{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T21:22:41Z","timestamp":1775251361569,"version":"3.50.1"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,7,25]],"date-time":"2020-07-25T00:00:00Z","timestamp":1595635200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,7,25]],"date-time":"2020-07-25T00:00:00Z","timestamp":1595635200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000030","name":"U.S. Centers for Disease Control and Prevention","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100009054","name":"U.S. President\u2019s Emergency Plan for AIDS Relief","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>The main advantage of GeneXpert MTB\/RIF<jats:bold>\u00ae<\/jats:bold> (Xpert) molecular diagnostic technology is the rapid detection of M<jats:italic>.tuberculosis<\/jats:italic> DNA and mutations associated with rifampicin (RIF) resistance for timely initiation of appropriate treatment and, consequently, preventing further transmission of the disease. We assessed time to treatment initiation and treatment outcomes of RIF-resistant and RIF-susceptible TB patients diagnosed and treated in Vladimir TB Dispensary, Russia in 2012, before and after implementation of GeneXpert MTB\/RIF\u00ae diagnostic technology.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>All adult patients suspected of having TB during February\u2013December 2012 underwent a clinical examination, chest x-ray, microscopy, culture, and phenotypic drug susceptibility testing (DST). Starting August 2012 Xpert diagnostic technology became available in the facility. We used logistic regression to compare treatment outcomes in pre-Xpert and post-Xpert periods. Kaplan-Meier curves and log-rank test were used to compare the time to treatment initiation between the groups.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Of 402 patients screened for TB during February\u2013December 2012, 338 were diagnosed with TB (280 RIF-susceptible, 58 RIF-resistant). RIF-resistant patients in the post-Xpert group started treatment with second-line drugs (SLD) earlier than those in pre-Xpert group (median 11 vs. 37\u2009days, Log-rank <jats:italic>p<\/jats:italic>\u2009=\u20090.02). The hazard ratio for time to SLD treatment initiation was significantly higher in post-Xpert group (HR:2.06; 95%CI:1.09,3.89) compared to pre-Xpert group. Among the 53\/58 RIF-resistant TB patients with available treatment outcome, 28 (53%) had successful outcomes (cured\/completed treatment) including 15\/26 (58%) in post-Xpert group versus 13\/27 (48%) in pre-Xpert group. The observed difference, however, was not statistically significant (OR:0.69; 95%CI:0.23,2.06).<\/jats:p>\n<jats:p>Among RIF-susceptible TB cases time to treatment initiation was not significantly different between the groups (2 vs. 3\u2009days, Log-rank <jats:italic>p<\/jats:italic>\u2009=\u20090.73). Of 252\/280 RIF-susceptible TB cases with treatment outcome, 199 (79%) cases had successful outcome including 94\/114 (82%) in post-Xpert group versus 105\/138 (76%) in pre-Xpert group (OR:0.68; 95%CI:0.36,1.26).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>We observed that availability of Xpert for initial diagnosis significantly reduced the time to SLD treatment for RIF-resistant patients in the Vladimir TB Dispensary. Although implementation of rapid diagnostics did not improve treatment outcomes, early diagnosis of MDR-TB is important for selection of appropriate treatment regimen and prevention of transmission of drug-resistant strains of TB.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12879-020-05243-9","type":"journal-article","created":{"date-parts":[[2020,7,25]],"date-time":"2020-07-25T10:02:26Z","timestamp":1595671346000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Impact of GeneXpert MTB\/RIF\u00ae on treatment initiation and outcomes of RIF-resistant and RIF-susceptible TB patients in Vladimir TB dispensary, Russia"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3873-7166","authenticated-orcid":false,"given":"Julia V.","family":"Ershova","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grigory V.","family":"Volchenkov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatiana R.","family":"Somova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatiana A.","family":"Kuznetsova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalia V.","family":"Kaunetis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorothy","family":"Kaminski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olga V.","family":"Demikhova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larisa N.","family":"Chernousova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irina A.","family":"Vasilyeva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleanor M.","family":"Kerr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Peter","family":"Cegielski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ekaterina V.","family":"Kurbatova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,7,25]]},"reference":[{"key":"5243_CR1","unstructured":"World Health Organization. Global tuberculosis report 2019 [cited 2019 Dec 9]. http:\/\/www.who.int\/tb\/publications\/global_report\/en\/."},{"key":"5243_CR2","unstructured":"World Health Organization. Xpert MTB\/RIF implementation manual [cited 2019 Dec 9]. http:\/\/www.who.int\/tb\/publications\/xpert_implem_manual\/en\/."