Assessing the utility of the Xpert Mycobacterium tuberculosis /rifampin assay for analysis of bronchoalveolar lavage fluid in patients with suspected pulmonary tuberculosis

Autor: Xueqin Xu, Wenjing Bai, Yong Pan, Shanshan Chen, Ke Xu, Lingling Liu, Lianpeng Wu, Zhihui Wang, Qiong Chi, Shuangliao Wu
Rok vydání: 2021
Předmět:
Adult
Male
Microbiology (medical)
medicine.medical_specialty
Tuberculosis
diagnosis
Clinical Biochemistry
Gastroenterology
Mycobacterium tuberculosis
Pulmonary tuberculosis
Drug Resistance
Multiple
Bacterial
Internal medicine
Tuberculosis
Multidrug-Resistant
polycyclic compounds
medicine
Humans
Immunology and Allergy
In patient
Antibiotics
Antitubercular
Tuberculosis
Pulmonary
Tuberculosis bacillus
Research Articles
Retrospective Studies
bronchoalveolar lavage fluid
medicine.diagnostic_test
biology
business.industry
Biochemistry (medical)
Mycobacterial culture
Public Health
Environmental and Occupational Health
Hematology
Middle Aged
bacterial infections and mycoses
biology.organism_classification
medicine.disease
Molecular Typing
Medical Laboratory Technology
Bronchoalveolar lavage
tuberculosis
Clinical diagnosis
Female
Rifampin
business
Research Article
Xpert MTB/RIF assay
Zdroj: Journal of Clinical Laboratory Analysis
ISSN: 1098-2825
0887-8013
DOI: 10.1002/jcla.24154
Popis: Background There is limited research assessing the utility of the Xpert Mycobacterium tuberculosis/rifampin (MTB/RIF) assay for the analysis of bronchoalveolar lavage fluid (BALF) in Chinese patients with suspected pulmonary tuberculosis (PTB). Thus, our objective was to determine the diagnostic accuracy of the Xpert MTB/RIF assay and evaluate its utility for the determination of rifampicin resistance. Methods We retrospectively analyzed BALF from 214 patients with suspected PTB between January 2018 and March 2019. Using mycobacterial culture or final clinical diagnosis as the reference standard, the diagnostic accuracy of the smear microscopy (SM), tuberculosis bacillus DNA (TB‐DNA), Xpert MTB/RIF assay, and the determination of rifampicin resistance based on the Xpert MTB/RIF assay were compared. Results As compared to mycobacterial culture, the sensitivity of the Xpert MTB/RIF assay, SM, and TB‐DNA were 85.5% (74.2%–93.1%), 38.7% (26.6%–51.9%), and 67.7% (54.7%–79.1%), respectively. As compared to the final diagnosis, the specificity of the Xpert MTB/RIF assay, SM, and TB‐DNA were 100.0% (95.9%–100.0%), 94.3% (87.1%–98.1%), and 98.9% (93.8%–100.0%), respectively. The sensitivity and specificity of the rifampicin resistance detection using the Xpert MTB/RIF assay were 100% and 98.0%, respectively, with liquid culture as the reference. Conclusions This study demonstrates that the analysis of BALF with the Xpert MTB/RIF assay provides a rapid and accurate tool for the early diagnosis of PTB. The accuracy of diagnosis was superior compared with the SM and TB‐DNA. Moreover, Xpert is a quick and accurate method for the diagnosis of rifampicin‐resistant tuberculosis and can also provide more effective guidance for the treatment of PTB or multidrug‐resistant tuberculosis (MDR‐TB).
The analysis of BALF with the Xpert MTB/RIF assay provides a rapid and accurate tool for the early diagnosis of PTB. The accuracy of diagnosis was superior compared to SM and TB‐DNA. Moreover, Xpert is a quick and accurate method for the diagnosis of rifampicin‐resistant tuberculosis and can also provide more effective guidance for the treatment of PTB or multidrug‐resistant tuberculosis (MDR‐TB).
Databáze: OpenAIRE
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