Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2020 Feb 1;45(3):163-169.
doi: 10.1097/BRS.0000000000003225.

Diagnostic Efficacy, Sensitivity, and Specificity of Xpert MTB/RIF Assay for Spinal Tuberculosis and Rifampicin Resistance

Jwalant Patel  1 , Mihir Upadhyay, Vishal Kundnani, Zahir Merchant, Sanyam Jain, Neil Kire
Affiliations
Observational Study

Diagnostic Efficacy, Sensitivity, and Specificity of Xpert MTB/RIF Assay for Spinal Tuberculosis and Rifampicin Resistance

Jwalant Patel et al. Spine (Phila Pa 1976). .

Abstract

Study design: A cross-sectional observational study.

Objective: This study aims to determine the diagnostic accuracy, sensitivity, and specificity of the Xpert MTB/RIF assay (Mycobacterium Tuberculosis/Rifampicin resistance) for the detection of spinal Tuberculosis (TB) and rifampicin (RIF) resistance.

Summary of background data: The Spinal TB is often a paucibacillary extra pulmonary tuberculosis which gives a major challenge in early diagnosis and initializing the correct anti-tubercular treatment (ATT). Due to its rapidity and sensitivity, the dependence and reliability on the Xpert MTB/RIF assay has increased in the last few years. The studies describing accuracy of the Xpert MTB/RIF assay in spinal TB are scanty.

Methods: This institutional review board-approved study included 360 diagnosed spinal TB patients. To determine the accuracy of the Xpert MTB/RIF assay, it was compared with other diagnostic tests like histopathology, acid fast bacilli (AFB) smear, culture, and drug sensitivity testing (DST).

Results: The Xpert MTB/RIF assay showed 86.3% sensitivity and 85.3% specificity when compared with culture for the diagnosis of Spinal TB and showed 75.86% sensitivity, 96.12% specificity for RIF resistance when compared to DST. Four cases were false positive and 11 cases were false negative for RIF resistance on the Xpert MTB/RIF assay.

Conclusion: The Xpert MTB/RIF assay is an efficient technique for the rapid diagnosis of spinal TB; however, a clinician should not solely rely on it for starting ATT. As there are false results also with this test which should be read cautiously and be well correlated with culture and DST pattern to guide the start of sensitive drug regimen only. The purpose is to prevent exposure of the second line drugs to false cases found on the Xpert MTB/RIF assay and avoid emergence of new acquired drug resistance.

Level of evidence: 4.

PubMed Disclaimer

References

    1. WHO Multidrug and extensively drug-resistant TB (M/XDR-TB): 2010 global report on surveillance and response Geneva. who/htm/tb/2010.3.
    1. Polley P, Dunn R. Noncontiguous spinal tuberculosis: incidence and management. Eur Spine J 2009; 18:1096–1101.
    1. Arora S, Kumar R. Tubercular spinal epidural abscess involving the dorsallumbar—sacral region without osseous involvement. J Infect Dev Ctries 2011; 5:544–549.
    1. Stop Tuberculosis Department Guidelines for the programmatic management of drug-resistant tuberculosis: emergency update 2008. WHO, Geneva. who/htm/tb/2008.402.
    1. WHO The Global Plan to Stop TB 2011–2015: transforming the fight towards elimination of tuberculosis Available at: http://www.stoptb.org/assets/documents/global/plan/TB_GlobalPlanToStopTB....

Publication types

MeSH terms

LinkOut - more resources