Application value of Xpert MTB/RIF detection system for cases of suspected pulmonary tuberculosis
TIAN Bin1, 2, WANG Xiao-jun1, WEN Lan1, GUO Yan-chang1
1. Changsha Center for Disease Control and Prevention,Changsha 410001,China; 2. Xiangya College of Medicine,Center South University,Changsha 410078,China
Abstract:The Xpert MTB/RIF assay is becoming the test of choice for the rapid diagnosis of tuberculosis and rifampin (RIF) resistance. The aim of this study was to evaluate the application value of Xpert MTB/RIF for suspected pulmonary tuberculosis cases. A total of 296 suspected pulmonary tuberculosis cases were confirmed by BACTEC MGIT 960 liquid culture system and Xpert MTB/RIF respectively. The Calculate efficiency index of Xpert MTB/RIF detection system by the results of etiology detection and antimicrobial susceptibility test of BACTEC MGIT 960 liquid culture were used as the gold standard. There were statistical significant differences for Xpert MTB/RIF detection system to gold standard (P<0.005),the sensitivity and specificity was 84.9% (118/139) and 97.5% (153/157) for etiology detection,was 85.2% (23/27) and 100.0% (91/91) for antimicrobial susceptibility test,and Kappa value was 0.829 and 0.829,respectively. Although Xpert MTB/RIF is different from BACTEC MGIT 960 detection system for etiology detection and antimicrobial susceptibility test in pulmonary tuberculosis cases,Xpert MTB/RIF detection system is worth popularization and application for tuberculosis laboratory in China,as the higher level of sensitivity and specificity,absolute advantage of speediness and easy operation.
田斌, 王孝君, 文岚, 郭彦昌. Xpert MTB/RIF 检测系统对肺结核临床诊断病例的应用价值[J]. 中国人兽共患病学报, 2016, 32(9): 798-801.
TIAN Bin, WANG Xiao-jun, WEN Lan, GUO Yan-chang. Application value of Xpert MTB/RIF detection system for cases of suspected pulmonary tuberculosis. Chinese Journal of Zoonoses, 2016, 32(9): 798-801.
[1] WHO. Global tuberculosis report 2015[EB/OL][2011-05-06]. http://apps.who.int/iris/bitstream/10665/191102/1/9789241565059_eng.pdf?ua=1. [2] Chinese Center for Disease Control and Prevention. Department of Disease Prevention and Control,Ministry of Health. Standard operation and quality assurance manual for sputum smear microscopic examination[M]. Beijing: Peking Union Medical College Press,2008. (in Chinese) 卫生部疾病预防控制局,中国疾病预防控制中心. 痰涂片镜检标准化操作及质量保证手册[M]. 北京:中国协和医科大学出版社,2008. [3] Wen L,Tian B,Chen FM,et al. Application evaluation of diagnose tuberculosis based on liquefaction of sputum by centrifugation[J]. Int J Lab Med,2013,(16): 2151-2152. (in Chinese) 文岚,田斌,陈发明,等. 液化集菌法检查痰中结核分枝杆菌的应用评价[J]. 