Utility of GeneXpert as a diagnostic tool for extra pulmonary tuberculosis
Journal Title: Medpulse International Journal of Microbiology - Year 2018, Vol 7, Issue 2
Abstract
Background: India has the highest tuberculosis (TB) burden with high rates of MDR TB. Conventional TB culture considered as the gold standard often leads to considerable delay in diagnosis. GeneXpert newer diagnostic modality for TB not only detects Mycobacterium tuberculosis but also rapidly detects rifampicin resistance. Additional studies from various patient population is needed to reinforce the need of GeneXpert for diagnosis of extra pulmonary TB (EPTB). Aims: To evaluate the utility of GeneXpert for the detection of Mycobacterium tuberculosis (MTB) in extrapulmonary specimens. Settings and Design: A randomized prospective study at a tertiary care hospital in Mumbai over a period of one year. Methods and Material: 100 suspected EPTB specimens [pus, tissue, pleural fluid, ascitic fluid, synovial fluid, cerebrospinal fluid (CSF) and urine] were subjected to AFB smear, culture by LJ and MGIT and GeneXpert as per standard protocols and results were compared. Statistical Analysis: Significance of differences among categorical variables was examined by the Chi-square test and Fischer’s exact test Results: AFB smear positivity was only 35%, while using GeneXpert, overall MTB detection rate and rifampicin resistance rate was 50% and 14% respectively. Sensitivity and specificity of GeneXpert were 89.58%, and 86.54% respectively with PPV- 86.00% and NPV- 90.00%. Conclusions: GeneXpert when compared with culture, shows high sensitivity and specificity for the diagnosis of EPTB.
Authors and Affiliations
Basu Shaoli, Baveja Sujata, Swami Anjali M, Taklikar Shripad
Keywords
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