2019, Number 2
Xpert®MTB/RIF for the diagnosis of tuberculosis under programmatic conditions in a region of high endemicity in Mexico
Full text
10.35366/NT192B
Language: Spanish
References: 9
Page: 122-125
PDF size: 323.11 Kb.
ABSTRACT
Background: the diagnosis of tuberculosis has been revolutionized in the last decade with the introduction of rapid molecular tests for species identification and drug resistance. Material and methods: the Xpert®MTB/RIF database of the Tijuana General Hospital and Tuberculosis Laboratory was analyzed for a period of three years, selecting the cases that also had smear microscopy and culture for tuberculosis. Results: There were 283 consecutive tests of Xpert®MTB/RIF, of which 192 also had culture results. The sensitivity of Xpert®MTB/RIF in smear positive patients (≥ 1+) was 94%; in patients with positive but with scant bacilli (quantified in bacilli per 100 and 200 fields), the sensitivity was 89.2%. The Xpert®MTB/RIF was positive in 93 of the 104 patients with positive culture for MTB (overall sensitivity of Xpert®MTB/RIF versus culture: 89.4%). Conclusions: The Xpert MTB/RIF is a highly reproducible test under programmatic conditions and should replace microscopy according to the recommendations of the World Health Organization as an initial test in patients with suspected drug-resistant tuberculosis and comorbidity due to HIV.REFERENCES
World Health Organization. Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: Xpert MTB/RIF assay for the diagnosis of pulmonary and extrapulmonary TB in adults and children. Policy update. WHO 2011. ISBN: 978 92 4 150633 5.
Dharan NJ, Blakemore R, Sloutsky A, et al. Performance of the G4 Xpert® MTB/RIF assay for the detection of Mycobacterium tuberculosis and rifampin resistance: a retrospective case-control study of analytical and clinical samples from high and low-tuberculosis prevalence settings. BMC Infect Dis 2016;16(1):764.