ABSTRACT
Objective To investigate the clinical value of Xpert M TB/RIF in the early diagnosis of tuberculous meningitis (TBM ) .Methods Totally 130 patients with central nervous system infection in our hospital from February 2015 to December 2016 were divided into two groups ,65 cases of TBM patients as the TBM group ,65 cases of non TBM patients as the non TBM group . The CSF samples of all patients were respectively detected by acid fast staining ,Roche solid culture and Xpert MTB/RIF assay .The test results were compared .Results With clinical diagnosis as the gold standard ,the sensitivity of Xpert MTB/RIF to detection of TBM was 43 .08% and specificity was 100 .00% .The sensitivity of solid culture to detection of TBM was 58 .46% and specificity was 98 .46% .The sensitivity of acid fast staining to detection of TBM was 9 .23% and specificity was 100 .00% .Based on the re-sults of drug sensitivity test of traditional proportional method ,the sensitivity of Xpert M TB/RIF to detection of rifampin resistance was 88 .89% and specificity was 98 .35% .Conclusion Xpert M TB/RIF is a new diagnostic technique for detecting TBM and ri-fampin resistance in patients .It has the advantages of rapid ,direct ,reliable and high specificity and is worthy of clinical application .
ABSTRACT
Objective To investigate the clinical value of Xpert M TB/RIF in the early diagnosis of tuberculous meningitis (TBM ) .Methods Totally 130 patients with central nervous system infection in our hospital from February 2015 to December 2016 were divided into two groups ,65 cases of TBM patients as the TBM group ,65 cases of non TBM patients as the non TBM group . The CSF samples of all patients were respectively detected by acid fast staining ,Roche solid culture and Xpert MTB/RIF assay .The test results were compared .Results With clinical diagnosis as the gold standard ,the sensitivity of Xpert MTB/RIF to detection of TBM was 43 .08% and specificity was 100 .00% .The sensitivity of solid culture to detection of TBM was 58 .46% and specificity was 98 .46% .The sensitivity of acid fast staining to detection of TBM was 9 .23% and specificity was 100 .00% .Based on the re-sults of drug sensitivity test of traditional proportional method ,the sensitivity of Xpert M TB/RIF to detection of rifampin resistance was 88 .89% and specificity was 98 .35% .Conclusion Xpert M TB/RIF is a new diagnostic technique for detecting TBM and ri-fampin resistance in patients .It has the advantages of rapid ,direct ,reliable and high specificity and is worthy of clinical application .
ABSTRACT
Objective To evaluate the clinical application of the automated nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance (Xpert M TB/RIF) in diagnosis of pulmonary tuberculosis in Wenzhou .Methods A total of 214 patients with suspected pulmonary tuberculosis , clinical diagnosed tuberculosis or suspected drug‐resistant tuberculosis were enrolled in this study .The patients′ sputum specimens were collected for acid‐fast smear ,liquid culture and Xpert M TB/RIF assay .The sensitivity and specificity of three tests for the detection of mycobacterium tuberculosis (M TB) were determined using the clinical final diagnosis as golden standard .The sensitivity and specificity of Xpert M TB /RIF for the detection of rifampin resistance were determined using liquid drug susceptibility as the golden standard .The sensitivity and specificity were compared using chi‐squared test .Results Using the clinical final diagnosis as golden standard ,Xpert M TB/RIF had significantly higher sensitivity than sputum acid‐fast smear (69 .5% vs 44 .1% , χ2 = 23 .31 ,P 0 .05) .The sensitivities of Xpert M TB /RIF in smear positive and smear negative M TB samples were 97 .4% and 47 .5% ,respectively ;the specificities in smear positive and smear negative M TB samples were both 100 .0% .The sensitivity and specificity of Xpert M TB /RIF for the detection of rifampin resistance were 92 .9% and 98 .8% ,respectively using the liquid drug susceptibility test as golden standard .Conclusions Xpert M TB/RIF can detect M TB and rifampin resistance rapidly and accurately with higher sensitivity ,which is highly valuable in practical application .