TY - JOUR T1 - Xpert MTB/RIF performance to diagnose tuberculosis and rifampicin resistance in a reference centre in southern Brazil JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00043-2019 VL - 5 IS - 3 SP - 00043-2019 AU - Cinara Silva Feliciano AU - Lucas José Bazzo Menon AU - Livia Maria Pala Anselmo AU - Anzaan Dippenaar AU - Robin Mark Warren AU - Wilson Araújo Silva, Jr AU - Valdes Roberto Bollela Y1 - 2019/07/01 UR - http://openres.ersjournals.com/content/5/3/00043-2019.abstract N2 - 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 ER -