Xpert Nucleic Acid Amplification vs. AFB Smear in Low-Prevalence Settings

In a large multicenter trial in the U.S., assay of a single sputum sample by Xpert was significantly more sensitive in detecting pulmonary tuberculosis than acid-fast bacilli smear on two or three sputum samples.

The Xpert MTB/RIF (Xpert) assay rapidly detects Mycobacterium tuberculosis using automated nucleic acid amplification. In areas of high tuberculosis (TB) prevalence, Xpert is both sensitive and specific. Although approved by the FDA since 2013, published data on the assay's use in the U.S. are limited, and the relatively low prevalence of TB in the U.S. could affect its parameters. To address this issue, researchers conducted a longitudinal, multicenter study at 21 U.S. sites and in Rio de Janeiro, Brazil, and Johannesburg, South Africa, two areas of high TB prevalence. Cepheid, the manufacturer of Xpert, assisted with study design, provided material support and funding, and reviewed the manuscript.

Between May 2012 and November 2013, adult …

Reviewing Author

Neil M. Ampel, MD

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Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Xpert Nucleic Acid Amplification vs. AFB Smear in Low-Prevalence Settings

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Reviewing Author