Tang Tingyu, Liu Fang, Lu Xiaoling, Huang Qingdong
Department of Respiratory Medicine, Zhejiang Hospital, Xihu District, Hangzhou, Zhejiang Province, China.
J Int Med Res. 2017 Apr;45(2):816-822. doi: 10.1177/0300060517698618. Epub 2017 Mar 29.
Objective To evaluate the performance of GeneXpert MTB/RIF in diagnosing pulmonary tuberculosis (TB) in China. Methods This cross-sectional study included sputum specimens of 240 suspected TB cases. Specimens were examined by light microscopy for the presence of acid-fast bacilli, which were cultured by the BACTEC MGIT 960 (M960) system and detected by the GeneXpert MTB/RIF assay. The positive rate, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and average turnaround time of methods were evaluated. Results The positive rate was 36.6% (87/238) for the GeneXpert MTB/RIF assay and 34.0% (81/238) by M960 culture, with no significant difference between methods (χ= 0.33, p > 0.05). According to culture results, sensitivity of the GeneXpert MTB/RIF assay was 84.0% (68/81), specificity was 87.8% (129/147), the PPV was 78.2% (68/87), and the NPV was 87.2% (129/148). The agreement for results between Gene Xpert MTB/RIF and the M960 system was 82.8% and the Kappa value was 0.73. Conclusion The GeneXpert MTB/RIF assay is a simple, rapid, and accurate test for detecting Mycobacterium tuberculosis in sputum specimens.
目的 评估GeneXpert MTB/RIF在中国诊断肺结核(TB)的性能。方法 这项横断面研究纳入了240例疑似TB病例的痰标本。通过光学显微镜检查标本中是否存在抗酸杆菌,将其用BACTEC MGIT 960(M960)系统培养,并通过GeneXpert MTB/RIF检测法进行检测。评估了方法的阳性率、敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)和平均周转时间。结果 GeneXpert MTB/RIF检测法的阳性率为36.6%(87/238),M960培养法的阳性率为34.0%(81/238),两种方法之间无显著差异(χ= 0.33,p > 0.05)。根据培养结果,GeneXpert MTB/RIF检测法的敏感性为84.0%(68/81),特异性为87.8%(129/147),PPV为78.2%(68/87),NPV为87.2%(129/148)。GeneXpert MTB/RIF与M960系统结果的一致性为82.8%,Kappa值为0.73。结论 GeneXpert MTB/RIF检测法是一种用于检测痰标本中结核分枝杆菌的简单、快速且准确的检测方法。