Review
Medicine, General & Internal
Mikashmi Kohli, Ian Schiller, Nandini Dendukuri, Mandy Yao, Keertan Dheda, Claudia M. Denkinger, Samuel G. Schumacher, Karen R. Steingart
Summary: Xpert Ultra and Xpert MTB/RIF are effective tools for diagnosing extrapulmonary tuberculosis, particularly for detecting rifampicin resistance cases. Xpert Ultra has higher sensitivity and lower specificity compared to Xpert MTB/RIF in diagnosing tuberculous meningitis, while both tests have similar sensitivity and specificity in detecting rifampicin resistance. Future research should address the limitations associated with using culture as a reference standard in paucibacillary specimens.
COCHRANE DATABASE OF SYSTEMATIC REVIEWS
(2021)
Article
Microbiology
Patrick Howlett, Pamela Nabeta, Nestan Tukvadze, Samuel G. Schumacher, Claudia M. Denkinger
Summary: High-throughput centralized testing for tuberculosis (TB) and drug resistance is crucial, however, limited comparative data exists. This study compared the performance of Abbott RealTime MTB and RealTime MTB RIF/INH to Xpert MTB/RIF Ultra and Xpert MTB/RIF, with Abbott assays showing lower sensitivity for TB detection but similar performance for resistance detection. The differences in TB detection may be attributed to the use of frozen samples for Abbott testing compared to fresh samples for Xpert. Further studies in compliance with manufacturer's instructions are necessary for a fair comparison.
MICROBIOLOGY SPECTRUM
(2021)
Article
Respiratory System
Patrick Orikiriza, Julianna Smith, Bob Ssekyanzi, Dan Nyehangane, Ivan Mugisha Taremwa, Esther Turyashemererwa, Onesmas Byamukama, Tobias Tusabe, Elisa Ardizzoni, Ben J. Marais, Eric Wobudeya, Elizabeth Kemigisha, Juliet Mwanga-Amumpaire, Dora Nampijja, Maryline Bonnet
Summary: This study evaluates the diagnostic accuracy of stool Xpert MTB/RIF and urine AlereLAM tests in children at high risk for disseminated tuberculosis. The results indicate that while stool Xpert MTB/RIF has excellent specificity, its sensitivity is suboptimal. Urine AlereLAM is compromised by poor sensitivity and specificity in children.
EUROPEAN RESPIRATORY JOURNAL
(2022)
Article
Microbiology
A. Andama, G. R. Whitman, R. Crowder, T. F. Reza, D. Jaganath, J. Mulondo, T. K. Nalugwa, F. C. Semitala, W. Worodria, C. Cook, R. C. Wood, K. M. Weigel, A. M. Olson, J. Lohmiller Shaw, M. Kato-Maeda, C. M. Denkinger, P. Nahid, G. A. Cangelosi, A. Cattamanchi
Summary: Tongue dorsum swabs have shown promise as alternatives to sputum for detecting Mycobacterium tuberculosis (MTB) in patients with pulmonary tuberculosis (TB). However, studies using the automated Cepheid Xpert MTB/RIF Ultra qPCR test (Xpert Ultra) have exhibited less sensitivity with tongue swabs, possibly because Xpert Ultra is optimized for testing sputum. In this study, using two new sample preprocessing methods, the diagnostic accuracy and semi-quantitative signals of Xpert Ultra performed on tongue swabs were assessed in adults with presumed TB in Kampala, Uganda.
JOURNAL OF CLINICAL MICROBIOLOGY
(2022)
Article
Medical Laboratory Technology
Yi-Ran Qiu, Yu-Yan Chen, Xin-Ran Wu, Ya-Ping Li, Xun-Jie Cao, Zi-Yuan Yu, Min Lin, Qiu-Yin Li, Ji-Chun Chen, Xin Yin, Shu-Chang Weng, Xu-Guang Guo
Summary: Xpert MTB/RIF is a rapid method with high specificity but relatively low sensitivity for detecting Mycobacterium tuberculosis in pleural effusion. Its overall accuracy is high, and there is no publication bias found in the study.
