{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:02:58Z","timestamp":1787022178227,"version":"build-2736575974"},"reference-count":23,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key R&D Program of China","doi-asserted-by":"crossref","award":["2023YFC2307301"],"award-info":[{"award-number":["2023YFC2307301"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Cepheid Investigator-Initiated Study award","award":["Cepheid-IIS-2023-0001"],"award-info":[{"award-number":["Cepheid-IIS-2023-0001"]}]},{"DOI":"10.13039\/501100012166","name":"National Key R&D Program of China","doi-asserted-by":"crossref","award":["2022YFC2305204"],"award-info":[{"award-number":["2022YFC2305204"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Public Health Personnel Training Sopport Program","award":["01056"],"award-info":[{"award-number":["01056"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The emergence of drug-resistant tuberculosis (DR-TB) has posed significant challenges to TB control. This study assessed the diagnostic performance of the Xpert MTB\/XDR test for detecting drug resistance in TB patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study analyzed 276 samples collected from clinically suspected MDR-TB patients in Auhui Chest Hospital from 01\/03\/2022\u201301\/03\/2023. The Xpert MTB\/XDR test was evaluated for its ability to detect resistance to isoniazid (INH), ethionamide (ETH), fluoroquinolones (FLQ), and second-line injectable drugs (SLIDs) compared with phenotypic drug susceptibility testing (pDST). Specimens were investigated by Sanger sequencing, where the MTB\/XDR test and pDST results were inconsistent. Afterward, the clinical performance of the Xpert MTB\/XDR test was also evaluated with the composite reference test (pDST\u2009+\u2009sequencing).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The sensitivity of the Xpert MTB\/XDR test against pDST in detecting resistance to INH and FLQ using 276 samples was 95.77% (95% CI: 91.83\u201398.16) and 93.83% (95% CI: 86.18\u201397.97), respectively. In contrast, a lower sensitivity of the MTB XDR test in predicting SLIDs and ETH resistance (sensitivity\u2009&lt;\u200975%) compared with pDST was demonstrated in this study. The specificity for detecting all drugs was greater than 90%. Thirty-three samples were retested by sequencing, which identified mutations predicting INH and FLQ resistance, determining whether resistant or not by combining pDST and sequencing results. When considering pDST\u2009+\u2009sequencing, the sensitivity and specificity of the MTB\/XDR assay for INH and FLQ drug targets increased, especially the detection specificity of FLQ has reached 100% (95% CI: 97.95\u2013100).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The Xpert MTB\/XDR has high sensitivity and specificity in drug-resistant tuberculosis patients, making it better suited to meet the needs of rapid, sensitive, and accurate detection for drug-resistant tuberculosis in resource-limited settings, and serving as a critical tool for achieving personalized treatment and TB control.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0331264","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T17:23:49Z","timestamp":1757697829000},"page":"e0331264","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluation of the Xpert MTB\/XDR test for detection of isoniazid, fluoroquinolones, and second-line injectable drugs resistance to Mycobacterium tuberculosis\u2014Anhui Province, China"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5704-8518","authenticated-orcid":true,"given":"Ruiqing","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xundi","family":"Bao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangjin","family":"Bao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chong","family":"Teng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongfang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhou","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruida","family":"Xing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xichao","family":"Ou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanlin","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"key":"pone.0331264.ref001","unstructured":"World Health Organization. Global tuberculosis report 2024. 2024."},{"key":"pone.0331264.ref002","unstructured":"World Health Organization. WHO consolidated guidelines on tuberculosis. 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Omar","year":"2024","journal-title":"J Clin Microbiol"},{"issue":"8","key":"pone.0331264.ref006","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0284545","article-title":"Evaluation of Xpert MTB\/XDR test for susceptibility testing of Mycobacterium tuberculosis to first and second-line drugs in Uganda","volume":"18","author":"A Katamba","year":"2023","journal-title":"PLoS One"},{"issue":"3","key":"pone.0331264.ref007","article-title":"Xpert MTB\/XDR: a 10-Color Reflex Assay Suitable for Point-of-Care Settings To Detect Isoniazid, Fluoroquinolone, and Second-Line-Injectable-Drug Resistance Directly from Mycobacterium tuberculosis-Positive Sputum","volume":"59","author":"Y Cao","year":"2021","journal-title":"J Clin Microbiol"},{"issue":"2","key":"pone.0331264.ref008","doi-asserted-by":"crossref","DOI":"10.1128\/spectrum.03991-22","article-title":"The Evolution and Transmission Dynamics of Multidrug-Resistant Tuberculosis in an Isolated High-Plateau Population of Tibet, 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isoniazid, fluoroquinolones, ethionamide, and amikacin","volume":"5","author":"S Pillay","year":"2022","journal-title":"Cochrane Database Syst Rev"},{"key":"pone.0331264.ref015","doi-asserted-by":"crossref","DOI":"10.1093\/infdis\/jiz097","article-title":"Guidance for the Evaluation of Tuberculosis Diagnostics That Meet the World Health Organization (WHO) Target Product Profiles: An Introduction to WHO Process and Study Design Principles","volume":"220","author":"CM Denkinger","year":"2019","journal-title":"J Infect Dis"},{"key":"pone.0331264.ref016","doi-asserted-by":"crossref","first-page":"3289","DOI":"10.2147\/IDR.S468997","article-title":"Discordance Between Phenotypic and WGS-Based Drug Susceptibility Testing Results for Some Anti-Tuberculosis Drugs: A Snapshot Study of Paired Mycobacterium tuberculosis Isolates with Small Genetic Distance","volume":"17","author":"D Sadovska","year":"2024","journal-title":"Infect Drug 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