Application of molecular biology to enhance the detection of infectious tuberculosis in general hospitals
Objective To understand the current status and issues of using Xpert for diagnosing infectious and drug-resistant tuberculosis(TB)in general hospitals,thus better exerting the frontrunner role of general hospitals in detecting TB.Methods This was a self-controlled before-and-after study comparing the proportion of pathogenetically positive patients,patients with Rifampicin-Resistant TB,and diagnosis time of patients with TB and Rifampicin-Resistant TB in general hospitals either using the Xpert or not.A total of 171 TB patients were enrolled,including 52 in the research group receiving Xpert,and 119 in the control group without examination of Xpert.Differences between groups were compared by the Wilcoxon signed rank test and Chi-square test(Fisher's exact test).Results In the research group,the proportion of positive TB diagnosed in general hospitals was significantly higher than that of the control group(78.85％[41/52]vs 54.62％[65/119],P＜0.05).The proportion of suspected cases diagnosed in general hospitals was significantly lower in the research group than that of the control group(3.85％[2/52]vs 20.17％[24/119],P＜0.05).The diagnosis time for TB in the research group was significantly shorter than that of the control group(1 day vs 4 days,P＜0.05).In the research group,there were 3 cases of Rifampicin-Resistant TB diagnosed within 1 day when they sought medical care in a general hospital.There was one Rifampicin-Resistant TB patient in the control group that failed to be diagnosed in the general hospital.Of 52 patients in the research group who were examined by both sputum smear and Xpert examination,the proportion of Mycobacterium Tuberculosis(MTB)detected by Xpert was significantly higher than that by sputum smear(76.92％[40/52]vs 48.07％[25/52],P＜0.05).Conclusion The use of Xpert technology can improve the diagnosis rate of TB,achieving an early detection of infectious TB and Rifampicin-Resistant TB.Epert is recommended to be included in the reimbursement of medical insurance,and acceleration of its application in general hospitals is essential.
tuberculosis,lungdrug resistancediagnostic techniquesself-control study
NETL
NSTL
万方数据
