How expert is genexpert test: A study done at a tertiary care centre for TB spine patients

Abstract

Study design: Retrospective study. Purpose: The aim of this study was to analyze various diagnostic tools, including Gene Xpert, for the management of tuberculosis of the spine. Aim of study: The aim of this study was to analyze various diagnostic tools for the management of tuberculosis of the spine, particularly the use of Gene Xpert, and to compare it with other diagnostic tools. Inclusion criteria: All cases which had at least one positive test out of Gene Xpert, smear, culture sensitivity and histopathology Exclusion criteria: All cases which tested negative for Gene Xpert, smear, culture sensitivity and histopathology Materials and methods: A Retrospective study done at Dr. R. N. Cooper Municipal General Hospital and HBT Medical College. Data collected from January 2018 to January 2020 on 2-year follow-up was available for 31 cases. Results: Among the cases in which Gene Xpert was used, the sensitivity for the detection of Mycobacterium tuberculosis was 77% (24/31). Moreover, the sensitivity of Gene Xpert to detect rifampicin resistance was 100% (31/31) in our study. In 11 of the 31 patients (35%), diagnosis was confirmed on the basis of a culture. All 31 (100%) patients exhibited a typical magnetic resonance imaging (MRI) picture. Among the 31 patients, 14 patients underwent biopsy, in 21 patients, diagnosis was confirmed on the basis of histopathology (67%). Smear microscopy was positive in 38% (12/31) of the patients. ESR was raised in 80% of the patients and CRP was reactive in 58% of the patients. TestSensitivity Gene Expert 77% Histopathology 67% Smear Microscopy 38% Culture 35%Conclusions: Gene Xpert is a rapid and highly sensitive tool to diagnose tuberculosis and rifampicin resistance in patients with tuberculosis of the spine. Furthermore, we achieved a 77% sensitivity for the detection of Mycobacterium tuberculosis and 100% sensitivity for the detection of rifampicin resistance in our study.