{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:22:32Z","timestamp":1787764952614,"version":"build-2784847793"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Xpert Ultra (Cepheid, USA) is recently introduced with an extra category of trace-positive results and higher sensitivity for tuberculosis (TB) diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The objective of the study was to assess the diagnostic accuracy of Xpert Ultra for extrapulmonary samples using culture and composite reference standard (CRS) as the gold standard.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>In a 1-year (March 2021\u201322) prospective observational study, samples of suspected extrapulmonary TB (EPTB) patients were subjected to Ziehl\u2013Neelsen staining, culture, and Xpert Ultra (Cepheid, Sunnyvale, CA) tests. Relevant clinical and treatment information was noted. The diagnostic accuracy of Xpert Ultra compared with culture and CRS was calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Out of 1720 suspected patients of EPTB, 223 (13%), predominantly males 135 (60%), with a mean age of 41.46 \u00b1 19.81 years, were diagnosed as TB positive following CRS criteria. The maximum cases were of pleural TB (35.4%), followed by central nervous system TB (17.9%), gastrointestinal TB (17.5%), and lymph node TB (12.1%). Of all samples, 150 (8.7%) were microbiologically confirmed, including 141 detected by Xpert ultra, 67 culture positive, and only 16 smear positive. Among the Xpert Ultra-positive samples, 35 showed trace results, including six false-positive results. Considering culture and CRS as the gold standard, the sensitivity (86.57%, 59.64%) and specificity (94.98%, 99.47%) of Xpert Ultra were calculated, respectively. Rifampicin resistance was detected in 1 (0.70%) sample.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Diagnosis of EPTB is a challenge and Xpert Ultra may detect TB at a very early stage. However, it is essential to rule out false-positive results. Additional studies are needed on Xpert Ultra to interpret trace results better.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijabmr.ijabmr_348_23","type":"journal-article","created":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T08:06:25Z","timestamp":1702281985000},"page":"224-229","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Diagnostic Efficacy of New Xpert Ultra for Extrapulmonary Tuberculosis Using Culture and Composite Reference Standard"],"prefix":"10.4103","volume":"13","author":[{"given":"Jyoti","family":"Chaudhary","sequence":"first","affiliation":[{"name":"Department of Microbiology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divjot Singh","family":"Chawla","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veenu","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akashdeep","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manisha","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,12,8]]},"reference":[{"key":"R1-20240902","doi-asserted-by":"crossref","first-page":"443","DOI":"10.4103\/lungindia.lungindia_165_22","article-title":"Diagnostic yield of CBNAAT in the diagnosis of extrapulmonary tuberculosis:A prospective observational study","volume":"39","author":"Nishal","year":"2022","journal-title":"Lung India"},{"key":"R2-20240902","doi-asserted-by":"crossref","first-page":"141","DOI":"10.3390\/jor1020015","article-title":"Extrapulmonary tuberculosis \u2013An update on the diagnosis, treatment and drug resistance","volume":"1","author":"Gopalaswamy","year":"2021","journal-title":"J Respir"},{"key":"R3-20240902","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/S1473-3099(17)30691-6","article-title":"Xpert MTB\/RIF Ultra for detection of Mycobacterium tuberculosis and rifampicin resistance:A prospective multicentre diagnostic accuracy study","volume":"18","author":"Dorman","year":"2018","journal-title":"Lancet Infect Dis"},{"key":"R4-20240902","doi-asserted-by":"crossref","first-page":"13959","DOI":"10.1038\/s41598-020-70613-x","article-title":"Xpert MTB\/RIF Ultra for rapid diagnosis of extrapulmonary tuberculosis in a high-income low-tuberculosis prevalence setting","volume":"10","author":"Hoel","year":"2020","journal-title":"Sci Rep"},{"key":"R7-20240902","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1016\/j.ijid.2022.07.016","article-title":"Accuracy of Xpert MTB\/RIF Ultra for the diagnosis of tuberculosis in adult patients:A retrospective cohort study","volume":"122","author":"Kaswala","year":"2022","journal-title":"Int J Infect Dis"},{"key":"R8-20240902","doi-asserted-by":"crossref","first-page":"3982","DOI":"10.18203\/2320-6012.ijrms20162919","article-title":"Evaluation of various culture and staining techniques for the detection of extra-pulmonary tuberculosis","volume":"4","author":"Gupta","year":"2016","journal-title":"Int J Res Med Sci"},{"key":"R9-20240902","doi-asserted-by":"crossref","first-page":"271","DOI":"10.17511\/ijmrr.2018.i05.06","article-title":"Role of genexpert in rapid molecular