Comparative study on the efficacy of three detection techniques in diagnosis of senile pulmonary tuberculosis

doi:10.3969/j.issn.1000-6621.2018.10.010

Abstract

Abstract:

Objective To investigate the diagnostic value of Mycobacterium tuberculosis and rifampicin resis-tance real-time fluorescence quantitative nucleic acid amplification (GeneXpert MTB/RIF), light emitting diode (LED) fluorescence staining and BACTEC MGIT 960 system liquid culture (MGIT liquid culture) in elderly patients with pulmonary tuberculosis.Methods A total of 250 elderly patients with pulmonary tuberculosis admitted to the Department of Pulmonary and Respiratory Infections of Shaoxing Municipal Hospital from 2013 to 2015 were collected. Among them, there were 159 males and 91 females, aged 65-89 years, with an average of (70.3±6.2) years. All of 250 sputum specimens were detected by LED fluorescence staining, MGIT liquid culture and GeneXpert MTB/RIF technique. The chi square test was used to compare between each group, and P<0.05 was considered statistically significant.Results The positive rates of LED fluorescence staining, MGIT liquid culture and GeneXpert MTB/RIF were 36.00% (90/250), 48.40% (121/250) and 50.40% (126/250) respectively. The positive rate of GeneXpert MTB/RIF (50.40%) was higher than that of LED fluorescence staining (36.00%) and the difference was statistically significant (χ²=10.56, P<0.01); and higher than that of MGIT liquid culture (48.40%), but the difference was not statistically significant (χ²=0.20, P>0.05); the positive rate of MGIT liquid culture (48.40%) was higher than that of LED fluorescence staining (36.00%). The difference was statistically significant (χ²=7.88, P<0.01). The sensitivity, specificity, positive predictive value and negative predictive value of GeneXpert MTB/RIF were 95.93% (118/123), 93.70% (119/127), 93.65% (118/126) and 95.97% (119/124) respectively, and the results of the two tests have excellent consistency (Kappa value was 0.90).Conclusion Among the three detection technologies in this study, GeneXpert MTB/RIF has a higher detection efficiency, which is highly consistent with the results of MGIT liquid culture, and has a good clinical application and promotion value.

Key words: Elderly, Tuberculosis, pulmonary, Nucleic acid amplification techniques, Microbial sensitivity tests, Laboratory techniques and procedures, Comparative study

Fa-xiang JIN,Wen-fang XU,Xiao-meng WANG,Zheng-wei LIU,Hua-yun WANG,Xue-fang CHEN,Xiao-jun. SUN. Comparative study on the efficacy of three detection techniques in diagnosis of senile pulmonary tuberculosis[J]. Chinese Journal of Antituberculosis, 2018, 40(10): 1079-1082. doi: 10.3969/j.issn.1000-6621.2018.10.010

Figures/Tables 1

References 13

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GeneXpert MTB/RIF	MGIT液体培养(例)		敏感度 (%)	特异度 (%)	阳性预测值 (%)	阴性预测值 (%)	Kappa值
GeneXpert MTB/RIF	阳性	阴性	敏感度 (%)	特异度 (%)	阳性预测值 (%)	阴性预测值 (%)	Kappa值
阳性	118	8	95.93	93.70	93.65	95.97	0.90
阴性	5	119

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