Genexpert xpress system

Manufactured by Cepheid

Sourced in Switzerland

The GeneXpert Xpress System is a compact, fully-automated molecular diagnostic platform designed for rapid and accurate identification of various target analytes, including infectious agents. The system utilizes real-time PCR technology to provide fast and reliable results. The GeneXpert Xpress System is capable of processing a wide range of sample types and delivers automated sample preparation, amplification, and detection within a single, self-contained cartridge.

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Lab products found in correlation

Cobas6800 ivd, by Roche (2 mentions) Cobas6800 based uct, by Qiagen (2 mentions)

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GeneXpert (95 citations) GeneXpert system (63 citations)

4 protocols using genexpert xpress system

RT-PCR Screening for Influenza and SARS-CoV-2

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According to our hospital standards, all patients admitted with fever or respiratory symptoms were screened for influenza infection by RT-PCR using either the GeneXpert Xpress System (Cepheid, Sunnyvale, USA) or a laboratory-developed assay^{23 (link)} throughout the influenza season. After the first case of COVID-19 was confirmed in Germany in January 2020^{24 (link)}, all symptomatic patients were additionally screened for SARS-CoV-2 infection by RT-PCR using either a laboratory developed test for the NeuMoDx 96 system (NeuMoDx inc., Ann Arbor, USA; distributed by QIAGEN)^{25 (link)}, a Cobas6800 IVD (Roche Diagnostics, Basel Switzerland), a GeneXpert Xpress System (Cepheid, Sunnyvale, USA) or a Cobas6800-based UCT (Ann Arbor, USA; distributed by QIAGEN)^{26 (link)}. Only patients with influenza or SARS-CoV-2 infection confirmed by RT-PCR were included in this analysis.

Brehm T.T., van der Meirschen M., Hennigs A., Roedl K., Jarczak D., Wichmann D., Frings D., Nierhaus A., Oqueka T., Fiedler W., Christopeit M., Kraef C., Schultze A., Lütgehetmann M., Addo M.M., Schmiedel S., Kluge S, & Schulze zur Wiesch J. (2021). Comparison of clinical characteristics and disease outcome of COVID-19 and seasonal influenza. Scientific Reports, 11, 5803.

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SARS-CoV-2 Testing and COVID-19 Treatment Protocols

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All SARS-CoV-2 tests performed used either reverse transcriptase polymerase chain reaction (RT-PCR) via Roche cobas 6800 or the Cepheid GeneXpert Xpress system of nasopharyngeal swab or bronchoalveolar lavage specimens. Disease severity was categorized as mild (oxygen saturation > 94% and no pneumonia), moderate (oxygen saturation < 94% and pneumonia), severe (high-flow nasal oxygen, no vasopressors, moderate impairment of renal and liver function), and critical and cytokine release syndrome (on vasopressors and intubated) (Supplementary Table S1, available online at www.jhltonline.org). Administration of glucocorticoids and COVID-19–directed therapies as well as consideration for participation in clinical trials was based on the discretion of the treating physicians (details in Supplementary Material online). Institutional protocols were followed for anticoagulation administration (Supplementary Figure S1 online). Modification of immunosuppression occurred on a case-by-case basis.

Singhvi A., Barghash M., Lala A., Mitter S.S., Parikh A., Oliveros E., Rollins B.M., Brunjes D.L., Alvarez-Garcia J., Johnston E., Ryan K., Itagaki S., Moss N., Pinney S.P., Anyanwu A, & Mancini D. (2020). Challenges in heart transplantation during COVID-19: A single-center experience. The Journal of Heart and Lung Transplantation, 39(9), 894-903.

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SARS-CoV-2 RT-PCR Confirmation Protocol

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RT-PCR for confirmation of SARS-CoV-2 infection was performed using swab samples from the upper respiratory tract or specimens from the lower respiratory tract using either a laboratory-developed test for the NeuMoDx 96 system (NeuMoDx inc., Ann Arbor, USA; distributed by QIAGEN) [11 (link)], a Cobas6800 IVD (Roche Diagnostics, Basel Switzerland), a GeneXpert Xpress System (Cepheid, Sunnyvale, CA, USA), or a Cobas6800-based UCT (Ann Arbor, MI, USA; distributed by QIAGEN) [12 (link)]. A total of 18 patients had only tested positive for SARS-CoV-2 before hospital admission but did not test positive at our institution.

Brehm T.T., Heyer A., Roedl K., Jarczak D., Nierhaus A., Nentwich M.F., van der Meirschen M., Schultze A., Christner M., Fiedler W., Kröger N., Huber T.B., Klose H., Sterneck M., Jordan S., Kreuels B., Schmiedel S., Addo M.M., Huber S., Lohse A.W., Kluge S, & Schulze zur Wiesch J. (2021). Patient Characteristics and Clinical Course of COVID-19 Patients Treated at a German Tertiary Center during the First and Second Waves in the Year 2020. Journal of Clinical Medicine, 10(11), 2274.

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Rapid and Accurate Influenza/RSV Detection

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Our laboratory has introduced the Xpert Flu/RSV Xpress Assay, which is a rapid, automated in vitro diagnostic test for qualitative detection and differentiation of influenza A and B viruses and RSV performed on the Cepheid GeneXpert Xpress System. The Xpert Flu/RSV Xpress Assay has consistently shown excellent performance [16 (link), 17 (link)]. In a recent prospective evaluation, the sensitivity was almost 100% for influenza A and B and 90.5% for RSV, and the specificity ranged from 98.6% to 99.7% for influenza A, influenza B, and RSV, respectively. The positive predictive value of the Xpert assay is 95.5% for Influenza A, 97.0% for Influenza B, and 90.5% for RSV [18 (link)]. Results are automatically sent to the local infection prevention and control team for continuous surveillance.

Chorazka M., Flury D., Herzog K., Albrich W.C, & Vuichard-Gysin D. (2021). Clinical outcomes of adults hospitalized for laboratory confirmed respiratory syncytial virus or influenza virus infection. PLoS ONE, 16(7), e0253161.

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