@article {Feliciano00043-2019, author = {Cinara Silva Feliciano and Lucas Jos{\'e} Bazzo Menon and Livia Maria Pala Anselmo and Anzaan Dippenaar and Robin Mark Warren and Wilson Ara{\'u}jo Silva, Jr and Valdes Roberto Bollela}, title = {Xpert MTB/RIF performance to diagnose tuberculosis and rifampicin resistance in a reference centre in southern Brazil}, volume = {5}, number = {3}, elocation-id = {00043-2019}, year = {2019}, doi = {10.1183/23120541.00043-2019}, publisher = {European Respiratory Society}, abstract = {Effective treatment of tuberculosis (TB) remains a serious public health problem in many countries, including Brazil, especially when considering drug-resistant disease. Xpert MTB/RIF has been implemented in many countries to reduce the time to TB diagnosis and to rapidly detect rifampicin resistance. The study aimed to describe and evaluate Xpert MTB/RIF performance in diagnosing pulmonary TB and rifampicin resistance in a tertiary healthcare facility in Brazil.A cross-sectional study was performed, which included all isolates of confirmed pulmonary TB patients from 2015 to 2018. Both Xpert MTB/RIF and GenoType MTBDRplus assays were performed to detect rifampicin and isoniazid resistance. In addition, isolates with detected resistance to rifampicin and/or isoniazid were analysed by phenotypic testing using MGIT-960 SIRE kit and whole-genome sequencing (WGS) using Illumina MiSeq Sequencing System.2148 respiratory specimens tested with Xpert MTB/RIF were included: n=1556 sputum, n=348 bronchoalveolar lavage and n=244 gastric washing. The overall Xpert MTB/RIF sensitivity in sputum was 94\% and the overall specificity was 98\%. The negative predictive value in sputum of all the patients was 99\% with a positive predictive value of 89\%. The concordance between Xpert MTB/RIF and phenotypic susceptibility test was 94.1\%, while its concordance with WGS was 78.9\%.Xpert MTB/RIF is a rapid and accurate diagnostic strategy for pulmonary TB, which can contribute to improvement in TB control. However, detection of rifampicin resistance might be associated with false-positive results.Xpert MTB/RIF has the potential to reduce the time to diagnose TB, with high accuracy, including paucibacillary disease. It is also feasible to detect rifampicin resistance, with a high concordance with phenotypic tests and whole-genome sequencing. http://bit.ly/2WW4jmt}, URL = {https://openres.ersjournals.com/content/5/3/00043-2019}, eprint = {https://openres.ersjournals.com/content/5/3/00043-2019.full.pdf}, journal = {ERJ Open Research} }