JOURNAL OF CLINICAL LABORATORY ANALYSIS
(2022)
Article
Infectious Diseases
Zibo Zhou, Yan Zheng, Leiming Wang
Summary: The Xpert MTB/RIF assay demonstrated high sensitivity and specificity for diagnosing BJTB from tissue specimens, with a significantly higher detection rate in granulation tissue compared to caseous necrotic tissue, sequestrum, and other necrotic connective tissues (P < 0.05).
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
(2021)
Article
Infectious Diseases
Juan Yang, Yanheng Shen, Lei Wang, LiXia Ju, Xiaocui Wu, Peng Wang, Xiaohui Hao, Qin Sun, Fangyou Yu, Wei Sha
Summary: The Xpert MTB/RIF assay demonstrated high sensitivity and moderate specificity in diagnosing pulmonary tuberculosis in bronchoalveolar lavage fluid (BALF), providing valuable microbiological evidence for clinical decisions. Special attention should be paid to re-evaluating very low semi-quantitative positive results to improve specificity.
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
(2021)
Article
Infectious Diseases
Xia Yu, Tingting Zhang, Yaoyao Kong, Fen Wang, Lingling Dong, Ming Han, Hairong Huang
Summary: Xpert-Ultra demonstrates significantly higher sensitivity in the detection of tuberculosis lymphadenitis, particularly in lymph node tissue.
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
(2022)
Article
Microbiology
Xia Yu, Fen Wang, Ruyan Ren, Lingling Dong, Yi Xue, Liping Zhao, Junnan Jia, Hairong Huang
Summary: This study evaluated the value of Xpert MTB/RIF Ultra (Xpert-Ultra) in diagnosing adult pulmonary tuberculosis (PTB) using stool samples, and compared it with Xpert MTB/RIF on respiratory tract specimens. The study found that although the yield in stool samples by Xpert-Ultra is lower, it can still be useful in detecting disease in presumptive TB patients who cannot expectorate sputum. Xpert-Ultra testing on stool specimens showed comparable sensitivity with Xpert on respiratory tract specimens, making it a promising strategy to improve PTB diagnosis in patients who cannot produce sputum.
MICROBIOLOGY SPECTRUM
(2023)
Article
Infectious Diseases
Pengju Liu, Yuan Liu, Yeqiang Wang, Sida Hao, Yong Qin
Summary: In this study, the diagnostic efficacy of the Xpert MTB/RIF assay in detecting epididymal tuberculosis was assessed. The results showed that the Xpert MTB/RIF assay had high sensitivity and specificity, making it a reliable diagnostic method for epididymal tuberculosis.
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES
(2022)
Article
Microbiology
Mary Mansfield, Anne Marie McLaughlin, Emma Roycroft, Lorraine Montgomery, Joseph Keane, Margaret M. Fitzgibbon, Thomas R. Rogers
Summary: The study demonstrates the improved sensitivity of the Ultra compared with the Xpert, particularly in smear negative TB disease, for both pulmonary and extrapulmonary samples in a low TB incidence setting. Cycle threshold (Ct) value for both assays was found to positively correlate with time to TB culture positivity, suggesting that Ct and semiquantitative results could be used as indicators of sample MTBC bacillary burden, and thus, perhaps, of transmission potential. This may have implications for the designation of patient isolation precautions.
MICROBIOLOGY SPECTRUM
(2022)
Article
Microbiology
Marisa C. C. Nielsen, Paula Clarner, Ruchi Paroha, Sunhee Lee, Phyu M. M. Thwe, Ping Ren
Summary: Tuberculosis (TB) is a major public health threat and remains a leading cause of death worldwide. The Cepheid Xpert (R) MTB/RIF tests are widely accepted for TB diagnosis, but their sensitivity on non-sputum samples has not been determined. This study systematically evaluated the sensitivity of US-IVD and Ultra tests on different sample types including CSF, tissue, and BAL. The Ultra test showed better sensitivity than US-IVD across all sample types, providing a foundation for early detection of pulmonary and extrapulmonary TB and potentially improving TB case detection rates.
