A meta-analysis of the accuracy of Xpert MTB/RIF in diagnosing intestinal tuberculosis

• Published in: Laboratory medicine Vol. 55; no. 2; pp. 238 - 244
• Main Authors: Ding, Yuan-Lin, Yan, Rui-Chao, Chen, Hao-Kai, Guo, Xu-Guang
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 07.03.2024
• Subjects: Accuracy; Analysis; Antibiotics, Antitubercular - pharmacology; Drug Resistance, Bacterial; Humans; Mycobacterium tuberculosis - genetics; Rifampin - pharmacology; Sensitivity and Specificity; Tuberculosis; Tuberculosis, Pulmonary - diagnosis; China; India; meta-analysis; Xpert MTB/RIF; diagnostic; intestinal tuberculosis; tuberculosis; Mycobacterium tuberculosis
• ISSN: 0007-5027; 1943-7730; 1943-7730
• DOI: 10.1093/labmed/lmad072

Objective A detection method with high efficiency and accuracy is urgently needed in clinical work. The purpose of our study was to determine the diagnostic accuracy of the Xpert MTB/RIF assay for intestinal tuberculosis (ITB). Methods We searched PubMed and 4 other databases from their establishment to July 19, 2022, for published essays of diagnostic performance in which Xpert MTB/RIF was used to test patients with clinically suspected ITB. An assessment of the quality of the selected literature was conducted using QUADAS-2. We built forest plots by MetaDiSc software. Results The pooled Xpert MTB/RIF sensitivity was 48%, and the specificity was 99%. Moreover, the positive likelihood ratio for ITB diagnosis was 21.61. The negative likelihood ratio was 0.54. There were substantial variations between the study estimates of sensitivity (I2 = 87.6%) and specificity (I2 = 82.4%). Conclusion Intestinal TB is detected with limited diagnostic sensitivity by Xpert MTB/RIF but with high specificity. An Xpert-positive result may facilitate the rapid identification of ITB cases. Nevertheless, a negative result has less certainty in excluding the disease.