis of XDR and Pre-XDR TB: A Systematic Review of Available Tools: Archivos De Bronconeumologia

Laura Saderi, Mariangela Puci, Biagio Di Lorenzo, Rosella Centis, Lia D'Ambrosio, Onno W. Akkerman, Jan-Willem C. Alffenaar, José A. Caminero, Jeremiah Muhwa Chakaya, Justin T. Denholm, Xhevat Kurhasani, Catherine W. M. Ong, Adrian Rendon, Denise Rossato Silva, Simon Tiberi, Dominik Zenner, Andrea M. Cabibbe, Giovanni Battista Migliori, Giovanni Sotgiu

Research output: Contribution to journalArticleAcademicpeer-review


INTRODUCTION: No previous systematic reviews have comprehensively investigated the features of Xpert MTB/XDR and other rapid tests to diagnose pre-XDR/XDR-TB. The aim of this systematic review is to assess existing rapid diagnostics for pre-XDR/XDR-TB from a point-of-care perspective and describe their technical characteristics (i.e., sensitivity, specificity, positive and negative predictive values). METHODS: Embase, PubMed, Scopus, and Web of Science were searched to detect the articles focused on the accuracy of commercially available rapid molecular diagnostic tests for XDR-TB according to PRISMA guidelines. The analysis compared the diagnostic techniques and approaches in terms of sensitivity, specificity, laboratory complexity, time to confirmed diagnosis. RESULTS: Of 1298 records identified, after valuating article titles and abstracts, 97 (7.5%) records underwent full-text evaluation and 38 records met the inclusion criteria. Two rapid World Health Organization (WHO)-endorsed tests are available: Xpert MTB/XDR and GenoType MTBDRsl (VER1.0 and VER 2.0). Both tests had similar performance, slightly favouring Xpert, although only 2 studies were available (sensitivity 91.4-94; specificity 98.5-99; accuracy 97.2-97.7; PPV 88.9-99.1; NPV 95.8-98.9). CONCLUSIONS: Xpert MTB/XDR could be suggested at near-point-of-care settings to be used primarily as a follow-on test for laboratory-confirmed TB, complementing existing rapid tests detecting at least rifampicin-resistance. Both Xpert MTB/XDR and GenoType MTBDRsl are presently diagnosing what WHO defined, in 2021, as pre-XDR-TB.
Original languageEnglish
Pages (from-to)S0300-2896(22)00498-7
JournalArchivos de bronconeumología
Publication statusPublished - 2022


  • Drug susceptibility test
  • GenoType MTBDRsl
  • Line probe assay
  • MDR-TB
  • Pre-XDR
  • Sensitivity
  • Specificity
  • Tuberculosis
  • XDR-TB
  • Xpert MTB/XDR

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