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

Saderi, Laura, Puci, Mariangela, Di Lorenzo, Biagio, Centis, Rosella, D’Ambrosio, Lia, Akkerman, Onno W., Alffenaar, Jan-Willem C., Caminero, José A., Muhwa, Jeremiah, Denholm, Justin T., Kurhasani, Xhevat, Ong, Catherine W.M., Rendon, Adrian, Silva, Denise Rossato, Tiberi, Simon, Zenner, Dominik, Cabibbe, Andrea M., Migliori, Giovanni Battista and Sotgiu, Giovanni (2022) 'Rapid Diagnosis of XDR and Pre-XDR TB: A Systematic Review of Available Tools'. Archivos de Bronconeumología, Vol 58, Issue 12, pp. 809-820.

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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.

Item Type:	Article
Subjects:	WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1016/j.arbres.2022.07.012
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	20 Jul 2023 13:04
Last Modified:	03 Aug 2023 09:15
URI:	https://archive.lstmed.ac.uk/id/eprint/21585

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