Volume 5, Issue 1, January 2020, Page: 14-17
GeneXpert's Performance in the Diagnosis of Pulmonary and Extrapulmonary Tuberculosis
Mouhib Hanane, Laboratory of Bacteriology-virology and Molecular Biology Military Hospital, Mohammed VI UHC, Marrakech, Morocco
Zahir Hanane, Laboratory of Bacteriology-virology and Molecular Biology Military Hospital, Mohammed VI UHC, Marrakech, Morocco
Arsalane Lamiae, Laboratory of Bacteriology-virology and Molecular Biology Military Hospital, Mohammed VI UHC, Marrakech, Morocco
Kamouni Youssef, Laboratory of Bacteriology-virology and Molecular Biology Military Hospital, Mohammed VI UHC, Marrakech, Morocco
Miloudi Mouhcine, Laboratory of Bacteriology-virology and Molecular Biology Military Hospital, Mohammed VI UHC, Marrakech, Morocco
Zouhair Said, Laboratory of Bacteriology-virology and Molecular Biology Military Hospital, Mohammed VI UHC, Marrakech, Morocco
Received: Nov. 13, 2019;       Accepted: Dec. 4, 2019;       Published: Jan. 7, 2020
DOI: 10.11648/j.ajlm.20200501.12      View  331      Downloads  156
Abstract
The diagnosis of tuberculosis is based on the isolation of acid-fast bacilli (AFB) on direct examination or on the culture isolation of mycobacteria tuberculosis complex (MCT). Currently, the introduction of molecular biology, essentially the Xpert / MTB / Rif or GeneXpertR test has increased the sensitivity and speed of diagnosis. The objective of our study is the evaluation of the performance of the Xpert / MTB / Rif molecular technique in the diagnosis of pulmonary and extrapulmonary tuberculosis. This is a descriptive retrospective study over a period of 22 months (June 2016 - April 2018). The study concerned all pulmonary and extrapulmonary specimens sent to the laboratory of bacteriology-virology and molecular biology of the HMA Marrakech for suspicion of tuberculosis. Diagnosis was performed on all specimens by direct examination on Ziehl-Neelsen stained smears, culture on Loweinstein Jensen solid medium (LJ) and GeneXpert molecular technical. Our study included 305 patients, 69% were men and 31% women. The clinical samples included in the study consisted of different specimens with a prevalenceof sputum (n = 127). Positivity was higher for GeneXpert MTB / RIF than for Ziehl-Neelsen and culture with respectively 18% (n = 54) for GeneXpert against 13% (n = 40) for culture and 8% (n = 24) for Ziehl-Neelsen. On all positive direct examination specimens, GeneXpert was positive in 100% of cases, on negative direct examination samples, GeneXpert was positive in 5% of cases. The positivity rate of GeneXpert was 10.6% for samples with negative culture and 100% for positive culture samples. The performance of GeneXpert was variable depending on the nature of the samples: sputum (23%), biopsy (15%), pleural fluid (13%). Four cases of resistance to rifampicin have been detected. Our study shows the great contribution of GeneXpert for the diagnosis of pulmonary and extrapulmonary tuberculosis as well as its place in the determination of multidrug resistance.
Keywords
Tuberculosis, GeneXpert, Culture, Direct Examination
To cite this article
Mouhib Hanane, Zahir Hanane, Arsalane Lamiae, Kamouni Youssef, Miloudi Mouhcine, Zouhair Said, GeneXpert's Performance in the Diagnosis of Pulmonary and Extrapulmonary Tuberculosis, American Journal of Laboratory Medicine. Vol. 5, No. 1, 2020, pp. 14-17. doi: 10.11648/j.ajlm.20200501.12
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Global tuberculosis report 2017. World Health Organization; 2017.
[2]
Jabri. H, Lakhdar. N, ElKhattabi. W, Afif. H. Les moyens diagnostiques de la tuberculose. Rev PneumolClin2016; 72: 320-325.
[3]
World Health Organization. (‎2015)‎. Global tuberculosis report 2015, 20th ed. World Health Organization.
[4]
Direction de l’épidémiologie et de la lutte contre les maladies. Maroc: Ministère de la santé publique; 2014.
[5]
Hillemann D, Rusch-Gerdes S, Boehme C, Richter E. Rapid molecular detection of extrapulmonary tuberculosis by the automated GeneXpert MTB/RIF system. J Clin Microbiol 2011; 49 (4): 1202–5.
[6]
World Health Organization. Policy Statement: Automated Real-Time Nucleic Acid Amplification Technology for Rapid and Simultaneous Detection of Tuberculosis and Rifampicin Resistance: Xpert MTB/RIF system. Geneva, Switzerland: World Health Organization; 2015.
[7]
Erkens CG, Kamphorst M, Abubakar I, et al. Tuberculosis contact investigation in low prevalence countries: a European consensus. EurRespir J 2010; 36: 925- 49.
[8]
Horoa. K, Guessanb. R, Koffia. M, Kouamé-N’Takpéc. N et all. TestXpert® MTB/RIF et dépistage des nouveaux cas de tuberculose pulmonaire en routine dans une zone de haute endémicité tuberculeuse. Rev Mal Respir 2017; 34: 749—757
[9]
Diallo. A, Issifi Kollo. A, Camara. M et all. Performance du GeneXpert MTB/RIF® dans le diagnostic de la tuberculose extra-pulmonaire à Dakar. PAMJ 2010-2015.
[10]
Tortoli E, Russo C, Piersimoni C, Mazzola E, Dal Monte P, Pascarella M, et al. Clinical validation of Xpert MTB/RIF for the diagnosis of extrapulmonary tuberculosis. Eur Respir J 2012; 40 (2): 442–7.
[11]
Slim-Saidi L, Mehiri-Zeghal E, Ghariani A, Tritar F. Nouvelles méthodes de diagnostic de la tuberculose. Rev PneumolClin 2015; 71: 110-21.
[12]
Vadwai V, Boehme C, Nabeta P, Shetty A, Alland D, Rodrigues C. Xpert MTB/RIF: a new pillar in diagnosis of extrapulmonary tuberculosis? JClinMicrobiol2011; 49 (7): 2540–5.
[13]
Marlowe EM, Novak-Weekley SM, Cumpio J, Sharp SE, Momeny MA, Babst A, et all. Evaluation of the Cepheid Xpert MTB/RIF assay for direct detection of Mycobacterium tuberculosis complex in respiratory specimens. J Clin Microbiol2011; 49 (4): 1621–3.
[14]
Lupande D, Kaishusha D, Mihigo C et all. GeneXpert MTB/RIF dans le dépistage de la tuberculose pulmonaire à l’Hôpital Provincial Général de Référence de Bukavu, à l’Est de la République Démocratique du Congo: quelles leçons tirées après 10 mois d’utilisation?PAMJ 2017; 27: 260.
[15]
Pandey S, Congdon J, Mcinnes B, Pop A et all. Evaluation of the GeneXpert MTB/RIF assay on extrapulmonary and respiratory samples other than sputum: a low burden country experience. Pathology 2017; 49 (1): 70–74.
[16]
Williamson DA, Basu I, Bower J, Freeman JT, Henderson G, Roberts SA. An evaluation of the Xpert MTB/RIF assay and detection of false-positive rifampicin resistance in Mycobacterium tuberculosis. DiagnMicrobiol Infect Dis 2012; 74 (2): 207–9.
Browse journals by subject