Rapid detection of tuberculosis and extrapulmonary rifampicin resistance by GeneXpert
10.3760/cma.j.issn.1008-6706.2019.21.004
- VernacularTitle: GeneXpert快速诊断肺结核和肺外结核标本利福平耐药的检测研究
- Author:
Yongle ZHENG
1
;
Xiuying WANG
Author Information
1. Department of Infection, the People's Hospital of Yueqing, Wenzhou, Zhejiang 325600, China
- Publication Type:Journal Article
- Keywords:
Tuberculosis, pulmonary;
Specimen handling;
Nucleic acid amplification techniques;
Smear layer;
Culture media;
Diagnosis;
Rifampin;
Sensitivity and specificity
- From:
Chinese Journal of Primary Medicine and Pharmacy
2019;26(21):2574-2577
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical value of GeneXpert in the rapid diagnosis of rifampicin resistance in tuberculosis and extrapulmonary tuberculosis.
Methods:From June 2018 to March 2019, a total of 122 tuberculosis patients admitted to the People's Hospital of Yueqing were selected.Among them, 109 patients with pulmonary tuberculosis and 13 patients with extrapulmonary tuberculosis.GeneXpert MTB/RIF, smear, LJ solid medium, BACTEC MGIT 960 liquid medium four detection methods were used to detect tuberculosis secretion.GeneXpert MTB/RIF, LJ solid medium, BACTEC MGIT 960 liquid medium three detection methods were used to detect extrapulmonary tuberculosis secretion.The sensitivity and specificity of GeneXpert MTB/RIF, smear, LJ solid medium, BACTEC MGIT 960 liquid medium for tuberculosis specimens were detected and compared, and the monitoring results of rifampicin resistance in extracorporeal tuberculosis specimens in culture medium detected by GeneXpert MTB/RIF, LJ solid medium, BACTEC MGIT 960 liquid were observed.
Results:The GeneXpert MTB/RIF, smear, LJ solid medium, BACTEC MGIT 960 liquid medium were used to detect 109 cases of tuberculosis, and the detection rates were 94.50%(103/109), 55.04%(60/109), 57.79% (63/109), 61.47%(67/109), respectively.The detection rates of extrapulmonary tuberculosis were 7.69%(1/13), 0.00%(0/13) and 15.38%(2/13), respectively.The sensitivity and specificity of the four methods for the diagnosis of tuberculosis had statistically significant differences(χ2=121.540, 127.610, all P<0.05). The diagnostic efficiency of GeneXpert MTB/RIF was significantly better than smear, LJ solid medium, BACTEC MGIT 960 liquid medium.The results of stratification analysis of rifampicin resistance using GeneXpert MTB/RIF, LJ solid medium and BACTEC MGIT 960 liquid medium showed that there were no statistically significant differences among the three methods and gold standard(χ2=0.750, 0.942, 0.947, all P>0.05).
Conclusion:GeneXpert technology has the advantages of simple operation, rapid detection and high detection rate.It has high clinical value for the rapid diagnosis of tuberculosis and extrapulmonary specimens and the detection of rifampicin resistance.
