Systematic Review of Pooling Sputum as an Efficient Method for Xpert MTB/RIF Tuberculosis Testing during the COVID-19 Pandemic
GeneXpert-based testing with Xpert MTB/RIF or Ultra assays is essential for tuberculosis diagnosis. However, testing may be affected by cartridge and staff shortages. More efficient testing strategies could help, especially during the coronavirus disease pandemic. We searched the literature to syste...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Centers for Disease Control and Prevention
2021-03-01
|
| Series: | Emerging Infectious Diseases |
| Subjects: | |
| Online Access: | https://wwwnc.cdc.gov/eid/article/27/3/20-4090_article |
| _version_ | 1818874596475011072 |
|---|---|
| author | Luis E. Cuevas Victor S. Santos Shirley Verônica Melo Almeida Lima Konstantina Kontogianni John S. Bimba Vibol Iem Jose Dominguez Emily Adams Ana Cubas Atienzar Thomas Edwards S. Bertel Squire Patricia J. Hall Jacob Creswell |
| author_facet | Luis E. Cuevas Victor S. Santos Shirley Verônica Melo Almeida Lima Konstantina Kontogianni John S. Bimba Vibol Iem Jose Dominguez Emily Adams Ana Cubas Atienzar Thomas Edwards S. Bertel Squire Patricia J. Hall Jacob Creswell |
| author_sort | Luis E. Cuevas |
| collection | DOAJ |
| description | GeneXpert-based testing with Xpert MTB/RIF or Ultra assays is essential for tuberculosis diagnosis. However, testing may be affected by cartridge and staff shortages. More efficient testing strategies could help, especially during the coronavirus disease pandemic. We searched the literature to systematically review whether GeneXpert-based testing of pooled sputum samples achieves sensitivity and specificity similar to testing individual samples; this method could potentially save time and preserve the limited supply of cartridges. From 6 publications, we found 2-sample pools using Xpert MTB/RIF had 87.5% and 96.0% sensitivity (average sensitivity 94%; 95% CI 89.0%–98.0%) (2 studies). Four-sample pools averaged 91% sensitivity with Xpert MTB/RIF (2 studies) and 98% with Ultra (2 studies); combining >4 samples resulted in lower sensitivity. Two studies reported that pooling achieved 99%–100% specificity and 27%–31% in cartridge savings. Our results show that pooling may improve efficiency of GeneXpert-based testing. |
| first_indexed | 2024-12-19T13:13:07Z |
| format | Article |
| id | doaj.art-e89c688187bb451fb362351c6d17ef92 |
| institution | Directory Open Access Journal |
| issn | 1080-6040 1080-6059 |
| language | English |
| last_indexed | 2024-12-19T13:13:07Z |
| publishDate | 2021-03-01 |
| publisher | Centers for Disease Control and Prevention |
| record_format | Article |
| series | Emerging Infectious Diseases |
| spelling | doaj.art-e89c688187bb451fb362351c6d17ef922022-12-21T20:19:53ZengCenters for Disease Control and PreventionEmerging Infectious Diseases1080-60401080-60592021-03-0127371972710.3201/eid2703.204090Systematic Review of Pooling Sputum as an Efficient Method for Xpert MTB/RIF Tuberculosis Testing during the COVID-19 PandemicLuis E. CuevasVictor S. SantosShirley Verônica Melo Almeida LimaKonstantina KontogianniJohn S. BimbaVibol IemJose DominguezEmily AdamsAna Cubas AtienzarThomas EdwardsS. Bertel SquirePatricia J. HallJacob CreswellGeneXpert-based testing with Xpert MTB/RIF or Ultra assays is essential for tuberculosis diagnosis. However, testing may be affected by cartridge and staff shortages. More efficient testing strategies could help, especially during the coronavirus disease pandemic. We searched the literature to systematically review whether GeneXpert-based testing of pooled sputum samples achieves sensitivity and specificity similar to testing individual samples; this method could potentially save time and preserve the limited supply of cartridges. From 6 publications, we found 