Review
Allergy
Claudia Signorino, Martina Votto, Maria De Filippo, Gian Luigi Marseglia, Luisa Galli, Elena Chiappini
Summary: This review examined the accuracy of the Ultra assay for diagnosing tuberculosis and rifampicin resistance in children. The results showed that Ultra had high sensitivity and specificity in diagnosing pulmonary tuberculosis. However, compared to Xpert MTB/RIF, Ultra had slightly higher sensitivity but lower specificity. Further studies are needed to evaluate the accuracy of Ultra in diagnosing childhood tuberculosis.
PEDIATRIC ALLERGY AND IMMUNOLOGY
(2022)
Article
Immunology
Helen Cox, Lesley Workman, Lindy Bateman, Zoe Franckling-Smith, Margaretha Prins, Juaneta Luiz, Judi Van Heerden, Lemese Ah Tow Edries, Samantha Africa, Veronica Allen, Cynthia Baard, Widaad Zemanay, Mark P. Nicol, Heather J. Zar
Summary: Oral swab specimens may be an alternative method for diagnosing childhood pulmonary tuberculosis, but the Xpert MTB/RIF Ultra assay has poor sensitivity. This prospective diagnostic accuracy study found that the sensitivity of the Xpert MTB/RIF Ultra assay with oral swab specimens was only 22%.
CLINICAL INFECTIOUS DISEASES
(2022)
Article
Infectious Diseases
A. Andama, D. Jaganath, R. Crowder, L. Asege, M. Nakaye, D. Katumba, J. Mukwatamundu, S. Mwebe, C. F. Semitala, W. Worodria, M. Joloba, S. Mohanty, A. Somoskovi, A. Cattamanchi
Summary: In Kampala, Uganda, the evaluation of Ultra cartridge for pulmonary tuberculosis diagnosis among adults showed a sensitivity of 90.5% and specificity of 98.1%, with no significant differences compared to Xpert. Considering trace results as positive increased case detection without significant loss of specificity.
BMC INFECTIOUS DISEASES
(2021)
Article
Environmental Sciences
David Veivers, Gail M. Williams, Brett G. Toelle, Adriana M. Cortes de Waterman, Yuming Guo, Lyn Denison, Bo-Yi Yang, Guang-Hui Dong, Bin Jalaludin, Guy B. Marks, Luke D. Knibbs
Summary: The association between indoor environment and lifetime prevalence of otitis media in Australian children was assessed. The study found that gas heating, reverse-cycle air conditioning, and pet ownership are significantly associated with higher odds of otitis media.
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
(2022)
Article
Obstetrics & Gynecology
Bronwyn K. Brew, Alison Gibberd, Guy B. Marks, Vanessa E. Murphy, Louisa Jorm, Georgina M. Chambers, Donna Hartz, Sandra Eades, Bridgette McNamara
Summary: The study demonstrates that maternal asthma in Indigenous women is associated with an increased risk of emergency cesarean sections, placental abruption, and threatened preterm labor. These risks may be mitigated by improved management of asthma exacerbations during pregnancy.
INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS
(2023)
Article
Respiratory System
Jate Ratanachina, Andre F. S. Amaral, Sara De Matteis, Herve Lawin, Kevin Mortimer, Daniel O. Obaseki, Imed Harrabi, Meriam Denguezli, Emiel F. M. Wouters, Christer Janson, Rune Nielsen, Amund Gulsvik, Hamid Hacene Cherkaski, Filip Mejza, Padukudru Anand Mahesh, Asma Elsony, Rana Ahmed, Wan Tan, Li Cher Loh, Abdul Rashid, Michael Studnicka, Asaad A. Nafees, Terence Seemungal, Althea Aquart-Stewart, Mohammed Al Ghobain, Jinping Zheng, Sanjay Juvekar, Sundeep Salvi, Rain Jogi, David Mannino, Thorarinn Gislason, A. Sonia Buist, Paul Cullinan, Peter Burney
Summary: This study aimed to assess the association between chronic obstructive pulmonary disease and occupation. Through cross-sectional data analysis of 28,823 adults aged 40 and above in 34 countries, it was found that working in environments with potential exposure to dusts or fumes was associated with respiratory symptoms but not lung function differences. Therefore, respiratory surveillance should be encouraged among high-risk dusty and fume job workers, especially in low- and middle-income countries.
EUROPEAN RESPIRATORY JOURNAL
(2023)
Article
Respiratory System
Yewon Chung, Frances L. Garden, Guy B. Marks, Hima Vedam
Summary: The study aimed to determine the causes and their effect on in-hospital mortality of hypercapnic respiratory failure (HRF). The results showed that HRF is associated with a range of potentially causative conditions, and some of them significantly impact hospital survival. Therefore, systematic evaluation of HRF patients may help to detect treatable comorbidities.
Article
Environmental Sciences
Igor Popovic, Ricardo J. Soares Magalhaes, Yurong Yang, Shukun Yang, Boyi Yang, Guanghui Dong, Xiaolin Wei, Greg J. Fox, Melanie S. Hammer, Randall Martin, Aaron van Donkelaar, Erjia Ge, Guy B. Marks, Luke D. Knibbs
Summary: This study conducted in a rural area in China with a high burden of tuberculosis found that there is a correlation between levels of air pollution, particularly PM2.5 and NO2, and tuberculosis incidence. These findings suggest that improving air quality in endemic regions may have beneficial effects on reducing tuberculosis incidence.
ENVIRONMENTAL POLLUTION
(2023)
Article
Respiratory System
Yue Leon Guo, Maria R. Ampon, Leanne M. Poulos, Sharon R. Davis, Brett G. Toelle, Guy B. Marks, Helen K. Reddel
Summary: This study estimated the contribution of obesity to breathlessness in Australian adults using the population attributable fraction (PAF). The results showed that obesity accounted for approximately a quarter of breathlessness symptoms and had a higher proportion in women.
Article
Allergy
Sinead Maire Langan, Amy R. Mulick, Charlotte E. Rutter, Richard J. Silverwood, Innes Asher, Luis Garcia-Marcos, Eamon Ellwood, Karen Bissell, Chen-Yuan Chiang, Asma El Sony, Philippa Ellwood, Guy B. Marks, Kevin Mortimer, A. Elena Martinez-Torres, Eva Morales, Virginia Perez-Fernandez, Steven Robertson, Hywel C. Williams, David P. Strachan, Neil Pearce
Summary: The prevalence of eczema has increased over the past 27 years, with significant variations in income and region. Understanding the reasons behind these differences can inform prevention strategies.
CLINICAL AND EXPERIMENTAL ALLERGY
(2023)
Article
Environmental Sciences
Nathaniel S. Marshall, Garry Cho, Brett G. Toelle, Renzo Tonin, Delwyn J. Bartlett, Angela L. D'Rozario, Carla A. Evans, Christine T. Cowie, Oliver Janev, Christopher R. Whitfeld, Nick Glozier, Bruce E. Walker, Roo Killick, Miriam S. Welgampola, Craig L. Phillips, Guy B. Marks, Ronald R. Grunstein
Summary: This study tested the effects of inaudible infrasound produced by large electricity-generating wind turbines on human physiology and psychology, and found that it did not have negative impacts.
