{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T20:21:00Z","timestamp":1792873260761,"version":"4.5.0"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,1]]},"abstract":"\n Objective\/Background:<\/jats:title>\n \n Extrapulmonary tuberculosis (EPTB), which accounts for 10%\u201340% of the global burden of TB, with the highest incidence in Sub-Saharan Africa, is strongly associated with human immunodeficiency virus infection. Diagnosing EPTB is challenging, and recently, there has been a concerted effort to evaluate the latest molecular diagnostics for diagnosing TB in a range of specimen types. The Xpert MTB\/RIF assay (Cepheid, Sunnyvale, CA, USA) is one such technology, which simultaneously detects\n Mycobacterium tuberculosis<\/jats:italic>\n and rifampicin resistance. Our objective was to evaluate the accuracy of the Xpert MTB\/RIF assay for the diagnosis of EPTB and detection of rifampicin resistance in routinely processed formalin-fixed, paraffin-embedded (FFPE) tissues, compared with histological detection of TB as the gold standard.\n <\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n A convenience set of 100 biobanked FFPE tissues, including lymph nodes (\n n<\/jats:italic>\n = 64), male genital tract tissue (\n n<\/jats:italic>\n = 10), abdominal tissue (\n n<\/jats:italic>\n = 8), female genital tissue (\n n<\/jats:italic>\n = 5), breast tissue (\n n<\/jats:italic>\n = 5), synovial tissue (\n n<\/jats:italic>\n = 4), skin (\n n<\/jats:italic>\n = 2), tongue tissue (\n n<\/jats:italic>\n = 1), and thyroid (\n n<\/jats:italic>\n = 1), from routine cases of clinically suspected EPTB admitted to the University Teaching Hospital, Lusaka, Zambia, were analyzed using the Xpert MTB\/RIF assay and in-house polymerase chain reaction (PCR) assay targeting IS6110, in parallel with Ziehl\u2013Neelsen (ZN) staining, against histology as the gold standard.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Some 66% of specimens had histological evidence of TB infection. ZN staining was positive for TB in 8% of cases, and Xpert MTB\/RIF was positive for TB in 25% of cases. Taking histology as the gold standard, the sensitivity and specificity were as follows: In lymph tissue the accuracy of the Xpert MTB\/RIF assay was 41% (95%CI 27-57), not significantly better than ZN or the in-house PCR assay. In non-lymph tissue the sensitivity of the in-house PCR assay was 82% (95%CI: 56%-95%), significantly higher than the Xpert MTB\/RIF assay (\n P<\/jats:italic>\n = 0.004). The Xpert MTB\/RIF assay indicated rifampicin resistance in just three cases.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n The Xpert MTB\/RIF assay is potentially a useful tool for the diagnosis of TB in routine FFPE tissues.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/2212-5531.201892","type":"journal-article","created":{"date-parts":[[2017,5,18]],"date-time":"2017-05-18T11:07:10Z","timestamp":1495105630000},"page":"87-93","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":28,"title":["Performance of the Xpert MTB\/RIF Assay in the Diagnosis of Tuberculosis in Formalin-fixed, Paraffin-embedded Tissues"],"prefix":"10.4103","volume":"6","author":[{"given":"Pascal","family":"Polepole","sequence":"first","affiliation":[{"name":"Department of Biomedical Sciences, University of School of Medicine, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mwila","family":"Kabwe","sequence":"additional","affiliation":[{"name":"University of and University College London Medical School (UNZA-UCLMS) Research and Training Programme, University Teaching Hospital, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mpanga","family":"Kasonde","sequence":"additional","affiliation":[{"name":"Department of Pathology and Microbiology, University Teaching Hospital, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Tembo","sequence":"additional","affiliation":[{"name":"University of and University College London Medical School (UNZA-UCLMS) Research and Training Programme, University Teaching Hospital, Lusaka, Zambia"},{"name":"Institute for Infectious Diseases, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Shibemba","sequence":"additional","affiliation":[{"name":"Department of Pathology and Microbiology, University Teaching Hospital, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"O'Grady","sequence":"additional","affiliation":[{"name":"Norwich Medical School, University of East Anglia, Norwich, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Kapata","sequence":"additional","affiliation":[{"name":"National TB and Leprosy Control Programme, Ministry of Community Development, Mother and Child Health, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alimuddin","family":"Zumla","sequence":"additional","affiliation":[{"name":"University of and University College London Medical School (UNZA-UCLMS) Research and Training Programme, University Teaching Hospital, Lusaka, Zambia"},{"name":"Department of Infection, Division of Infection and Immunity, University College London, United Kingdom"},{"name":"National Institute for Health Research Biomedical Research Centre at UCL Hospitals, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Bates","sequence":"additional","affiliation":[{"name":"University of and University College London Medical School (UNZA-UCLMS) Research and Training Programme, University Teaching Hospital, Lusaka, Zambia"},{"name":"Department of Infection, Division of Infection and Immunity, University College London, United Kingdom"},{"name":"National Institute for Health Research Biomedical Research Centre at UCL Hospitals, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R2-20250603","doi-asserted-by":"crossref","first-page":"e40774","DOI":"10.1371\/journal.pone.0040774","article-title":"Evaluation of the burden of 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