It is fast, has minimal hands-on technical time, with the added benefit of being able to detect Rifampicin resistance-conferring genetic mutations, and has revolutionized the diagnostic pathway for pulmonary TB.
Xpert MTB/RIF (Xpert) is a DNA-based automated diagnostic test for the detection of Mtb via the identification of the rpoB gene. Koegelenberg, in Reference Module in Biomedical Sciences, 2019 Pleural Fluid Xpert MTB/RIF and Ultra (Cepheid) 57 The use of T.SPOT.TB alone or in combination with TST in LTBI screening is highly financially favorable in light of the financial costs of TB outbursts and disease prevention. 56 Six or more positive “spots” on the T.SPOT.TB test indicate a positive result. It is expected that this product will set a new tone in TB diagnosing, especially in patients with negative TST results. The product has been approved for use in the European Union in 2004 and by the US FDA in 2008. No uncertain results are mentioned in the test description, and increased laboratory intensity is declared. 55 The test is appropriate for diagnosing LTBI as well as TB. T.SPOT.TB is a novel, sensitive standard used mainly in immunocompromised patients the false-negative result bias is very low among patients taking corticosteroids with this test in comparison to TST. This method uses an exactly defined and equal number of isolated mononuclear cells because of this there is no bias from IFN-γ produced by other cell populations. In contrast with QFT-G, there is no need for special collecting tubes during T.SPOT.TB (collection into lithium–heparin tubes) because the specific antigens ESAT-6 and CFP-10 are added to the sample later in the laboratory. T.SPOT.TB is a breakthrough in vitro diagnostic test based on the principles of the so-called single-cell method, or ELISpot, which enables the overall number of IFN-γ-producing T lymphocytes to be established.
Rovenský, in Infection and Autoimmunity (Second Edition), 2015 4 The Test for Establising the Number of Cells Producing IFN-γ T.SPOT
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