ENVIRONMENTAL HEALTH PERSPECTIVES
(2023)
Editorial Material
Respiratory System
Guy B. B. Marks
Article
Environmental Sciences
Slobodan Nickovic, Slavko Petkovie, Luka Ilic, Goran Pejanovic, Zoran Mijic, Alfredo Huete, Guy Marks
Summary: Researchers have developed a physically-based pollen model (DREAM-POLL) to predict the occurrence of thunderstorm asthma (TA). By running the model over Southern Australian grass fields for 2010 and 2016 pollen seasons, they successfully predicted four major TA outbreaks. The model can be implemented for other geographical domains and different pollen types.
SCIENCE OF THE TOTAL ENVIRONMENT
(2023)
Review
Health Care Sciences & Services
Seng Hansun, Ahmadreza Argha, Siaw-Teng Liaw, Branko G. Celler, Guy B. Marks
Summary: This systematic literature review confirms the high potential of machine learning (ML) and deep learning (DL) for tuberculosis (TB) detection using chest radiography (CXR). However, future studies need to pay attention to two aspects of risk of bias, namely the reference standard and the flow and timing aspects.
JOURNAL OF MEDICAL INTERNET RESEARCH
(2023)
Article
Respiratory System
A. L. Innes, S. T. Nguyen, V. Lebrun, T. T. H. Nguyen, T. P. Huynh, V. L. Quach, G. L. Hoang, T. B. Nguyen, T. B. P. Nguyen, H. M. Pham, A. Martinez, N. Dinh, V. L. Dinh, B. H. Nguyen, T. T. H. Truong, V. C. Nguyen, V. N. Nguyen, T. H. Mai
Summary: This study compared the results of different thresholds of TST and QFT in household contacts and found that tuberculin reagents affect the positivity rates of TST. The study highlights the importance of monitoring the reliability of TBI diagnosis in high TB burden countries to optimize eligibility for TB preventive treatment.
PUBLIC HEALTH ACTION
(2023)
Article
Public, Environmental & Occupational Health
Paula Jops, John Cowan, Martha Kupul, Richard Nake Trumb, Stephen M. Graham, Mathias Bauri, Herolyn Nindil, Stephen Bell, Tess Keam, Suman Majumdar, William Pomat, Ben Marais, Guy B. Marks, John Kaldor, Andrew Vallely, Angela Kelly-Hanku
Summary: Tuberculosis is a major public health issue in the South Fly District of Western Province, Papua New Guinea. Our research shows that structural barriers, rather than patient delay, hinder timely TB diagnosis and care in rural areas. The findings highlight the need for a person-centred and effective decentralized model of TB care to ensure equitable access to essential health services.
GLOBAL PUBLIC HEALTH
(2023)
Article
Public, Environmental & Occupational Health
Luis Garcia-Marcos, Chen-Yuan Chiang, M. Innes Asher, Guy B. Marks, Asma El Sony, Refiloe Masekela, Karen Bissell, Eamon Ellwood, Philippa Ellwood, Neil Pearce, David P. Strachan, Kevin Mortimer, Eva Morales
Summary: This study aimed to assess asthma medicine use, management plan availability, and disease control in childhood, adolescence, and adulthood across different country settings. The study found variations in asthma medicine use, low utilization of management plans, and inadequate disease control. Strategies should be implemented to improve adherence to asthma treatment guidelines worldwide, especially in low-income and middle-income countries, with a focus on access to affordable and quality-assured essential asthma medicines.
LANCET GLOBAL HEALTH
(2023)
Article
Respiratory System
Yijun Zhou, Maria R. Ampon, Michael J. Abramson, Alan L. James, Graeme P. Maguire, Richard Wood-Baker, David P. Johns, Guy B. Marks, Helen K. Reddel, Brett G. Toelle
Summary: This study aimed to investigate the relationship between health burden, quality of life, and severity of airway obstruction in Australian adults aged 40 years and above. The results showed that greater airflow limitation was associated with higher burden and worse quality of life.
INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE
(2023)