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Chest Infections |

GeneXpert MTB/RIF Assay vs. Mtb Culture vs DSSM for the Detection of MDRTB: The Western Visayas Medical Center, Philippines Experience from January to December 2014

Fel Angelie Colon, MD; marian celis, MD; ma bemerly sira, MD; Kathryn Joyce Gorriceta, MD
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Western Visayas Medical Center, Q. Abeto St., Mandurriao, Iloilo City, Philippines


Chest. 2015;148(4_MeetingAbstracts):136A. doi:10.1378/chest.2263351
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Abstract

SESSION TITLE: Chest Infections Posters: Tuberculosis

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: There are 27 “ high burden countries” of MDRTB in which the Philippines is included.. In 2012 there was an estimated 170,00 deaths from MDRTB and 450,000 new cases of MDRTB. To prevent further spread of TB rapid diagnostic test is needed . It used to take two months to detect MDRTB using sputum culture but only about 2 hours using GeneXpert. To find out if the GeneXpert currently used at WVMC is as sensitive and specific compared to Mtb culture and DSSM to detect MDRTB this study was conducted. To find out the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of GeneXpert, Mtb culture and DSSM (Direct sputum smear microscopy) for the detection of MDRTB.

METHODS: Review of medical records of patients enrolled at WVMC PMDT (Programmatic Multi Drug Resistant TB) Unit from January to December 2014. Inclusion Criteria: 1. All patients enrolled at WVMC PMDT with GeneXpert, Mtb culture and DSSM results Exclusion Criteria: 1. Patients with incomplete results for GeneXpert, Mtbculture and DSSM

RESULTS: A total of 60 patients were included in the study. All had positive geneXpert 100% (60/60) and Mtb culture 100% (60/60). Of these 60 patients 45 had positive DSSM 75% (45/60) while 28% (17/60) had negative DSSM. The study showed GeneXpert had a sensitivity of 100% (60/60), specificity of 100% (60/60), positive predictive value (PPV) of 100% (60/60) and negative predictive value of 100% (60/60). Mtb culture also has a sensitivity of 100% (60/60) , specificity of 100% (60/60) ,PPV of 100% (60/60) and NPV of 100% (60/60). DSSM showed a sensitivity of 100% (60/60), specificity of 100% (60/60), PPV of 100% (45/45) and NPV of 0% (0/17).

CONCLUSIONS: GeneXpert is a highly sensitive, specific and rapid diagnostic tool for MDRTB detection with a high PPV and NPV. GeneXpert is as sensitive as Mtb culture for the detection of MDRTB. DSSM is a highly sensitive 100% and specific 100% diagnostic tool for MDRTB detection with high PPV 100% but with a very low NPV 0%.

CLINICAL IMPLICATIONS: GeneXpert is a rapid and accurate device that can diagnose MDRTB GeneXpert is as sensitive as Mtb culture to diagnose MDRTB. DSSM is a poor diagnostic tool to detect MDRTB

DISCLOSURE: The following authors have nothing to disclose: Fel Angelie Colon, marian celis, ma bemerly sira, Kathryn Joyce Gorriceta

No Product/Research Disclosure Information


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