Analysis on the effect of GeneXpert MTB/RIF single test and mixed test on sputum samples for actively screening tuberculosis in key population of Guangxi

doi:10.19982/j.issn.1000-6621.20230122

Abstract

Abstract:

Objective: To find a more effective etiological detection scheme for actively screening tuberculosis (TB) among key populations in Guangxi Zhuang Autonomous Region (Guangxi) by comparing the results of single and mixed detection of GeneXpert MTB/RIF (Xpert) on sputum samples. Methods: A total of 205 sputum samples of TB key population screening subjects in Xincheng County, Laibin City, Guangxi were collected from November 20, 2021 to March 31, 2022. Xpert was used to conduct single test and mixed test (five samples mixed into one sample) on the collected sputum samples. The positive detection rate, drug resistance rate, failure rate, Ct values, detection time and reagent consumption of the two methods were compared. Results: The positive rate of single test was 9.76% (20/205), and the positive rate of mixed test was 43.90% (18/41). Single test failure rate was 1.95% (4/205), mixed test failure rate was 7.32% (3/41), the difference was not statistically significant (χ²=1.882, P=0.170). The average Ct values of the five molecular probes (Probe A, B, C, D, E) about mixed test were 24.95±4.01, 25.06±3.38, 25.07±3.54, 25.81±3.87 and 26.25±4.72, higher than those of single test (24.47±4.33, 24.82±3.90, 24.75±4.09, 25.50±4.32, and 25.75±4.67), there were no significant difference in Ct values between the mixed and single test of the five molecular probes (t_A=-0.717,P_A=0.482;t_B=-0.396,P_B=0.696;t_C=-0.506,P_C=0.619;t_D=-0.495,P_D=0.626;t_E=-0.748,P_E=0.464). The detection time and reagent consumption of mixed test followed by single test were reduced by 31.70% (42/132.5) and 35.89% (75/209) compared with single test only. Conclusion: For conducting large-scale sputum screening among key TB population, it can effectively reduce the cost and time of detection by performing mixed sample test first and then conducting single test on each of the samples of positive mixed samples.

Key words: Mycobacterium tuberculosis, Sputum, Molecular biology

CLC Number:

Qin Huifang, Liang Xiaoyan, Zhou Lingyun, Lan Yumei, Lin Mei, Zhang Zhitong, Huang Yan, Wei Xiaolin, Liang Dabin. Analysis on the effect of GeneXpert MTB/RIF single test and mixed test on sputum samples for actively screening tuberculosis in key population of Guangxi[J]. Chinese Journal of Antituberculosis, 2023, 45(9): 880-884. doi: 10.19982/j.issn.1000-6621.20230122

Figures/Tables 3

References 14

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混检阳性样本编号	混检结果		单检阳性编号	单检结果
混检阳性样本编号	结核分枝杆菌检出	利福平药物敏感性	单检阳性编号	结核分枝杆菌检出	利福平药物敏感性
1~5	中	敏感	2	中	敏感
11~15	中	敏感	11	中	敏感
16~20	低	敏感	17	中	敏感
			18	极低	敏感
21~25	中	敏感	21	中	敏感
41~45	低	敏感	45	极低	敏感
51~55	低	敏感	51	低	敏感
56~60	低	敏感	60	低	敏感
61~65	低	敏感	65	低	敏感
76~80	极低	敏感	77	低	敏感
86~90	低	敏感	87	中	敏感
91~95	低	敏感	92	低	敏感
101~105	低	敏感	103	低	敏感
126~130	低	敏感	130	低	敏感
131~135	低	敏感	132	低	敏感
141~145	低	敏感	144	中	敏感
155~160	低	敏感	158	极低	敏感
171~175^a	极低	耐药	174	极低	敏感
186~190	中	敏感	186	中	敏感
			189	中	敏感

检测方式	检测管数	失败重检次数	检测次数	每批检测时间(h)	检测总时间(h)
单检	205	4	53	2.5	132.5
混检	41	3	11	3.0	33.0
再次单检^a	90	0	23	2.5	57.5
合计	131	3	34	5.5	90.5

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