| The value of Gene Xpert MTB/RIF detection in feces in the early and rapid diagnosis of HIV negative intestinal tuberculosis |
| Received:March 04, 2020 Revised:March 30, 2020 Click here to download the full text |
| Citation of this paper:XIONG Yu,GAO Xu-Sheng,DING Cai-Hong,WANG Qing,PANG Yu,TANG Pei-jun.The value of Gene Xpert MTB/RIF detection in feces in the early and rapid diagnosis of HIV negative intestinal tuberculosis[J].Chinese Journal of Clinical Medicine,2020,27(4):679-683 |
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| Author Name | Affiliation | E-mail | | XIONG Yu | Shandong Chest Hospital, Department of tuberculosis, Jinan 250013, Shangdong, China | | | GAO Xu-Sheng | Shandong Chest Hospital, Department of tuberculosis, Jinan 250013, Shangdong, China | | | DING Cai-Hong | Shandong Chest Hospital, Department of tuberculosis, Jinan 250013, Shangdong, China | dingdding_64@163.com | | WANG Qing | Shandong Chest Hospital, Department of tuberculosis, Jinan 250013, Shangdong, China | | | PANG Yu | Beijing Chest Reference Lab, Beijing Chest Hospital, Beijing 101149, China | | | TANG Pei-jun | Suzhou Fifth People's Hospital, Department of tuberculosis, Suzhou 215007, Jiangsu, China | |
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| Abstract:Objective: To evaluate the value of Gene Xpert MTB/RIF detection in feces for the early and rapid diagnosis of patients with HIV negative intestinal tuberculosis.Methods: Totally, 254 HIV-negative patients with suspected intestinal tuberculosis admitted in three tuberculosis hospitals, Shandong Provincial Chest Hospital, Beijing Chest Hospital, and Suzhou Fifth People’s Hospital from January 2018 to June 2019 were included. The feces (stool) samples of all patients were collected, and each sample was analyzed by Xpert detection, smear acid fast bacilli examination, and BACTEC MGIT 960 (MGIT 960) mycobacterium culture. The sensitivity and specificity of stool samples detected by Xpert were evaluated using the clinical diagnosis as a standard. Rifampicin drug sensitivity test was carried out for all positive strains. The consistency between Xpert test results and MGIT 960 drug sensitivity test results was compared.Results: Among the 254 patients, 139 (54.7%) were diagnosed as intestinal tuberculosis and 115 (45.3%) as non-intestinal tuberculosis. Of the 139 patients with intestinal tuberculosis, 60 (43.2%) were positive for MGIT 960 mycobacterium culture, 79 (56.8%) were diagnosed as intestinal tuberculosis according to the clinical manifestations, enteroscopy results and therapeutic effects of antituberculosis. With the standard diagnosis based on the clinical diagnosis, the sensitivity of Xpert[60.4% (84/139)], was higher than that of acid fast smear[13.2% (17/139)]. The sensitivity difference between the above two methods was of statistical significance (P<0.001). The specificity of Xpert was 100%. There was a statistical significant difference in the sensitivity between MGIT 960 and Xpert detection[43.2% (60 /139) vs 98.3% (59/60), P=0.004]. The sensitivity of Xpert was. The positive rate of Xpert results was 31.6% (25/79) in patients who had negative acid fast smear and MGIT 960 mycobacterium culture results but were clinically diagnosed as intestinal tuberculosis.Conclusions: The detection of Mycobacterium tuberculosis in fecal samples by Xpert is more sensitive than acid fast smear and MGIT 960 mycobacterium culture, and it can detect rifampicin resistance at the same time, providing bacteriological basis for early rapid diagnosis of intestinal tuberculosis. |
| keywords:intestinal tuberculosis nucleic acid amplification technology gene Xpert MTB / RIF feces diagnosis |
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