Diagnostic efficacy of Xpert MTB/RIF in rapid diagnosis of pulmonary tuberculosis and rifampicin resistance
Objective:To explore the efficacy of Xpert MTB/RIF detection in rapid diagnosis of pulmonary tuberculosis and rifampicin resistance.Methods:A total of 529 sputum and alveolar lavage fluid sam-ples from patients diagnosed with pulmonary tuberculosis at Jinyintan Hospital in Wuhan City from January 2018 to December 2018 were collected.Xpert MTB/RIF technology,liquid culture(BACTEC MGIT960 culture)method and fluorescence staining method were used to detect Mycobac-terium tuberculosis(MTb),respectively.The sensitivity and specificity of Xpert MTB/RIF in detect-ing MTb in sputum and alveolar lavage fluid,and the resistance to rifampicin were analyzed.The re-sults showed that using the liquid culture method as the gold standard for detecting MTb,the sensitivi-ty,and specificity of Xpert MTB/RIF for detecting MTb in sputum was 83.50%(197/236)and 86.69%(254/293),respectively;however,the sensitivity and specificity in alveolar lavage fluid were 94.93%(262/276)and 82.21%(208/253),respectively.The positive rates of detecting MTb in spu-tum and bronchoalveolar lavage fluid using Xpert MTB/RIF technology were 48.2%and 58.0%,re-spectively,with statistically significant differences between the two methods(P<0.05).Using the ab-solute concentration method as the gold standard,the sensitivity and specificity of XpertMTb/RIF technology for detecting rifampicin resistance were 100%and 99.4%,respectively.Conclusion:The sensitivity and specificity of Xpert MTB/RIF in detecting MTb are high,and the sensitivity in alveo-lar lavage fluid is higher than that in sputum samples.This method is reliable for diagnosing rifampicin resistance.
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