2-sample pools using Xpert MTB/RIF had 87.5% and 96.0% sensitivity (average sensitivity 94%; 95% CI 89.0%–98.0%) (2 studies). Four-sample pools averaged 91% sensitivity with Xpert MTB/RIF (2 studies) and 98% with Ultra (2 studies); combining >4 samples resulted in lower sensitivity. Two studies reported that pooling achieved 99%–100% specificity and 27%–31% in cartridge savings. Our results show that pooling may improve efficiency of GeneXpert-based testing.https://wwwnc.cdc.gov/eid/article/27/3/20-4090_articleantimicrobial resistancecoronavirus diseaseCOVID-19diagnosticsXpert MTB/RIF testingmycobacteria |
| spellingShingle | Luis E. Cuevas Victor S. Santos Shirley Verônica Melo Almeida Lima Konstantina Kontogianni John S. Bimba Vibol Iem Jose Dominguez Emily Adams Ana Cubas Atienzar Thomas Edwards S. Bertel Squire Patricia J. Hall Jacob Creswell Systematic Review of Pooling Sputum as an Efficient Method for Xpert MTB/RIF Tuberculosis Testing during the COVID-19 Pandemic Emerging Infectious Diseases antimicrobial resistance coronavirus disease COVID-19 diagnostics Xpert MTB/RIF testing mycobacteria |
| title | Systematic Review of Pooling Sputum as an Efficient Method for Xpert MTB/RIF Tuberculosis Testing during the COVID-19 Pandemic |
| title_full | Systematic Review of Pooling Sputum as an Efficient Method for Xpert MTB/RIF Tuberculosis Testing during the COVID-19 Pandemic |
| title_fullStr | Systematic Review of Pooling Sputum as an Efficient Method for Xpert MTB/RIF Tuberculosis Testing during the COVID-19 Pandemic |
| title_full_unstemmed | Systematic Review of Pooling Sputum as an Efficient Method for Xpert MTB/RIF Tuberculosis Testing during the COVID-19 Pandemic |
| title_short | Systematic Review of Pooling Sputum as an Efficient Method for Xpert MTB/RIF Tuberculosis Testing during the COVID-19 Pandemic |
| title_sort | systematic review of pooling sputum as an efficient method for xpert mtb rif tuberculosis testing during the covid 19 pandemic |
| topic | antimicrobial resistance coronavirus disease COVID-19 diagnostics Xpert MTB/RIF testing mycobacteria |
| url | https://wwwnc.cdc.gov/eid/article/27/3/20-4090_article |
| work_keys_str_mv | AT luisecuevas systematicreviewofpoolingsputumasanefficientmethodforxpertmtbriftuberculosistestingduringthecovid19pandemic AT victorssantos systematicreviewofpoolingsputumasanefficientmethodforxpertmtbriftuberculosistestingduringthecovid19pandemic AT shirleyveronicameloalmeidalima systematicreviewofpoolingsputumasanefficientmethodforxpertmtbriftuberculosistestingduringthecovid19pandemic AT konstantinakontogianni systematicreviewofpoolingsputumasanefficientmethodforxpertmtbriftuberculosistestingduringthecovid19pandemic AT johnsbimba systematicreviewofpoolingsputumasanefficientmethodforxpertmtbriftuberculosistestingduringthecovid19pandemic AT viboliem systematicreviewofpoolingsputumasanefficientmethodforxpertmtbriftuberculosistestingduringthecovid19pandemic AT josedominguez systematicreviewofpoolingsputumasanefficientmethodforxpertmtbriftuberculosistestingduringthecovid19pandemic AT emilyadams systematicreviewofpoolingsputumasanefficientmethodforxpertmtbriftuberculosistestingduringthecovid19pandemic AT anacubasatienzar systematicreviewofpoolingsputumasanefficientmethodforxpertmtbriftuberculosistestingduringthecovid19pandemic AT thomasedwards systematicreviewofpoolingsputumasanefficientmethodforxpertmtbriftuberculosistestingduringthecovid19pandemic AT sbertelsquire systematicreviewofpoolingsputumasanefficientmethodforxpertmtbriftuberculosistestingduringthecovid19pandemic AT patriciajhall systematicreviewofpoolingsputumasanefficientmethodforxpertmtbriftuberculosistestingduringthecovid19pandemic AT jacobcreswell systematicreviewofpoolingsputumasanefficientmethodforxpertmtbriftuberculosistestingduringthecovid19pandemic |