detection of extrapulmonary tuberculosis in tertiary care hospital","volume":"6","author":"Yadhav","year":"2018","journal-title":"Int J Med Res Rev"},{"key":"R10-20240902","doi-asserted-by":"crossref","first-page":"9","DOI":"10.5005\/ijcdas-64-1-9","article-title":"Role of CBNAAT in the diagnosis of extra-pulmonary tuberculosis:Experience from a tertiary care hospital in India","volume":"64","author":"Alwani","year":"2022","journal-title":"Indian J Chest Dis Allied Sci"},{"key":"R11-20240902","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1111\/tmi.13452","article-title":"Incidence, risk factors and clinical characteristics of extra-pulmonary tuberculosis patients:A ten-year study in the North of Iran","volume":"25","author":"Shirzad-Aski","year":"2020","journal-title":"Trop Med Int Health"},{"key":"R12-20240902","doi-asserted-by":"crossref","first-page":"fmac056","DOI":"10.1093\/tropej\/fmac056","article-title":"Effect of concomitant tuberculosis infection on COVID-19 disease in children:A Matched, retrospective cohort study","volume":"68","author":"Mathur","year":"2022","journal-title":"J Trop Pediatr"},{"key":"R13-20240902","doi-asserted-by":"crossref","first-page":"1818","DOI":"10.1128\/JCM.03553-13","article-title":"Diagnostic accuracy of Xpert MTB\/RIF for extrapulmonary tuberculosis specimens:Establishing a laboratory testing algorithm for South Africa","volume":"52","author":"Scott","year":"2014","journal-title":"J Clin Microbiol"},{"key":"R14-20240902","first-page":"157","article-title":"Evaluation of the accuracy of Xpert MTB\/RIF assay in comparison to liquid culture in extrapulmonary tuberculosis (EPTB) patients","volume":"6","author":"Srivastava","year":"2018","journal-title":"J Adv Med Dent Scie Res"},{"key":"R15-20240902","doi-asserted-by":"crossref","first-page":"181","DOI":"10.17511\/ijmrr.2016.i02.010","article-title":"Comparison of conventional methods with gene xpert mtb\/rif assay for rapid detection of mycobacterium tuberculosis and rifampicin resistance in extra-pulmonary samples","volume":"4","author":"Avashia","year":"2016","journal-title":"Int J Med Res Rev"},{"key":"R16-20240902","doi-asserted-by":"crossref","first-page":"3065","DOI":"10.1128\/JCM.00491-11","article-title":"Comparison of two molecular methods for rapid diagnosis of extrapulmonary tuberculosis","volume":"49","author":"Causse","year":"2011","journal-title":"J Clin Microbiol"},{"key":"R17-20240902","doi-asserted-by":"crossref","first-page":"e0249734","DOI":"10.1371\/journal.pone.0249734","article-title":"Performance of Xpert MTB\/RIF Ultra for diagnosis of pulmonary and extra-pulmonary tuberculosis, one year of use in a multi-centric hospital laboratory in Brussels, Belgium","volume":"16","author":"Mekkaoui","year":"2021","journal-title":"PLoS One"},{"key":"R18-20240902","doi-asserted-by":"crossref","first-page":"3148","DOI":"10.3390\/jcm12093148","article-title":"Xpert MTB\/RIF Ultra trace results:Decision Support for the treatment of extrapulmonary tuberculosis in low TB Burden countries","volume":"12","author":"Guillouzouic","year":"2023","journal-title":"J Clin Med"},{"key":"R19-20240902","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1186\/s12879-019-4687-7","article-title":"Evaluation of GeneXpert MTB\/RIF system performances in the diagnosis of extrapulmonary tuberculosis","volume":"19","author":"Mechal","year":"2019","journal-title":"BMC Infect Dis"},{"key":"R20-20240902","doi-asserted-by":"crossref","first-page":"817661","DOI":"10.3389\/fmicb.2022.817661","article-title":"Rapid molecular diagnosis of extra-pulmonary tuberculosis by Xpert\/RIF Ultra","volume":"13","author":"Rindi","year":"2022","journal-title":"Front Microbiol"},{"key":"R21-20240902","doi-asserted-by":"crossref","first-page":"28","DOI":"10.5588\/pha.21.0066","article-title":"Prevalence and interpretation of Xpert(\u00ae) Ultra trace results among presumptive TB patients","volume":"12","author":"Chilukutu","year":"2022","journal-title":"Public Health Action"},{"key":"R22-20240902","doi-asserted-by":"crossref","first-page":"362","DOI":"10.4103\/MJBL.MJBL_40_22","article-title":"Prevalence of rifampicin-resistant Mycobacterium tuberculosis by CBNAAT in a tertiary care hospital of West Bengal, India","volume":"19","author":"Adhikary","year":"2022","journal-title":"Med J Babylon"}],"container-title":["International Journal of Applied &amp; Basic Medical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijabmr.ijabmr_348_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:53:12Z","timestamp":1787763192000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijabmr.ijabmr_348_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/ijabmr.ijabmr_348_23","relation":{},"ISSN":["2229-516X","2248-9606"],"issn-type":[{"value":"2229-516X","type":"print"},{"value":"2248-9606","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10]]},"assertion":[{"value":"2023-08-02","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-13","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}