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

• Laura Saderi ^[1] ; Mariangela Puci ^[1] ; Biagio Di Lorenzo ^[1] ; Rosella Centis ^[9] ; Lia DAmbrosio ^[10] ; Onno W. Akkerman ^[2] ; Jan-Willem C. Alffenaar ^[11] ; José A. Caminero ^[12] ; Jeremiah Muhwa Chakaya ^[3] ; Justin T. Denholm ^[4] ; Xhevat Kurhasani ^[13] ; Catherine W.M. Ong ^[5] ; Adrian Rendon ^[6] ; Denise Rossato Silva ^[7] ; Simon Tiberi ^[8] ; Dominik Zenner ^[8] ; Andrea M. Cabibbe ^[14] ; Giovanni Battista Migliori ^[9] ; Giovanni Sotgiu ^[1]
  1. [1] University of Sassari

     University of Sassari

     Sassari, Italia

     
  2. [2] University of Groningen

     University of Groningen

     Países Bajos

     
  3. [3] Kenyatta University

     Kenyatta University

     Kenia

     
  4. [4] University of Melbourne

     University of Melbourne

     Australia

     
  5. [5] National University of Singapore

     National University of Singapore

     Singapur

     
  6. [6] Universidad Autónoma de Nuevo León

     Universidad Autónoma de Nuevo León

     México

     
  7. [7] Universidade Federal do Rio Grande do Sul

     Universidade Federal do Rio Grande do Sul

     Brasil

     
  8. [8] Queen Mary University of London

     Queen Mary University of London

     Reino Unido

     
  9. [9] Respiratory Diseases Clinical Epidemiology Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy
  10. [10] Public Health Consulting Group, Lugano, Switzerland
  11. [11] Sydney Institute for Infectious Diseases, University of Sydney, Sydney, NSW, Australia
  12. [12] Servicio de Neumología, Hospital Universitario de Gran Canaria “Dr. Negrín”, Las Palmas de Gran Canaria, España
  13. [13] UBT Higher Education Institution, Prishtina, Kosovo
  14. [14] Emerging Bacterial Pathogens Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy

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• Localización: Archivos de bronconeumología: Organo oficial de la Sociedad Española de Neumología y Cirugía Torácica SEPAR y la Asociación Latinoamericana de Tórax ( ALAT ), ISSN 0300-2896, Vol. 58, Nº. 12 (December), 2022, págs. 809-820
• Idioma: inglés
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• Resumen

  • 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.