Iqbal Azhar, Shafique Muhammad, Zahoor Muhammad Asif, Muzammil Saima, Nawaz Zeeshan, Jabbar Abdul, Khurshid Mohsin, Hussain Riaz, Islam Md Akhttarul, Almatroudi Ahmad, Allemailem Khaled Saleh, Rasool Muhammad Hidayat, Aslam Bilal
Department of Microbiology, Government College University Faisalabad, Pakistan.
Department of Clinical Medicine, Faculty of Veterinary Science, University of Veterinary and Animal Sciences, Lahore, Punjab, Pakistan.
J Infect Dev Ctries. 2022 Apr 30;16(4):698-704. doi: 10.3855/jidc.14990.
Multidrug-resistant Mycobacterium tuberculosis (MDR-TB) is one of the leading causes of death in the world. The resource constraints make it difficult to diagnose and monitor the cases of MDR-TB. GeneXpert is a recognized tool used to diagnose the patients of pulmonary tuberculosis in clinical settings across the globe.
The present one-year cross-sectional study was conducted to estimate the occurrence of MDR-TB in patients with pulmonary TB. A total of 1000 patients suspected of pulmonary tuberculosis were included in this study. A random convenient sampling technique was done to collect the sputum samples (twice) from the patients. Samples were processed for the detection of Mycobacterium tuberculosis using conventional detection methods like the Ziehl Nelson staining method and fluorescent microscopy. Additionally, Cepheid GeneXpert was used for molecular detection of MDR-TB in smear-positive samples of pulmonary tuberculosis by amplifying the rifampicin resistance determining region (RRDR; rpoB gene). All the tests were performed in the biosafety level III lab of District Headquarters Hospital Nankana Sahib.
It was observed that 103 (10.3%) individuals were diagnosed as positive for tuberculosis among 1000 patients. Among these 103 TB positive cases, there were 11 (10.7%) patients diagnosed with rifampicin resistance gene (RR-Gene) of Mycobacterium tuberculosis.
Overall findings of the study showed that MDR-TB is prevalent in pulmonary TB patients and GeneXpert is the most sensitive technique for early diagnosis of the disease, which may be very helpful in the treatment and control of this public health menace in low and middle-income countries.
耐多药结核分枝杆菌（MDR-TB）是全球主要死因之一。资源限制使得耐多药结核病病例的诊断和监测变得困难。GeneXpert是一种公认的工具，用于在全球临床环境中诊断肺结核患者。
本为期一年的横断面研究旨在估计肺结核患者中耐多药结核病的发生率。本研究共纳入1000例疑似肺结核患者。采用随机便利抽样技术从患者中收集痰液样本（两次）。使用传统检测方法如萋-尼氏染色法和荧光显微镜对样本进行处理，以检测结核分枝杆菌。此外，通过扩增利福平耐药决定区（RRDR；rpoB基因），使用赛沛GeneXpert对肺结核涂片阳性样本中的耐多药结核病进行分子检测。所有检测均在南卡纳·萨希布地区总部医院的生物安全三级实验室进行。
观察发现，1000例患者中有103例（10.3%）被诊断为结核病阳性。在这103例结核病阳性病例中，有11例（10.7%）患者被诊断出结核分枝杆菌利福平耐药基因（RR基因）。
该研究的总体结果表明，耐多药结核病在肺结核患者中普遍存在，而GeneXpert是该病早期诊断最敏感的技术，这可能对中低收入国家控制这种公共卫生威胁的治疗和控制非常有帮助。
