title: [Rapid diagnosis of pleural tuberculosis by Xpert MTB/RIF assay].
abstract: OBJECTIVE
  Early diagnosis of pleural tuberculosis (TB) is particularly difficult. The aim of this study was to investigate the diagnostic accuracy of the Xpert MTB/RIF (Xpert) assay using pleural biopsy and pleural fluid specimens in patients with suspected pleural TB negative for sputum acid-fast bacilli (AFB) smear.
  
  
  METHODS
  In this study, 134 sputum smear-negative suspected pleural TB patients were selected. Paired pleural fluid and pleural biopsy specimens were tested for Mycobacterium tuberculosis by standard smear-microscopy, Lowenstein-Jensen and mycobacterial growth indicator tube (MGIT) culture, and the Xpert assay. Mycobacterial culture from pleural biopsy specimens were used as a reference standard for sensitivity and specificity calculations. Detection of rifampicin resistance was compared to the MGIT method.
  
  
  RESULTS
  The sensitivity of the Xpert assay using pleural biopsy specimens for the diagnosis of pleural TB was 85.5% (47/55), and the specificity was 97.2% (69/71). The sensitivity and specificity of the Xpert assay in pleural fluid were 43.6% (24/55) and 98.6% (70/71), respectively. The Xpert assay correctly identified 90.0% (10/11) of phenotypic rifampicin-resistant cases and 93.9% (31/33) of phenotypic rifampicin-susceptible cases.
  
  
  CONCLUSIONS
  The Xpert assay on pleural biopsy specimens may provide an accurate diagnosis of pleural TB in patients who had a negative AFB smear.
authors.affiliation: Department of Clinical Laboratory, First Teaching Hospital of Tianjin University, Tianjin 300193, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Liu
authors.forename: Zikun
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Email: djh4321@126.com.
authors.forename: Jinghui
authors.initials: J
authors.lastname: Du
mesh_terms: D006801:Humans; D008828:Microbiological Techniques; D012293:Rifampin; D013183:Sputum; D014396:Tuberculosis, Pleural
chemical_list: D012293:Rifampin