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

Laura Saderi; Mariangela Puci; Biagio Di Lorenzo; Rosella Centis; Lia D’Ambrosio; Onno W. Akkerman; Jan-Willem C. Alffenaar; José A. Caminero; Chakaya Muhwa; 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

doi:10.1016/j.arbres.2022.07.012

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

Laura Saderi, Mariangela Puci, Biagio Di Lorenzo, Rosella Centis, Lia D’Ambrosio, Onno W. Akkerman, Jan-Willem C. Alffenaar, José A. Caminero, Chakaya Muhwa, 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

Clinical Sciences

Research output: Contribution to journal › Article › peer-review

15 Citations (Scopus)

Abstract

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 language	English
Pages (from-to)	809-820
Number of pages	12
Journal	Archivos de Bronconeumologia
Volume	58
Issue number	12
Early online date	1 Dec 2022
DOIs	https://doi.org/10.1016/j.arbres.2022.07.012
Publication status	Published - 1 Dec 2022

Keywords

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

Access to Document

10.1016/j.arbres.2022.07.012

Cite this

Saderi, L., Puci, M., Di Lorenzo, B., Centis, R., D’Ambrosio, L., Akkerman, O. W., Alffenaar, J.-W. C., Caminero, J. A., Muhwa, C., Denholm, J. T., Kurhasani, X., Ong, C. W. M., Rendon, A., Silva, D. R., Tiberi, S., Zenner, D., Cabibbe, A. M., Migliori, G. B., & Sotgiu, G. (2022). Rapid Diagnosis of XDR and Pre-XDR TB: A Systematic Review of Available Tools. Archivos de Bronconeumologia, 58(12), 809-820. https://doi.org/10.1016/j.arbres.2022.07.012

@article{902716beeacd4965a47526ca6eadfab3,

title = "Rapid Diagnosis of XDR and Pre-XDR TB: A Systematic Review of Available Tools",

abstract = "IntroductionNo 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). MethodsEmbase, 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. ResultsOf 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.",

keywords = "Drug susceptibility test, GenoType MTBDRsl, Line probe assay, MDR-TB, Pre-XDR, Sensitivity, Specificity, Tuberculosis, XDR-TB, Xpert MTB/XDR",

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

year = "2022",

month = dec,

day = "1",

doi = "10.1016/j.arbres.2022.07.012",

language = "English",

volume = "58",

pages = "809--820",

journal = "Archivos de Bronconeumologia",

issn = "0300-2896",

publisher = "Sociedad Espanola de Neumologia y Cirugia Toracica (SEPAR)",

number = "12",

}

Saderi, L, Puci, M, Di Lorenzo, B, Centis, R, D’Ambrosio, L, Akkerman, OW, Alffenaar, J-WC, Caminero, JA, Muhwa, C, Denholm, JT, Kurhasani, X, Ong, CWM, Rendon, A, Silva, DR, Tiberi, S, Zenner, D, Cabibbe, AM, Migliori, GB & Sotgiu, G 2022, 'Rapid Diagnosis of XDR and Pre-XDR TB: A Systematic Review of Available Tools', Archivos de Bronconeumologia, vol. 58, no. 12, pp. 809-820. https://doi.org/10.1016/j.arbres.2022.07.012

TY - JOUR

T1 - Rapid Diagnosis of XDR and Pre-XDR TB: A Systematic Review of Available Tools

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 - Muhwa, Chakaya

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 - 2022/12/1

Y1 - 2022/12/1

N2 - IntroductionNo 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). MethodsEmbase, 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. ResultsOf 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 - IntroductionNo 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). MethodsEmbase, 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. ResultsOf 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 - 10.1016/j.arbres.2022.07.012

DO - 10.1016/j.arbres.2022.07.012

M3 - Article

SN - 0300-2896

VL - 58

SP - 809

EP - 820

JO - Archivos de Bronconeumologia

JF - Archivos de Bronconeumologia

IS - 12

ER -

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

Abstract

Keywords

Access to Document

Fingerprint

Cite this