Application value of GeneXpert MTB/RIF in the detection of MTB rifampicin resistance

doi:10.3969/j.issn.2095-3755.2019.03.002

Abstract

Abstract:

Objective To evaluate the application value of GeneXpert MTB/RIF (GeneXpert) technology in the detection of MTB rifampicin resistance.Methods A total of 414 sputum specimens from patients with suspected pulmonary tuberculosis admitted to the Fifth People’s Hospital of Suzhou from January to December 2018 were collected. Meanwhile, acid fast staining of sputum smear, BACTEC MGIT 960 (MGIT 960) liquid culture and GeneXpert test were conducted to compare the positive detection rates of different methods. Based on the results of MGIT 960 liquid culture and improved roche drug sensitivity test (referred to as “drug sensitivity test”) as references, the efficacy of GeneXpert in the detection of MTB rifampicin resistance was analyzed.Results The positive detection rate of sputum smear was 18.6% (77/414), the positive detection rate of MGIT 960 culture was 31.4% (130/414), and the positive detection rate of GeneXpert test was 35.3% (146/414). The positive detection rate of GeneXpert or MGIT 960 culture was significantly higher than that of sputum smear (χ ²=29.22, P<0.001; χ ²=18.09, P<0.001). No statistically significant difference was observed between the positive detection rates of GeneXpert and MGIT 960 culture (χ ²=1.39, P=0.238). Among the 146 positive samples detected by GeneXpert, the detection rate of rifampicin resistance was 9.6% (14/146), and the detection rate of rifampicin resistance among the 130 positive samples detected by MGIT 960 culture was 9.2% (12/130), without statistical significant difference (χ ²=0.01, P=0.919). Based on the results of MGIT 960 culture and drug sensitivity test as references, the sensitivity, specificity, coincidence rate, and the Kappa value of GeneXpert test were 81.8% (9/11), 98.9% (87/88), 96.9% (96/99) and 0.84, respectively. Conclusion Compared with MGIT 960 liquid culture method and drug sensitivity test, GeneXpert technology has better detection efficiency for MTB rifampicin resistance.

Key words: Mycobacterium tuberculosis, Microbial sensitivity tests, Rifampin, Nucleic acid amplification techniques, Evaluation studies

YU Da-wei,SONG Hua-feng,QIU Wen-na,XUE Jing,LI Fang-hua,XU Ping. Application value of GeneXpert MTB/RIF in the detection of MTB rifampicin resistance[J]. Journal of Tuberculosis and Lung Health , 2019, 8(3): 160-162. doi: 10.3969/j.issn.2095-3755.2019.03.002

Figures/Tables 1

References 12

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GeneXpert 检测	MGIT 960药敏试验结果		敏感度 (%)	特异度 (%)	阳性预测值(%)	阴性预测值(%)	符合率 (%)	Kappa值
GeneXpert 检测	耐药(份)	敏感(份)	敏感度 (%)	特异度 (%)	阳性预测值(%)	阴性预测值(%)	符合率 (%)	Kappa值
耐药	9	1	81.8	98.9	90.0	97.8	97.0	0.84
敏感	2	87
合计	11	88

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