Comparison of GeneXpert MTB/RIF assay and LED-FM microscopy for the diagnosis of extra pulmonary tuberculosis in Khyber Pakhtunkhwa, Pakistan

Khan, Anwar Sheed; Ali, Sajid; Khan, Muhammad Tahir; Ahmed, Sajjad; Khattak, Yasir; Abduljabbar,; Irfan, Muhammad; Sajjad, Wasim

doi:10.1016/j.bjm.2018.02.011

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Brazilian Journal of Microbiology

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Sumário

Clinical Microbiology • Braz. J. Microbiol. 49 (4) • Oct-Dec 2018 • https://doi.org/10.1016/j.bjm.2018.02.011 copy

Comparison of GeneXpert MTB/RIF assay and LED-FM microscopy for the diagnosis of extra pulmonary tuberculosis in Khyber Pakhtunkhwa, Pakistan

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

GeneXpert is one of the recent technological instruments used to diagnose tuberculosis in a short span of time. In this study, the performance of GeneXpert MTB/RIF assay for the diagnosis of extrapulmonary tuberculosis (EPTB) was compared with light-emitting diode Fluorescent Microscopy (LED-FM) in Khyber Pakhtunkhwa, Pakistan. A total of 737 EPTB samples were collected from tuberculosis (TB) suspected patients. Out of these samples, male to female ratio was 53% (n = 390) to 47% (n = 347) respectively. The sensitivity and specificity was 73% and 100% for GeneXpert, while 40% and 100% for LED-FM microscopy. This shows that the sensitivity of GeneXpert is 40–50%, higher than LED-FM microscopy. GeneXpert also detected low number of bacilli as compared to LED-FM microscopy.

Keywords:
GeneXpert; LED-FM microscopy; Sensitivity; Specificity

Types	Total sample 2015	2014	Total sample	Total number of processed sample	Positive
					LED FM	GeneXpert	Culture
Pleural fluid	85	45	129	259	22 (8%)	30 (12%)	52 (20%)
BAL	1	1	23	25	3 (12%)	7 (28%)	8 (32%)
CSF	18	15	26	59	5 (8%)	10 (17%)	12 (20%)
Pus	31	20	31	82	4 (5%)	10 (12%)	12 (15%)
Acsetic fluid	48	20	57	125	8 (6%)	14 (11%)	14 (11%)
Synovail fluid	1	1	11	13	2 (15%)	6 (46%)	7 (54%)
Urine	15	10	22	47	4 (9%)	4 (9%)	7 (15%)
Pericardial fluid	17	10	29	56	2 (4%)	6 (11%)	7 (12%)
Bone marrow	20	15	1	36	0	3 (8%)	6 (17%)
Tissues	16	8	11	35	2 (8%)	5 (14%)	5 (14%)
Total	252	145	340	737	52 (7%)	95 (13%)	130 (18%)
				M = 390	53%
				F = 347	47%

	Total		Pleural fluid		BAL		CSF		Pus		Ascetic fluid		Synovail fluid		Urine		Pericardial Fluid		Bone Marrow		Tissues.
	GX	LED-FM	GX	LED-FM	GX	LED-FM	GX	LED-FM	GX	LED-FM	GX	LED-FM	GX	LED-FM	GX	LED-FM	GX	LED-FM	GX	LED-FM	GX	LED-FM
Sensitivity %	73	40	58	42	88	38	83	42	83	33	100	57	86	29	57	57	86	29	50	0	100	40
Specificity %	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100
PPV	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100
NPV	95	89	90	87	94	77	96	87	98	90	100	95	86	55	93	93	98	91	91	83	100	91

Sociedade Brasileira de Microbiologia USP - ICB III - Dep. de Microbiologia, Sociedade Brasileira de Microbiologia, Av. Prof. Lineu Prestes, 2415, Cidade Universitária, 05508-900 São Paulo, SP - Brasil, Ramal USP 7979, Tel. / Fax: (55 11) 3813-9647 ou 3037-7095 - São Paulo - SP - Brazil
E-mail: bjm@sbmicrobiologia.org.br

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[1] Conflicts of interest

The authors declare no conflicts of interest.