国际检验医学杂志,2013(16):2151-2152. [4] Nicol MP. Xpert MTB/RIF: monitoring response to tuberculosis treatment[J]. Lancet Respir Med,2013,1(6): 427-428. doi:10.1016/S2213-2600(13)70133-4 [5] Yu X,Zhao L,Jiang G,et al. Macrocolonies (Granules) formation as a cause of false-negative results in the MGIT 960 system: Cause analysis and correlation with mycobacterial species[J]. Biomed Res Int,2015,2015. doi:10.1155/2015/501847 [6] Chinese Center for Disease Control and Prevention. Department of Disease Prevention and Control,Ministry of Health Guidelines for the implementation of tuberculosis control and prevention program in China[M]. Beijing: Peking Union Medical College Press,2009. (in Chinese) 卫生部疾病预防控制局,卫生部医政司,中国疾病预防控制中心. 中国结核病防治规划实施工作指南[M]. 北京:中国协和医科大学出版社,2009. [7] Guo JW,Yuan SS,Tan YH,et al. Application of Xpert MTB/RIF for the detection of Mycobacterium tuberculosis and rifampin resistance in sputa from pulmonary tuberculosis patients [C]//The summit Forum on scientific research and TB control & prevention (2014). Yan'an Shanxi: china academic journal electronic publishing house, 2014:58-63. (in chinese) 郭婧玮,袁仕善,谭云洪,等. Xpert MTB/RIF对肺结核患者痰标本中结核分枝杆菌及其利福平耐药快速检测的应用性研究[C]//2014科学研究与结核病防治高峰论坛. 陕西延安:中国学术期刊电子出版社, 2014:58-63. [8] Li Y,Zhang TH,Xian XP,et al. Application significance of Xpert MTB/RIF assay on the detection of MTB[J]. Lab Med,2016,31(1): 52-55. (in Chinese) 李妍,张天华,鲜小萍,等. Xpert MTB/RIF技术在MTB检测中的应用价值[J]. 检验医学,2016,31(1):52-55. [9] Ardizzoni E,Fajardo E,Saranchuk P,et al. Implementing the Xpert(R) MTB/RIF diagnostic test for tuberculosis and rifampicin resistance: Outcomes and lessons learned in 18 countries[J]. PLoS One,2015,10(12): e144656. doi:10.1371/journal.pone.0144656 [10] Sharma SK,Kohli M,Yadav RN,et al. Evaluating the diagnostic accuracy of Xpert MTB/RIF assay in pulmonary tuberculosis[J]. PLoS One,2015,10(10): e141011. doi:10.1371/journal.pone.0141011 [11] Zhao Y,Liang QF,Lin SF,et al. Analysis of detection rifampin drug resistance to multi drug resistant Mycobacterium tuberculosis by Xpert MTB/RIF detection technology[J]. Chin J Health Lab Tec,2015,(15): 2621-2622. (in Chinese) 赵永,梁庆福,林淑芳,等. Xpert MTB/RIF检测技术用于耐多药结核分枝杆菌利福平耐药检测分析[J]. 中国卫生检验杂志,2015(15):2621-2622. [12] Gounder A,Gounder S,Reid SA. Evaluation of the implementation of the Xpert(R) MTB/RIF assay in Fiji[J]. Public Health Action,2014,4(3): 179-183. doi:10.5588/pha.14.0025 [13] Arora D,Jindal N,Bansal R,et al. Rapid detection of Mycobacterium tuberculosis in sputum samples by cepheid Xpert assay: A clinical study[J]. J Clin Diagn Res,2015,9(5): C3-C5. doi:10.7860/JCDR/2015/11352.5935 [14] Garcia-Basteiro AL,Ismail MR,Carrilho C,et al. The role of Xpert MTB/RIF in diagnosing pulmonary tuberculosis in post-mortem tissues[J]. Sci Rep,2016,6: 20703. doi:10.1038/srep20703 [15] Wu YQ,Li YL. Trendment on diagnosis and treatment of non tuberculous Mycobactera [J]. Chin J Zoonoses,2010,26(5): 491-494. (in Chinese) 吴琪茵,黎友伦. 非结核分枝杆菌病的流行趋势、诊断及治疗[J]. 中国人兽共患病学报,2010,26(5):491-494. [16] Zhou AP,He YJ,Sun YN,et al. Epidemiology of non tuberculous Mycobactera in Xi’an,China [J]. Chin J Zoonoses,2015,31(12): 1196-1199. (in Chinese) 周爱萍,贺拥军,孙亚楠,等. 西安市非结核分枝杆菌感染现状调查分析[J]. 中国人兽共患病学报,2015,31(12):1196-1199.