Abstract:

Objective To analyze the value of applying molecular diagnosis and liquid culture methods in improving the diagnostic capabilities of tuberculosis in general hospitals. Methods Data of diagnostic basis, etiological test and the results, submitting time of specimen and result returning time, admission time and discharge time of 1438 inpatients diagnosed with pulmonary tuberculosis and reported with infectious disease cards in China-Japan Friendship Hospital from March 2014 to December 2018 in the medical record system were collected. The changes in the pathogenic diagnosis ability and time of diagnosis of tuberculosis were analyzed, between 2014-2016 when the hospital only carried out acid-fast staining and solid culture method of mycobacteria (Roche culture method), and 2017-2018 when the hospital carried out molecular diagnosis technique (GeneXpert MTB/RIF test) and liquid culture method (BACTEC MGIT 960 mycobacterium rapid liquid culture). Results The positive rate of pathogenic detection of pulmonary tuberculosis increased from 19.83% (24/121) in 2014 to 53.89% (256/475) in 2018. The difference of positive rate of pathogenic detection of pulmonary tuberculosis before and after the use of molecular diagnosis technique and liquid culture method was significant (22.68% (132/582) vs. 49.65% (425/856), χ²=106.184, P=0.000). After carrying out the GeneXpert MTB/RIF test (2017-2018), the rate of rifampin-resistant was found to be 7.45% (28/376), while drug resistant tuberculosis couldn’t be diagnosed before the use of the test. After carrying out molecular diagnosis technique and liquid culture method (2017-2018), the diagnosis time of tuberculosis was 7.00 (3.00, 12.00) d, which was significantly shorter than before (2014-2016)(10.00 (6.00, 14.00) d; Z=-7.815, P=0.000). Conclusion The application of molecular diagnosis technique and liquid culture method in general hospital can improve the diagnosis of tuberculosis and shorten the diagnosis time.

Key words: Tuberculosis,pulmonary, Early diagnosis, Molecular diagnostic techniques, Hospitals,general, Evaluation studies