Application value of lavage fluid XpertMTB/RIF, culture of Mycobacterium tuberculosis, and Mycobacterium tuberculosis-DNA detection in the diagnosis of tuberculosis / 中国基层医药

ABSTRACT

Objective:To analyze the application value of XpertMTB/RIF, culture of Mycobacterium tuberculosis (MTB), and detection of Mycobacterium tuberculosis DNA (TB-DNA) in the diagnosis of tuberculosis.Methods:From January 2018 to January 2020, 75 patients admitted to Wenzhou Central Hospital and diagnosed with tuberculosis in clinic were selected in the research.The results of clinical diagnosis were used as the gold standard.The sensitivity, specificity and accuracy of XpertMTB/RIF, TB cultureand TB-DNA in the detection of tuberculosis were analyzed.The resistance of MTB to rifampicin and the adverse reactions such as blood in sputum and fever of patients were evaluated.Results:The sensitivity, specificity and accuracy of XpertMTB/RIF in detecting tuberculosis were 95.24%, 72.71%and 85.33%, respectively.The sensitivity, specificityand accuracy of TB culture in detecting tuberculosis were 80.95%, 66.67% and 74.67%, respectively.The sensitivity, specificity and accuracy of TB-DNA detection in detecting tuberculosis were 78.57%, 69.70%and 74.67%, respectively.There were statistically significant differences in the sensitivity among XpertMTB/RIF, TBand TB-DNA in detecting tuberculosis (χ 2=4.086, 5.126, P=0.043, 0.024). The result of clinical diagnosis was used as the gold standard.In the positive samples obtained, the sensitivity and specificity of XpertMTB/RIF in detection of drug resistance were 72.73% and 93.55%, respectively.The sensitivity and specificity of TB were 54.55% and 74.19%, respectively, and the sensitivity and specificity of TB-DNA were 63.64% and 70.97%, respectively.The sensitivity and specificity of XpertMTB/RIF in detection of drug resistance were higher than those of TB culture and TB-DNA, and the difference in specificity was statistically significant (χ 2=4.292, 5.415, P=0.038, 0.020). In the fiberoptic bronchoscopy, alveolar lavage and brush biopsy, 75 patients did not have serious adverse reactions.After operation, there were 2 cases with blood in the sputum and 1 case with fever.The adverse reactions of above patients disappeared after 1-3 days. Conclusion:XpertMTB/RIF, TB culture and TB-DNA have good clinical application value in detecting MTB in specimens of patients of tuberculosis, but in terms of rapid detection of tuberculosis and resistance to rifampicin, XpertMTB/RIF detection is more accurate.