Xpert MTB/RIF Ultra as a diagnostic tool for pleural tuberculosis: a study at Indian tertiary care centre.

This article evaluates the diagnostic efficacy of Xpert MTB/RIF Ultra, an advanced molecular assay, for detecting pleural tuberculosis (TB) using pleural fluid samples at a tertiary care center in India. Among 232 pleural TB suspects categorized by a composite reference standard, Xpert MTB/RIF Ultra demonstrated higher sensitivity (52.5%) than smear microscopy, culture, and the earlier Xpert MTB/RIF assay, particularly improving microbiological confirmation in probable TB cases where standard tests were negative. While specificity was slightly lower due to some false positives in non-TB controls, the assay showed promise as a less invasive diagnostic tool compared to biopsy-based methods. The study concludes that Xpert MTB/RIF Ultra can enhance pleural TB diagnosis using pleural fluid, but recommends further validation across diverse settings before widespread implementation.