Abstract：
Precise and timely detection of tuberculosis (TB) is crucial to reduce transmission. This study aims to assess the accuracy of Xpert MTB/RIF Ultra on stool samples and systematically review the performance of Xpert MTB/RIF Ultra with different sample types by meta-analysis. Stool samples of smear-negative pulmonary TB (PTB), cervical lymph node TB, and abdominal TB patients were tested on the Xpert MTB/RIF Ultra system. Meta-analysis was performed on a set of 44 studies. Data were grouped by sample type, and the pooled sensitivity and specificity of Xpert MTB/RIF Ultra were calculated. The sensitivity of Xpert MTB/RIF Ultra with stool samples was 100% for smear-negative PTB, 27.27% for cervical lymph node TB, and 50% for abdominal TB patients, with 100% specificity for all included TB groups. The summary estimate for all PTB samples showed 84.2% sensitivity and 94.5% specificity, and EPTB samples showed 88.6% sensitivity and 96.4% specificity. Among all sample types included in our meta-analysis, urine showed the best performance for EPTB diagnosis. This pilot study supports the use of stool as an alternative non-invasive sample on Xpert MTB/RIF Ultra for rapid testing, suitable for both PTB and EPTB diagnosis.
摘要：
准确及时地检测结核病（TB）对于减少传播至关重要。本研究旨在评估XpertMTB/RIFUltra对粪便样本的准确性，并通过荟萃分析系统地回顾XpertMTB/RIFUltra对不同样本类型的表现。涂片阴性肺结核（PTB）的粪便样本，颈淋巴结结核，和腹部结核病患者在XpertMTB/RIFUltra系统上进行测试。对一组44项研究进行了荟萃分析。数据按样本类型分组，并计算XpertMTB/RIFUltra的合并敏感性和特异性。XpertMTB/RIFUltra对粪便样本的敏感性为100%，对涂片阴性的PTB，颈部淋巴结结核占27.27%，50%为腹部结核病患者，对所有纳入的结核病组具有100%的特异性。所有PTB样本的汇总估计显示84.2%的灵敏度和94.5%的特异性,和EPTB样本显示88.6%的敏感性和96.4%的特异性。在我们的荟萃分析中包括的所有样本类型中，尿液显示EPTB诊断的最佳表现。这项初步研究支持使用粪便作为XpertMTB/RIFUltra的替代非侵入性样品进行快速测试，适用于PTB和EPTB诊断。
