TY - JOUR
T1 - Rapid Diagnosis of XDR and Pre-XDR TB: A Systematic Review of Available Tools
T2 - Archivos De Bronconeumologia
AU - Saderi, Laura
AU - Puci, Mariangela
AU - Di Lorenzo, Biagio
AU - Centis, Rosella
AU - D'Ambrosio, Lia
AU - Akkerman, Onno W.
AU - Alffenaar, Jan-Willem C.
AU - Caminero, José A.
AU - Chakaya, Jeremiah Muhwa
AU - Denholm, Justin T.
AU - Kurhasani, Xhevat
AU - Ong, Catherine W. M.
AU - Rendon, Adrian
AU - Silva, Denise Rossato
AU - Tiberi, Simon
AU - Zenner, Dominik
AU - Cabibbe, Andrea M.
AU - Migliori, Giovanni Battista
AU - Sotgiu, Giovanni
PY - 2022
Y1 - 2022
N2 - 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.
AB - 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.
KW - Drug susceptibility test
KW - GenoType MTBDRsl
KW - Line probe assay
KW - MDR-TB
KW - Pre-XDR
KW - Sensitivity
KW - Specificity
KW - Tuberculosis
KW - XDR-TB
KW - Xpert MTB/XDR
U2 - https://doi.org/10.1016/j.arbres.2022.07.012
DO - https://doi.org/10.1016/j.arbres.2022.07.012
M3 - Article
C2 - 35945071
SN - 1579-2129
SP - S0300-2896(22)00498-7
JO - Archivos de bronconeumología
JF - Archivos de bronconeumología
ER -