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Abstract
Evaluation of: Tortoli E, Russo C, Piersimoni C et al. Clinical validation of Xpert MTB/RIF for the diagnosis of extrapulmonary tuberculosis. Eur. Respir. J. doi:10.1183/09031936.00176311 (2012) (Epub ahead of print).
The Xpert® MTB/RIF assay has been CE-marked for rapid molecular diagnosis of TB in Europe and has been endorsed by the WHO as a replacement for sputum smear microscopy for diagnosis of pulmonary TB in low- and middle-income countries. However, few data are available to inform recommendations for use of the assay for testing nonsputum clinical samples when investigating suspected extrapulmonary TB (EPTB). We review and discuss the findings of Tortoli and colleagues, who evaluated the assay used for this purpose in a large study of adults and children in Italy. They provide a per-sample analysis of 268 diagnoses of EPTB at a range of anatomic sites (sensitivity: 81.3%; 95% CI: 76.2–85.8) and data for 1206 samples in which EPTB was excluded (specificity: 99.8%; 95% CI: 99.4–100). We discuss how this paper forms an important addition to the growing body of literature demonstrating the utility of Xpert MTB/RIF for EPTB diagnosis when applied to diverse types of clinical samples.
Financial & competing interests disclosure
SD Lawn is funded by the Wellcome Trust, London, UK. AI Zumla acknowledges support from: EuropeAID, Belgium; European and Developing Countries Clinical Trials Partnership (EDCTP), The Netherlands; UK MRC; and UBS Optimus Foundation, Switzerland, University College London Hospitals Comprehensive Biomedical Research Centre (UCLH-CBRC) and the UCL Hospitals NHS Foundation Trust. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
No writing assistance was utilized in the production of this manuscript.