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Tuberculosis & Respiratory Diseases

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Vol.85 No.1
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Head-to-Head Comparison between Xpert MTB/RIF Assay and Real-Time Polymerase Chain Reaction Assay Using Bronchial Washing Specimens for Tuberculosis Diagnosis

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2022, v.85 no.1, pp.89-95
https://doi.org/10.4046/trd.2021.0100
Doosoo Jeon, M.D. (Pusan National University Yangsan Hospital, Pusan National University School of Medicine)
Eunjeong Son, M.D. (Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan)
Jinook Jang, M.D. (Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan)
Taehwa Kim, M.D. (Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan)
Jin Ho Jang, M.D. (Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan)
Jae Heun Chung, M.D. (Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan)
Hee Yun Seol, M.D. (Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan)
Hye Ju Yeo, M.D. (Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan)
Seong Hoon Yoon, M.D. (Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan)
Seung Eun Lee, M.D. (Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan)
Woo Hyun Cho, M.D. (Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan)
Yun Seong Kim, M.D. (Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan)
Doosoo, J. M. , Eunjeong, S. M. , Jinook, J. M. , Taehwa, K. M. , Jin, H. J. M. , Jae, H. C. M. , Hee, Y. S. M. , Hye, J. Y. M. , Seong, H. Y. M. , Seung, E. L. M. , Woo, H. C. M. , & Yun, S. K. M. (2022). Head-to-Head Comparison between Xpert MTB/RIF Assay and Real-Time Polymerase Chain Reaction Assay Using Bronchial Washing Specimens for Tuberculosis Diagnosis. Tuberculosis & Respiratory Diseases, 85(1), 89-95, https://doi.org/10.4046/trd.2021.0100
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Abstract

Background: With the introduction of Xpert MTB/RIF assay (Xpert), its incorporation into tuberculosis (TB) diagnosticalgorithm has become an important issue. The aim of this study was to evaluate the performance of the Xpert assay incomparison with a commercial polymerase chain reaction (PCR) assay. Methods: Medical records of patients having results of both Xpert and AdvanSure TB/NTM real-time PCR (AdvanSure)assays using the same bronchial washing specimens were retrospectively reviewed. Results: Of the 1,297 patients included in this study, 205 (15.8%) were diagnosed with pulmonary TB. Usingmycobacterial culture as the reference method, sensitivity of the Xpert assay using smear-positive specimens was 97.5%,which was comparable to that of the AdvanSure assay (96.3%, p=0.193). However, the sensitivity of the Xpert assay usingsmear-negative specimens was 70.6%, which was significantly higher than that of the AdvanSure assay (52.9%, p=0.018). Usng phenotypic drug susceptibility testing as the reference method, sensitivity and specificity for detecting rifampicinresistance were 100% and 99.1%, respectively. Moreover, a median turnaround time of the Xpert assay was 1 day, whichwas significantly shorter than 3 days of the AdvanSure assay (p<0.001). Conclusion: In comparison with the AdvanSure assay, the Xpert assay had a higher sensitivity using smear-negativespecimens, a shorter turnaround time, and could reliably predict rifampin resistance. Therefore, the Xpert assay might bepreferentially recommended over TB-PCR in Korean TB diagnostic algorithm.

keywords
Tuberculosis, Polymerase Chain Reaction, Molecular Diagnostic Techniques

Tuberculosis & Respiratory Diseases

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