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ReviewFree Access

Xpert® MTB/RIF assay: development, evaluation and implementation of a new rapid molecular diagnostic for tuberculosis and rifampicin resistance

    Stephen D Lawn

    † Author for correspondence

    The Desmond Tutu HIV Centre, Institute for Infectious Disease & Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory 7925, Cape Town, South Africa.

    Department of Clinical Research, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK

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    Email the corresponding author at stevelawn@yahoo.co.uk

    &
    Mark P Nicol

    Division of Medical Microbiology, Faculty of Health Sciences, University of Cape Town, South Africa

    National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa

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    Published Online:30 Sep 2011https://doi.org/10.2217/fmb.11.84

    Abstract

    Global TB control efforts have been severely hampered by the lack of diagnostic tests that are accurate, simple to use and can be applied at the point of clinical care. This has been further compounded by the widespread inability to test for drug resistance. The Xpert® MTB/RIF assay is a rapid molecular assay that can be used close to the point of care by operators with minimal technical expertise, enabling diagnosis of TB and simultaneous assessment of rifampicin resistance to be completed within 2 h. Moreover, this can be accomplished using unprocessed sputum samples as well as clinical specimens from extrapulmonary sites. We review in detail the development of this assay, its evaluation within the laboratory, its utility among adult and pediatric TB suspects, its use as a screening tool for HIV-associated TB and studies of its implementation at the district and sub-district levels in resource-limited settings. Following endorsement by the WHO in 2010, we consider the next steps in the implementation of the assay and its potential impact in high burden settings.

    Papers of special note have been highlighted as: ▪ of interest

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