Indian journal of medical microbiology · 2026
Detection of drug-resistant Extrapulmonary tuberculosis by Xpert® MTB/XDR assay - a comparison with phenotypic drug susceptibility testing and line probe assay.
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Sharma Kusum, Sharma Megha, Joshi Himanshu, Shree Ritu, Singla Neeraj, Sharma Vishal, Sharma Aman, Singh Ramandeep, Modi Manish, Sharma Navneet, Sinha S K, Dhillon M S, Gupta Amod
Аннотация
PURPOSE: An important step towards Tuberculosis elimination is rapid identification of extrapulmonary tuberculosis (EPTB) cases and universal drug-susceptibility testing (DST). This study evaluated the performance of Xpert® MTB/XDR assay in detecting drug-resistant EPTB and compared its performance with phenotypic and genotypic DST.
METHODS: 62 samples diagnosed as EPTB by Xpert® MTB/RIF Ultra were subjected to Xpert® MTB/XDR assay (Xpert®-XDR), phenotypic DST using mycobacterial growth indicator tube and genotypic DST using line probe assay (LPA). Gene sequencing was done to settle discordant results. Tests were compared using categorial agreement (CA), very major error (VME) and major error (ME).
RESULTS: 57 cases having Ct values between 15 and 22 in Xpert® MTB/RIF Ultra were detected by Xpert®-XDR. 100% concordance was noted between Xpert®-XDR and phenotypic & genotypic DST in reporting susceptibility against isoniazid and second-line injectables. Three cases and one case of false-resistance were reported against phenotypic and genotypic DST, respectively. Categorical agreement was 98.8% against phenotypic DST and 99.6% against genotypic DST. There were no VMEs and MEs were within acceptable range.
CONCLUSION: Xpert®-XDR can be used as a reflex test following EPTB detection (e.g., by Xpert®-Ultra) to direct early and successful therapy in settings with high TB and DR-TB burden.
METHODS: 62 samples diagnosed as EPTB by Xpert® MTB/RIF Ultra were subjected to Xpert® MTB/XDR assay (Xpert®-XDR), phenotypic DST using mycobacterial growth indicator tube and genotypic DST using line probe assay (LPA). Gene sequencing was done to settle discordant results. Tests were compared using categorial agreement (CA), very major error (VME) and major error (ME).
RESULTS: 57 cases having Ct values between 15 and 22 in Xpert® MTB/RIF Ultra were detected by Xpert®-XDR. 100% concordance was noted between Xpert®-XDR and phenotypic & genotypic DST in reporting susceptibility against isoniazid and second-line injectables. Three cases and one case of false-resistance were reported against phenotypic and genotypic DST, respectively. Categorical agreement was 98.8% against phenotypic DST and 99.6% against genotypic DST. There were no VMEs and MEs were within acceptable range.
CONCLUSION: Xpert®-XDR can be used as a reflex test following EPTB detection (e.g., by Xpert®-Ultra) to direct early and successful therapy in settings with high TB and DR-TB burden.