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Efficacy of Xpert MTB/RIF Ultra for the early diagnosis of tuberculous meningitis
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  • Han Yang,
  • Ai-fang Li,
  • Yong-feng Zhang,
  • Yuan-li Yang
Han Yang
Xi’an Chest Hospital
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Ai-fang Li
Xi’an Chest Hospital
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Yong-feng Zhang
Xi’an Chest Hospital
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Yuan-li Yang
Xi’an Chest Hospital

Corresponding Author:[email protected]

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Abstract

Objectives: We aimed to evaluate the efficacy of GeneXpert MTB/RIF Ultra (Ultra) for the early diagnosis of tuberculous meningitis (TBM). Methods: Seventy-nine patients were analyzed. Mycobacterium tuberculosis was measured in the cerebrospinal fluid (CSF), using Ultra, GeneXpert MTB/RIF (Xpert), Metagenomic Next-Generation Sequencing (mNGS), and Mycobacteria Growth Indicator Tube (MGIT) assays. The detection performance and rifampicin drug sensitivity of each method were analyzed based on clinical diagnoses. Results: The sensitivity (56.4%), area under the curve (AUC, 0.782), and Kappa value (0.521) of Ultra were higher than the sensitivity, AUC, and Kappa value of MGIT (20%, 0.600, 0.236), Xpert (40%, 0.700, 0.236), and mNGS (32.7%, 0.664, 0.352). In the 31 Ultra positive cases, 24 were rifampicin susceptible, and 7 were rifampicin indeterminate. Conclusion: The Ultra assay detected Mycobacterium tuberculosis in CSF with higher sensitivity, compared with other assays. Thus, the Ultra test can be used for the early diagnosis of TBM.