},{"key":"5243_CR3","unstructured":"World Health Organization. Using the Xpert MTB\/RIF assay to detect pulmonary and extrapulmonary tuberculosis and rifampicin resistance in adults and children [cited 2019 Dec 9]. http:\/\/www.who.int\/tb\/publications\/xpert-mtb-rif-assay-diagnosis-meeting-report\/en\/."},{"issue":"7","key":"5243_CR4","doi-asserted-by":"publisher","first-page":"882","DOI":"10.5588\/ijtld.15.0696","volume":"20","author":"JZ Metcalfe","year":"2016","unstructured":"Metcalfe JZ, Makumbirofa S, Makamure B, Sandy C, Bara W, Mason P, et al. Xpert MTB\/RIF detection of rifampin resistance and time to treatment initiation in Harare, Zimbabwe. Int J Tuberc Lung Dis. 2016;20(7):882\u20139 PubMed PMID: PMC4961684.","journal-title":"Int J Tuberc Lung Dis"},{"key":"5243_CR5","doi-asserted-by":"publisher","first-page":"CD009593","DOI":"10.1002\/14651858.CD009593.pub4","volume":"6","author":"DJ Horne","year":"2019","unstructured":"Horne DJ, Kohli M, Zifodya JS, Schiller I, Dendukuri N, Tollefson D, Schumacher SG, Ochodo EA, Pai M, Steingart KR. Xpert MTB\/RIF and Xpert MTB\/RIF ultra for pulmonary tuberculosis and rifampicin resistance in adults. Cochrane Database Syst Rev. 2019;6:CD009593. https:\/\/doi.org\/10.1002\/14651858.CD009593.pub4.","journal-title":"Cochrane Database Syst Rev"},{"key":"5243_CR6","unstructured":"World Health Organization. Xpert MTB\/RIF assay for the diagnosis of pulmonary and extra pulmonary TB in adults and children [cited 2019 Dec 9]. Available from: http:\/\/www.who.int\/tb\/laboratory\/xpert_policyupdate\/en\/."},{"key":"5243_CR7","unstructured":"World Health Organization. Global tuberculosis report 2013 [cited 2020 June 9]. Available from: http:\/\/www.who.int\/tb\/publications\/global_report\/en\/."},{"key":"5243_CR8","unstructured":"Tuberculosis in the Russian Federation 2011: an analytical review of statistical indicators used in the Russian Federation and in the world (in Russian). Moscow: Ministry of Health of the Russian Federation et al., 2013. Available from: http:\/\/mednet.ru\/images\/stories\/files\/CMT\/tbreview2011.pdf."},{"key":"5243_CR9","unstructured":"Tuberculosis in the Russian Federation. An analytical review of the TB statistical indicators used in the Russian Federation. 2009. Available from: http:\/\/www.mednet.ru\/images\/stories\/files\/static\/VOZ_tub_2009_eng.pdf."},{"issue":"11","key":"5243_CR10","doi-asserted-by":"publisher","first-page":"2048","DOI":"10.3201\/eid2111.150813","volume":"21","author":"J Ershova","year":"2015","unstructured":"Ershova J, Volchenkov GV, Kaminski DA, Somova TR, Kuznetsova TA, Kaunetis NV, et al. Epidemiology of primary multidrug-resistant tuberculosis, Vladimir region, Russia. Emerg Infect Dis. 2015;21(11):2048\u201351. https:\/\/doi.org\/10.3201\/eid2111.150813.","journal-title":"Emerg Infect Dis"},{"key":"5243_CR11","doi-asserted-by":"crossref","unstructured":"Kurbatova EV, Kaminski DA, Erokhin VV, Volchenkov GV, Andreevskaya SN, Chernousova LN, Demikhova OV, Ershova JV, Kaunetis NV, Kuznetsova TA, Larionova EE, Smirnova TG, Somova TR, Vasilieva IA, Vorobieva AV, Zolkina SS, Cegielski JP. Performance of Cepheid\u00ae Xpert MTB\/RIF\u00ae and TB biochip\u00ae MDR in two regions of Russia with a high prevalence of drug-resistant tuberculosis. Eur J Clin Microbiol Infect Dis. 2013 Jun;32(6):735\u201343 PMID: 23263819.","DOI":"10.1007\/s10096-012-1798-0"},{"key":"5243_CR12","unstructured":"World Health Organization. Definitions and reporting framework for tuberculosis. [cited 2020 Apr 4). Available from: https:\/\/www.who.int\/tb\/publications\/definitions\/en\/."},{"key":"5243_CR13","doi-asserted-by":"crossref","unstructured":"Cox HS, Mbhele S, Mohess N, Whitelaw A, Muller O, Zemanay W, et al. Impact of Xpert MTB\/RIF for TB Diagnosis in a Primary Care Clinic with High TB and HIV Prevalence in South Africa: A Pragmatic Randomised Trial. PLoS Med. 2014;11(11):e1001760. 01\/02\/received 10\/13\/accepted PubMed PMID: PMC4244039.","DOI":"10.1371\/journal.pmed.1001760"},{"issue":"9","key":"5243_CR14","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1093\/trstmh\/trw060","volume":"110","author":"D Nair","year":"2016","unstructured":"Nair D, Navneethapandian PD, Tripathy JP, Harries AD, Klinton JS, Watson B, et al. Impact of rapid molecular diagnostic tests on time to treatment initiation and outcomes in patients with multidrug-resistant tuberculosis, Tamil Nadu, India. 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Lancet. 383(9915):424\u201335.","DOI":"10.1016\/S0140-6736(13)62073-5"},{"issue":"10","key":"5243_CR17","doi-asserted-by":"publisher","first-page":"1216","DOI":"10.5588\/ijtld.15.0183","volume":"19","author":"YW Kim","year":"2015","unstructured":"Kim YW, Seong MW, Kim TS, Yoo CG, Kim YW, Han SK, et al. Evaluation of Xpert\u00ae MTB\/RIF assay: diagnosis and treatment outcomes in rifampicin-resistant tuberculosis. Int J Tuberc Lung Dis. 2015;19(10):1216\u201321.","journal-title":"Int J Tuberc Lung Dis"},{"key":"5243_CR18","doi-asserted-by":"publisher","first-page":"1708","DOI":"10.1038\/s41591-018-0224-2","volume":"24","author":"MZ Imperial","year":"2018","unstructured":"Imperial MZ, Nahid P, Phillips PPJ, Davies GR, Fielding K, Hanna D, et al. A patient-level pooled analysis of treatment-shortening regimens for drug-susceptible pulmonary tuberculosis. 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All enrolled patients (adults 18\u2009years old and above) provided written informed consent.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"543"}}