{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T13:23:10Z","timestamp":1783516990428,"version":"3.55.0"},"reference-count":30,"publisher":"American Society for Microbiology","issue":"7","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2026,7,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Rapid diagnosis of drug-resistant tuberculosis (DR-TB) is very challenging, specifically in extra-pulmonary TB specimens. The current study was performed on non-sputum specimens. All specimens were subjected on Xpert MTB\/RIF Ultra followed by Xpert MTB\/XDR, Ziehl-Neelsen (ZN) Staining, liquid culture, line probe assay (LPA), and drug susceptibility testing (DST). Out of 1,152 non-sputum specimens, 218 were observed to be positive on Xpert MTB\/RIF Ultra and were selected for further investigation. From 218 MTBC positive, Xpert MTB\/XDR yielded 174 (79.8%) positive while 25 (11.5%) were negative. On comparison with reference standards, ZN smear, and culture, the sensitivity was 100% and 95.51% with specificity of 17.86% and 18.63%, respectively. DST sensitivity and specificity were 84.62% and 96.61%, 83.33% and 96.88%, 50% and 98.75%, 50% and 98.72%, and 50% and 98.75%, respectively, for isoniazid, fluoroquinolones, amikacin, kanamycin, and capreomycin in culture positive specimens. The sensitivity and specificity of Xpert MTB\/XDR assay, compared with LPA (MTBDR\n                      <jats:italic toggle=\"yes\">plus<\/jats:italic>\n                      and MTBDR\n                      <jats:italic toggle=\"yes\">sl<\/jats:italic>\n                      ), was between 94.12%\u2013100% and 98.39%\u2013100%, respectively. Sensitivity and specificity of Xpert MTB\/XDR matched with culture-DST and LPA results for all the tested drugs. Its placement in diagnostic algorithms with Xpert MTB\/RIF Ultra under National TB Programs will enhance patient outcome by providing prompt switch to a DST guided treatment regimen.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>IMPORTANCE<\/jats:title>\n                    <jats:p>This study provides crucial evidence supporting the use of Xpert MTB\/XDR for rapid detection of DR-TB in non-sputum specimens including extra-pulmonary specimens, where diagnosis remains challenging due to paucibacillary in nature. By demonstrating high sensitivity and specificity compared with culture-DST and LPA, the assay shows strong potential to be integrated into the National TB Elimination Program (NTEP) diagnostic algorithm. Early detection of resistance to isoniazid, fluoroquinolones, and second-line injectables enables timely transition to DST-guided treatment, reducing delays and improving patient outcomes. The findings highlight the assay\u2019s ability to reduce dependency on conventional laboratory-based DST, shortening turnaround time and strengthening decentralized diagnostic capacity. This study provides programmatic evidence for policy-level adoption, supporting India\u2019s efforts toward DR-TB control and elimination.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/jcm.01401-25","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T15:27:46Z","timestamp":1781278066000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Xpert MTB\/XDR performance in non-sputum samples for diagnosis of drug-resistant tuberculosis at a North Indian tertiary care center"],"prefix":"10.1128","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9065-999X","authenticated-orcid":true,"given":"Binit Kumar","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Medicine, All India Institute of Medical Sciences","place":["New Delhi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3722-4310","authenticated-orcid":true,"given":"Pankaj","family":"Jorwal","sequence":"additional","affiliation":[{"name":"Department of Medicine, All India Institute of Medical Sciences","place":["New Delhi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishant","family":"Thakur","sequence":"additional","affiliation":[{"name":"Department of Medicine, All India Institute of Medical Sciences","place":["New Delhi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manish","family":"Soneja","sequence":"additional","affiliation":[{"name":"Department of Medicine, All India Institute of Medical Sciences","place":["New Delhi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naveet","family":"Wig","sequence":"additional","affiliation":[{"name":"Department of Medicine, All India Institute of Medical Sciences","place":["New Delhi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankita","family":"Anand","sequence":"additional","affiliation":[{"name":"Department of Medicine, All India Institute of Medical Sciences","place":["New Delhi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shikha","family":"Dhawan","sequence":"additional","affiliation":[{"name":"Centre for Social Integration and Borderless World","place":["Uttar Pradesh, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_4_2_2","unstructured":"2023. Global Tuberculosis Report 2023 - World | ReliefWeb. Available from: https:\/\/reliefweb.int\/report\/world\/global-tuberculosis-report-2023"},{"key":"e_1_3_4_3_2","unstructured":"India TB Report 2024. 2024. Ministry of Health and Family Welfare New Delhi Central TB Division"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02268-10"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.01086-22"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1099\/acmi.0.000665.v3"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tube.2020.102014"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(21)00452-7"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02314-20"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-024-09562-z"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.03616-2020"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD014841.pub2"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2023.1149741"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30691-6"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","unstructured":"Katamba A Ssengooba W Sserubiri J Semugenze D William KG Abdunoor N Byaruhanga R Turyahabwe S Joloba ML. 2023. Evaluation of Xpert \u00ae MTB\/XDR test for susceptibility testing of Mycobacterium tuberculosis to first and second-line drugs in Uganda. medRxiv. doi:10.1101\/2023.04.03.23288099","DOI":"10.1101\/2023.04.03.23288099"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2021.115397"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","unstructured":"\u00c7apuk S Tarhan G Ceyhan \u0130. 2023. Characterization of resistance mutations against first and second line antituberculosis drugs of multi-drug resistant Mycobacterium tuberculosis strains isolated from clinical samples by In house PCR method and comparison of resistance profiles. Preprints. doi:10.22541\/au.170667324.42914068\/v1","DOI":"10.22541\/au.170667324.42914068\/v1"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2019.07.027"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0201731"},{"key":"e_1_3_4_20_2","unstructured":"Asia WHORO for SE. 2021. Optimizing active case-finding for tuberculosis: Implementation lessons from South-East Asia. World Health Organization. Regional Office for South-East Asia. https:\/\/iris.who.int\/handle\/10665\/343105."},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11033-020-05413-7"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012768.pub3"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(23)00190-8"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1515\/biol-2020-0052"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s44197-023-00150-z"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0268483"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00017-2018"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cegh.2018.08.004"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0141011"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.01832-22"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tube.2023.102340"}],"container-title":["Journal of Clinical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/jcm.01401-25","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/jcm.01401-25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T13:00:42Z","timestamp":1783515642000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/jcm.01401-25"}},"subtitle":[],"editor":[{"given":"Mark","family":"Nicol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,7,8]]},"references-count":30,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7,8]]}},"alternative-id":["10.1128\/jcm.01401-25"],"URL":"https:\/\/doi.org\/10.1128\/jcm.01401-25","relation":{},"ISSN":["0095-1137","1098-660X"],"issn-type":[{"value":"0095-1137","type":"print"},{"value":"1098-660X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,8]]},"assertion":[{"value":"2025-09-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e01401-25"}}