Abstract
ObjectiveThe purpose of this study was to evaluate the diagnostic efficacy of Xpert MTB/RIF for tuberculous pericarditis (TBP).MethodsWe searched relevant databases for Xpert MTB/RIF for TBP diagnosis until April 2021 and screened eligible studies for study inclusion. We evaluated the effectiveness of Xpert MTB/RIF when the composite reference standard (CRS) and mycobacterial culture were the gold standards, respectively. We performed meta-analyses using a bivariate random-effects model, and when the heterogeneity was obvious, the source of heterogeneity was further discussed.ResultsWe included seven independent studies comparing Xpert MTB/RIF with the CRS and six studies comparing it with culture. The pooled sensitivity, specificity, and area under the curve of Xpert MTB/RIF were 65% (95% confidence interval, 59–72%), 99% (97–100%), and 0.99 (0.97–0.99) as compared with the CRS, respectively, and 75% (53–88%), 99% (90–100%), and 0.94 (0.92–0.96) as compared with culture, respectively. There was no significant heterogeneity between studies when CRS was the gold standard, whereas heterogeneity was evident when culture was the gold standard.ConclusionsThe sensitivity of Xpert MTB/RIF for diagnosing TBP was moderate and the specificity was good; thus, Xpert MTB/RIF can be used in the initial diagnosis of TBP.
Highlights
Tuberculosis (TB) is a major global public health threat to human health [1]
The sensitivity of Xpert Mycobacterium tuberculosis (MTB)/RIF for diagnosing Tuberculous pericarditis (TBP) was moderate and the specificity was good; Xpert MTB/RIF can be used in the initial diagnosis of TBP
We searched the relevant studies in Embase, PubMed, the Cochrane Library, China National Knowledge Infrastructure (CNKI), and the Wanfang database for researches, which assessing the diagnostic accuracy of Xpert MTB/RIF for TBP up to April 2021
Summary
Tuberculosis (TB) is a major global public health threat to human health [1]. Tuberculosisrelated mortality remains high in developing countries, especially among those co-infected with acquired immunodeficiency syndrome (AIDS) and tuberculosis [2]. The early diagnosis of TBP is still very difficult and is often postponed [6] The reason for this is that the amount of MTB in pericardial fluid is generally very low, which results in a low positive rate for the commonly used acid fast bacillus (AFB) smear, and MTB culture takes weeks to produce results and cannot guide early diagnosis [8]. Other tests, such as pericardial effusion adenosine deaminase, indirectly helpful in the diagnosis, do not provide a direct microbiological basis [9]
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