Comparison of sputum smear,solid culture method,and GeneXpert MTB/RIF alone and in combination for the detection of Mycobacterium tuberculosis
Objective To evaluate the ability of sputum smear,solid culture method,and GeneXpert MTB/RIF in the detection of Mycobacterium tuberculosis.Methods A total of 568 patients with suspected pulmonary tu-berculosis who were admitted to the People's Hospital of Jizhou District,Tianjin,from January 2019 to March 2024 were selected.Sputum smear,solid culture method,and GeneXpert MTB/RIF were utilized simultaneously in order to detect M.tuberculosis for these M.tuberculosis-confirmed cases.This study compared the detection capability of the three methods above with the final clinical diagnosis serving as the gold standard.Results The final clinical di-agnosis was based on the criteria WS 288-2017[1],among 568 suspected tuberculosis patients,280 tuberculosis pa-tients,and 288 non-tuberculosis patients.The detection sensitivity of sputum smear,solid culture method,and GeneXpert MTB/RIF for M.tuberculosis,was 60.4％,84.3％,and 95.0％,respectively.The difference was sta-tistically significant(x2=109.616,P＜0.001),and the GeneXpert MTB/RIF method showed the highest sensitivi-ty.There was no significant difference in the detection specificity of these three methods above(x2=1.002,P=0.606).The detection sensitivity of the pairwise combinations of the above three methods for M.tuberculosis,was 92.9％,98.2％,and 99.6％,respectively.The difference was statistically significant(x2=23.893,P＜0.001),and the combination of the Gene Xpert MTB/RIF method and solid culture method showed the highest sensitivity.There was no significant difference in the detection specificity of the pairwise combinations of the above three methods(x2=0.502,P=0.778).The sensitivity of the three-method combination was 100％,consistent with the gold standard.There was no significant difference in the detection specificity of the three-method combination and the gold standard(x2=2.007,P=0.157).Conclusion The three-method combination is superior to the single method and the combination of any two methods in the detection of M.tuberculosis,so it is suggested that the simultaneous detec-tion of three methods is helpful to improve the detection rate of M.tuberculosis and avoid missed diagnosis.
万方数据
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