Point-of-care tests for tuberculous meningitis (TBM) are needed. We studied the diagnostic accuracy of the lipoarabinomannan (LAM) lateral flow assay (LFA), LAM enzyme-linked immunosorbent assay (ELISA), and Xpert MTB/RIF in cerebrospinal fluid (CSF) in an autopsy cohort of Ugandan HIV-infected adults. We obtained written informed consent postmortem from the next of kin. A complete autopsy was ...

BACKGROUND Nucleic acid amplification tests are increasingly used for the rapid diagnosis of tuberculosis. We undertook a comparative study of the efficiency and diagnostic yield of a real-time PCR senX3-regX3 based assay versus the classical IS6110 target and the new commercial methods. METHODS This single-blind prospective comparative study included 145 consecutive samples: 76 from patients...

We read with interest the systematic review by C. Denkinger and co-workers on the use of the Xpert MTB/ RIF assay for diagnosing extrapulmonary tuberculosis (TB) [1], particularly in light of World Health Organization (WHO) endorsement of Xpert MTB/RIF and its recent policy statement on extrapulmonary TB [1–3]. Given the severe clinical course and high mortality associated with TB meningitis, c...

We read the recent paper by Rufai et al. with interest (1). The authors tested a subset of samples containing Mycobacterium tuberculosis previously tested by the Hain line probe assay (LPA) with the Xpert MTB/RIF assay to identify discordant results between these two test methods. The authors’ results favored LPA over Xpert MTB/RIF in sensitivity for rifampin (RIF) resistance detection. These r...

Background. Despite low sensitivity in detection of Mycobacterium tuberculosis, sputum acid-fast smear remains the main diagnostic method. This study aimed to compare the diagnostic performance of Xpert MTB/RIF assay versus conventional sputum acid-fast smear. Materials and Methods. A cross-sectional study was conducted at Chiang Mai University Hospital, Thailand. Patients who were ≥15 years ol...

Performance characteristics of five assays for detection of Clostridium difficile toxin were compared using fresh stool samples from patients with C. difficile infection (CDI). Assays were performed simultaneously and according to the manufacturers' instructions. Patients were included in the study if they exhibited clinical symptoms consistent with CDI. Nonmolecular assays included glutamate d...

OBJECTIVES/HYPOTHESIS The World Health Organization endorsed the Xpert MTB/RIF assay for the diagnosis of pulmonary tuberculosis (TB), but there is limited information about the utility of this assay for the diagnosis of TB lymphadenitis. Therefore, the objective of this study was to assess the diagnostic accuracy of Xpert MTB/RIF assay in HIV-infected patients with palpable cervical lymph node...

BACKGROUND Xpert MTB/RIF assay is a highly sensitive test for TB diagnosis, but still costly to most low-income countries. Several implementation strategies instead of frontline have been suggested; however with scarce data. We assessed accuracy of different Xpert MTB/RIF implementation strategies to inform national roll-out. METHODS This was a cross-sectional study of 1,924 adult presumptive...

The Food and Drug Administration (FDA) has cleared the Xpert MTB/RIF Assay (Cepheid; Sunnyvale, California) with an expanded intended use that includes testing of either one or two sputum specimens as an alternative to examination of serial acid-fast stained sputum smears to aid in the decision of whether continued airborne infection isolation (AII) is warranted for patients with suspected pulm...

BACKGROUND A proportion of patients with tuberculosis diagnosed by sputum culture during screening before antiretroviral therapy (ART) have false-negative Xpert MTB/RIF assay results (Xpert-negative tuberculosis). We determined the characteristics and early ART program outcomes of such patients. METHODS Adult patients who enrolled in a South African township ART service were systematically sc...