Zhang M, et al. - Given the WHO recommendation of using the re-engineered Xpert MTB/RIF Ultra (Xpert Ultra) that was developed to overcome the limitations of the Xpert MTB/RIF assay, researchers investigated the accuracy of Xpert Ultra for the detection of tuberculosis (TB) and rifampicin (RIF) resistance via performing a systematic review and meta-analysis. They analyzed 16 studies. Outcomes suggest that Xpert Ultra is a rapid and highly sensitive test for TB detection and simultaneous detection of RIF resistance and it seems to be a viable alternative in sensitivities in both PTB and EPTB, and also shows a good performance in RIF resistance detection. For the diagnosis of TB, it showed sensitivity of 87.2% (95% CI: 82.5–90.8%) and a specificity of 96.5% (95% CI: 95.1–97.5%) and for RIF resistance detection, it had sensitivity of 95.1% (95% CI: 91.6–97.2%) and specificity of 98.9% (95% CI: 97.6–99.5%). They identified heterogeneity attributable to the category of population, TB prevalence, the reference standard, sample state, sample type and study design. As per subgroup analyses, Xpert Ultra showed good performance in settings with a low TB burden.