{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:19:16Z","timestamp":1785410356140,"version":"3.56.0"},"reference-count":18,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T00:00:00Z","timestamp":1692230400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NIH","award":["NURTURE: D43TW010132"],"award-info":[{"award-number":["NURTURE: D43TW010132"]}]},{"DOI":"10.13039\/501100001713","name":"EDCTP","doi-asserted-by":"crossref","award":["TMA2018CDF-2351"],"award-info":[{"award-number":["TMA2018CDF-2351"]}],"id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"crossref"}]},{"name":"MUII+","award":["Uganda Medical Informatics Centre (UMIC) Bioinformatics endeavour"],"award-info":[{"award-number":["Uganda Medical Informatics Centre (UMIC) Bioinformatics endeavour"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Drug-Resistant Tuberculosis (DR-TB) is one of the major challenges to TB control.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Design and methods<\/jats:title>\n<jats:p>This was a blinded, laboratory-based cross-sectional study using sputum samples or culture isolates. Samples were from patients with rifampicin-resistant\u2014TB and\/or with high risk for isoniazid (INH) resistance and\/or 2<jats:sup>nd<\/jats:sup> line fluoroquinolones (FQ) and injectable agents (IAs). The diagnostic accuracy of the Xpert<jats:sup>\u00ae<\/jats:sup> MTB\/XDR test was compared to MGIT960 and the Hain Genotype<jats:sup>\u00ae<\/jats:sup> MTBDR<jats:italic>plus<\/jats:italic> and MDRsl assays (LPA) as reference DST methods. Factors for laboratory uptake of the Xpert<jats:sup>\u00ae<\/jats:sup> MTB\/XDR test were also evaluated.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of the 100 stored sputum samples included in this study, 65\/99 (65.6%) were resistant to INH, 5\/100 (5.0%) were resistant to FQ and none were resistant to IAs using MGIT960. The sensitivity and specificity, n (%; 95% Confidence Interval, CI) of Xpert<jats:sup>\u00ae<\/jats:sup> MTB\/XDR test for; INH was 58 (89.2; 79.1\u201395.5) and 30 (88.2; 72.5\u201396.6) and for FQ; 4 (80.0; 28.3\u201399.4) and 95 (100; 96.2\u2013100), respectively. Using LPA as a reference standard, a total of 52\/98 (53.1%) were resistant to INH, 3\/100 (3.0%) to FQ, and none to IA. The sensitivity and specificity, n (%; 95%CI) of Xpert<jats:sup>\u00ae<\/jats:sup> MTB\/XDR test compared to LPA for; INH was 50 (96.1; 86.7\u201399.5) and 34 (74.0; 58.8\u201385.7) for FQ 3 (100; 29.2\u2013100) and 96 (99.0; 94.3\u201399.9) respectively. The factors for laboratory uptake and roll-out of the Xpert<jats:sup>\u00ae<\/jats:sup> MTB\/XDR test included: no training needed for technicians with, and one day for those without, previous Xpert-ultra experience, recording and reporting needs were not different from those of Xpert-ultra, the error rate was 4\/100 (4%), one (1%) indeterminate rate and test turn-around-time were 1hr\/45 minutes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>There is high sensitivity and specificity of Xpert<jats:sup>\u00ae<\/jats:sup> MTB\/XDR test for isoniazid and fluoroquinolones. There are acceptable Xpert<jats:sup>\u00ae<\/jats:sup> MTB\/XDR test attributes for the test uptake and roll-out.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0284545","type":"journal-article","created":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T17:43:19Z","timestamp":1692294199000},"page":"e0284545","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":13,"title":["Evaluation of Xpert MTB\/XDR test for susceptibility testing of Mycobacterium tuberculosis to first and second-line drugs in Uganda"],"prefix":"10.1371","volume":"18","author":[{"given":"Achilles","family":"Katamba","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1643-110X","authenticated-orcid":true,"given":"Willy","family":"Ssengooba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Sserubiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derrick","family":"Semugenze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George William","family":"Kasule","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdunoor","family":"Nyombi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Byaruhanga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stavia","family":"Turyahabwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses L.","family":"Joloba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,8,17]]},"reference":[{"key":"pone.0284545.ref001","unstructured":"WHO. Global tuberculosis report 2022. Geneva: World Health Organization; 2022.URL: https:\/\/www.who.int\/publications\/i\/item\/9789240061729. Accessed 16 November 2022. 