Accuracy of Xpert MTB/RIF assay in diagnosis of tuberculosis a comparison to culture
Retrospective analysis from south Kashmir, India
Keywords:
accuracy Xpert, CB-NAAT, diagnosis tuberculosis, GeneXpert® system, MTB, MTB/RIF assayAbstract
This study was done to assess the performance of CB-NAAT (Cepheid GeneXpert®) system for the diagnosis of MTB, from south Kashmir, India. Pulmonary & extra pulmonary specimens received at the laboratory, from new clinically suspected tuberculosis patients were used. The samples were divided into three portions, one part each for AFB direct smear, CB-NAAT and culture, respectively. The concentrates were cultured on LJ media.CB-NAAT was done using Cepheid GeneXpert® system. Sensitivity, Specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) were calculated, by considering the culture results as the gold standard.831 patients were included, 682 pulmonary and 149 extra pulmonary samples. The true positive occurrence for smear microscopy was 95.83%.The true positive rate of detection of MTB by CB-NAAT was 75.74%.The sensitivity, specificity, PPV and NPV of smear microscopy were 38.33, 99.54, 95.83 and 85.38% respectively. The sensitivity, specificity, PPV and NPV of CB-NAAT was seen to be 84.45, 94.93, 75.73, and 97.02 % respectively. This study could therefore, favor the use of CB-NAAT, using the Cepheid GeneXpert® system, as a rapid method for the detection of MTB alone. Further research is required for development of a better diagnostic method that can simultaneously distinguish MTB and NTM.
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