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Vol. 149. Issue 9.
Pages 399-405 (November 2017)
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Vol. 149. Issue 9.
Pages 399-405 (November 2017)
Review
DOI: 10.1016/j.medcle.2017.09.021
Xpert® MTB/RIF: Usefulness for the diagnosis of tuberculosis and resistance to rifampicin
Xpert® MTB/RIF: utilidad en el diagnóstico de la tuberculosis y de la resistencia a la rifampicina
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Andrea Vergara Gómeza, Julià González-Martína,b, Alberto L. García-Basteirob,c,d,
Corresponding author
a Servicio de Microbiología, CDB, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
b Institut de Salut Global de Barcelona (ISGlobal), Barcelona, Spain
c Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
d Amsterdam Institute for Global Health and Development (AIGHD), Ámsterdam, Netherlands
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Tables (3)
Table 1. Sensitivity and specificity of the Xpert® MTB/RIF for the detection of pulmonary TB.
Table 2. Sensitivity and specificity of Xpert® MTB/RIF for extrapulmonary TB detection.
Table 3. New technologies based on nucleic acid amplification for the diagnosis of tuberculosis.
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Abstract

The advent of the Xpert® MTB/RIF technique was a revolution in the diagnosis of tuberculosis, especially in areas with high incidence and low resources. It allows the detection of Mycobacterium tuberculosis complex and simultaneously the most common resistance mutations to rifampicin in less than 2h. For respiratory samples the sensitivity is very high, but it decreases for extrapulmonary samples and children. Although it is faster and simpler than conventional methods, it presents some limitations and new and better techniques are needed to reduce the number of cases and deaths caused by tuberculosis. This review aims to assess the scientific evidence around the diagnostic performance of Xpert® MTB/RIF in different types of samples and populations, as well as analyze its strengths and limitations for TB diagnosis.

Keywords:
Tuberculosis
Xpert® MTB/RIF
Mycobacterium tuberculosis
Rifampicin
Resumen

La aparición de la técnica Xpert® MTB/RIF supuso una revolución en el diagnóstico de la tuberculosis, especialmente en zonas con alta incidencia y pocos recursos. Permite la detección de Mycobacterium tuberculosis complex y, simultáneamente, de las mutaciones más comunes de resistencia a rifampicina en menos de 2h. Su sensibilidad en muestras respiratorias es muy alta, pero disminuye en muestras extrapulmonares y en niños. Aunque más rápida y simple que los métodos convencionales, presenta ciertas limitaciones y aún son necesarias nuevas y mejores herramientas diagnósticas que contribuyan a reducir los casos y las muertes por tuberculosis. Esta revisión pretende compendiar la evidencia científica en torno al rendimiento diagnóstico de Xpert® MTB/RIF en diferentes tipos de muestras y poblaciones, así como analizar sus ventajas y limitaciones para el diagnóstico de tuberculosis.

Palabras clave:
Tuberculosis
Xpert® MTB/RIF
Mycobacterium tuberculosis
Rifampicina

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