Evaluation of direct detection of mycobacterium tuberculosis complex in extra-pulmonary clinical specimens with Cepheid Genexpert platform

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Evaluation of direct detection of mycobacterium tuberculosis complex in extra-pulmonary clinical specimens with Cepheid Genexpert platform

 

Author: Ma, Chi Wah Jerry
Title: Evaluation of direct detection of mycobacterium tuberculosis complex in extra-pulmonary clinical specimens with Cepheid Genexpert platform
Degree: M.Sc.
Year: 2015
Subject: Tuberculosis -- Diagnosis
Mycobacterium tuberculosis -- Diagnosis
Hong Kong Polytechnic University -- Dissertations
Department: Dept. of Health Technology and Informatics
Pages: vii, 45 leaves ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2800157
URI: http://theses.lib.polyu.edu.hk/handle/200/7906
Abstract: Extrapulmonary tuberculosis (EPTB) is considered a major clinical problem and has been noted to have significantly increased worldwide, especially in industrialized countries, which accounts for approximately 20% of Tuberculosis (TB) cases. Xpert MTB/RIF has been proven to be an excellent point-of-care platform to diagnose pulmonary TB in highly endemic countries with a fully automatic molecular system. In this study, we aimed to investigate the ability of the Xpert system to detect extrapulmonary tuberculosis in Hong Kong. We included 231 extrapulmonary clinical samples which correspond to 188 patients. By comparing with the gold standard culture method as well as the clinical diagnosis of TB records, an overall sensitivity of 81.8% and specificity of 100% was obtained. For the biopsy specimens, the sensitivity is around 80% while the non-biopsy specimens including the body fluid, pus & urine was 100%. The performance of Xpert is better in the AFB microscopy positive than in the negative sample, with a sensitivity of 100% in the positive compared to 75% in the negative samples. Even though the conventional culture method is still considered the main tool in the diagnosis of extrapulmonary TB, the Xpert system provides an alternative method to screen for EPTB in a more efficient way with higher sensitivity and faster turnaround time compared with smear microscopy. Hence, including traditional culture methods as well as the Xpert as a combo test for the screening of EPTB is recommended.

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