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Xpert MTB/RIF assay (Cepheid) was performed at Mycobacterial Laboratory, Research Institute for Health Sciences (RIHES), Chiang Mai University. The method was performed according to manufacturer's instruction of Xpert MTB/RIF [12]. The specimen was excluded from the analysis if (1) it was an invalid sample for Xpert assay or sample error according to Cepheid package insert, or (2) the culture was contaminated. 2.3. Data Collection Demographic data including age, sex, past medical history of lung diseases, and HIV serostatus were recorded. Clinical data including fever, days of fever, chest pain, dyspnea, hemoptysis, weight loss, cough, [http://www.selleckchem.com/products/c646.html C646 cost] and the extrapulmonary sites of tuberculosis were collected. Laboratory results included sputum acid-fast smear, sputum mycobacterial culture results, sputum Xpert MTB/RIF results, and chest radiographic findings were collected. Sputum acid-fast smear results were categorized into positive (reported AFB found per field as 1+, 2+, 3+, and 4+) or negative. Sputum Xpert MTB/RIF results were also categorized into positive (reported Xpert detected as very low, low, medium, and high), or negative. Sputum cultures were reported as M. tuberculosis, NTM, contaminated culture, or no growth. 2.4. Statistical Analysis [http://www.selleckchem.com/products/azd5363.html buy AZD5363] Descriptive data were presented in percentages, mean �� SD, and median (IQR) as appropriate. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of Xpert and sputum acid-fast smear were compared to tuberculosis culture as a reference standard using contingency 2 �� 2 tables and exact binomial confidence intervals. The sensitivity and specificity between sputum smear and Xpert were compared using McNemar's test. Among culture-confirmed pulmonary tuberculosis, comparison of characteristics between patients with positive and negative sputum acid-fast smear was performed using ��2 test or Fisher's exact test for categorical data and Student's t-test or Mann-Whitney U test for continuous data. Factors associated with negative sputum acid-fast smear were tested in univariate models. Factors with the p value of [https://en.wikipedia.org/wiki/Chlormezanone Chlormezanone] analysis were then tested in a multivariate logistic regression model. All statistical analyses were performed using Stata statistical software version 10.0 (Stata Statistical Software: Release 10.0, Stata Corporation, College Station, TX, 2007). This study was approved from the Faculty of Medicine, Chiang Mai University ethical committee. 3. Results 3.1. Demographic and Clinical Data Sixty consecutive patients who met the inclusion criteria providing 127 sputum specimens were enrolled to the study. Of 127 specimens, 2 were invalid for Xpert, 2 were sample error, 14 were contaminated, and 11 grew NTM. After exclusion of 18 specimens, 109 sputum specimens from 57 patients were included in the analysis.