2021."},{"issue":"4","key":"pone.0284545.ref002","doi-asserted-by":"crossref","first-page":"e121","DOI":"10.1016\/S1473-3099(21)00613-7","article-title":"Can the GeneXpert MTB\/XDR deliver on the promise of expanded, near-patient tuberculosis drug-susceptibility testing?","volume":"22","author":"K Naidoo","year":"2022","journal-title":"Lancet Infect Dis"},{"key":"pone.0284545.ref003","unstructured":"WHO. World Health Organization. Rapid Implementation of the Xpert MTB\/RIF diagnostic test. Technical and Operational \u2018How-to\u2019 Practical considerations. URL; http:\/\/apps.who.int\/iris\/bitstream\/10665\/44593\/1\/9789241501569_eng.pdf. Accessed 06 January 2023. 2011."},{"key":"pone.0284545.ref004","unstructured":"WHO. World Health Organization. The End TB strategy. URL: https:\/\/www.who.int\/publications\/i\/item\/WHO-HTM-TB-2015.19; Accessed 4th January 2023.2017."},{"issue":"2","key":"pone.0284545.ref005","doi-asserted-by":"crossref","first-page":"ofw068","DOI":"10.1093\/ofid\/ofw068","article-title":"Implementation of Xpert MTB\/RIF in Uganda: Missed Opportunities to Improve Diagnosis of Tuberculosis","volume":"3","author":"CF Hanrahan","year":"2016","journal-title":"Open Forum Infect Dis"},{"issue":"9","key":"pone.0284545.ref006","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.5588\/ijtld.16.0200","article-title":"Higher cost of implementing Xpert((R)) MTB\/RIF in Ugandan peripheral settings: implications for cost-effectiveness","volume":"20","author":"E Hsiang","year":"2016","journal-title":"Int J Tuberc Lung Dis"},{"issue":"1","key":"pone.0284545.ref007","doi-asserted-by":"crossref","first-page":"11826","DOI":"10.1038\/s41598-019-48401-z","article-title":"Variable ability of rapid tests to detect Mycobacterium tuberculosis rpoB mutations conferring phenotypically occult rifampicin resistance","volume":"9","author":"G Torrea","year":"2019","journal-title":"Scientific reports"},{"issue":"1","key":"pone.0284545.ref008","doi-asserted-by":"crossref","first-page":"115397","DOI":"10.1016\/j.diagmicrobio.2021.115397","article-title":"Analytical performance of the Xpert MTB\/XDR(R) assay for tuberculosis and expanded resistance detection","volume":"101","author":"SB Georghiou","year":"2021","journal-title":"Diagn Microbiol Infect Dis"},{"issue":"2","key":"pone.0284545.ref009","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/S1473-3099(21)00452-7","article-title":"Detection of isoniazid, fluoroquinolone, ethionamide, amikacin, kanamycin, and capreomycin resistance by the Xpert MTB\/XDR assay: a cross-sectional multicentre diagnostic accuracy study","volume":"22","author":"A Penn-Nicholson","year":"2022","journal-title":"Lancet Infect 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Resist"},{"issue":"2","key":"pone.0284545.ref013","doi-asserted-by":"crossref","first-page":"dlac029","DOI":"10.1093\/jacamr\/dlac029","article-title":"Acquired bedaquiline resistance during the treatment of drug-resistant tuberculosis: a systematic review","volume":"4","author":"JS Mallick","year":"2022","journal-title":"JAC Antimicrob Resist"},{"key":"pone.0284545.ref014","doi-asserted-by":"crossref","first-page":"1047965","DOI":"10.3389\/fpubh.2022.1047965","article-title":"Whole-genome sequencing to characterize the genetic structure and transmission risk of Mycobacterium tuberculosis in Yichang city of China","volume":"10","author":"L Ji","year":"2022","journal-title":"Front Public Health"},{"key":"pone.0284545.ref015","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.meegid.2016.02.019","article-title":"Whole genome sequencing to complement tuberculosis drug resistance surveys in Uganda","volume":"40","author":"W Ssengooba","year":"2016","journal-title":"Infect 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