Performance Comparison of GeneXpert MTB/RIF, Gene Chip Technology, and Modified Roche Culture Method in Detecting Mycobacterium tuberculosis and Drug Susceptibility in Sputum

Abstract

Our aim of this study was to observe and analyze the performance of the real-time fluorescence quantitative nucleic acid amplification detection of Mycobacterium tuberculosis/rifampicin resistance (GeneXpert MTB/RIF), gene chip technology, and modified Roche culture method in detecting MTB in sputum submitted for inspection and drug susceptibility. Patients with smear-negative suspected pulmonary TB (n = 120) in our hospital were enrolled in this study using a random number table, and sputum samples submitted for inspection were tested by the GeneXpert MTB/RIF, gene chip technology, and modified Roche culture method. With clinical diagnosis as the gold standard, the performance (mainly sensitivity and specificity) of the above three detection methods in the diagnosis of MTB was compared. Next, the drug susceptibility test (DST) was carried out on sputum samples, tested positive by the three methods. With the solid culture results as the evaluation criteria, the performance of the three detection methods in the diagnosis MTB and DST was compared. When compared with the modified Roche culture method, the GeneXpert MTB/RIF had the highest positive rate and a shorter overall test duration ( P < 0.05 ). In contrast with the gene chip technology, the GeneXpert MTB/RIF exhibited higher sensitivity and negative predictive value (NPV) and lower specificity, accuracy, positive predictive value (PPV), and Kappa value ( P < 0.05 ). According to analysis of the diagnostic performance of the three detection methods, GeneXpert MTB/RIF displayed the highest diagnostic sensitivity, ideal predictive values, and the highest similarity with clinical diagnosis in results ( P < 0.05 ). The detection of susceptibility to isoniazid (INH) and RIF showed that the GeneXpert MTB/RIF and gene chip technology performed ideally in DST of MTB. In comparison with the modified Roche culture method, the GeneXpert MTB/RIF and gene chip technology have more prominent performance in detecting MTB and drug susceptibility. Besides, to further improve the accuracy of clinical diagnosis, various molecular biology detection methods can be combined to avoid delaying of the best time for the diagnosis and treatment of the disease.

Comparison of 3 diagnostic methods for pulmonary tuberculosis in suspected patients with negative sputum smear or no sputum

“…A previous study suggested that the GeneXpert MTB/RIF assay and culture had similar results in sputum-negative patients, [ 13 ] while another study showed higher performance of the GeneXpert MTB/RIF assay compared to culture in sputum. [ 6 ] Hence, the selection of culture as the gold standard in this study might influence the results. However, the GeneXpert MTB/RIF assay still had undeniable advantages over culture due to its simultaneous detection of M. tuberculosis and rifampicin resistance, rapid testing of within 2 hours, and the involvement of minimal manipulations and hence minimal biohazard.…”

“…The GeneXpert MTB/Rif and gene chip assays were reported to be more sensitive than culture for detecting M. tuberculosis in sputum. [ 6 ] The GeneXpert MTB/Rif assay also tended to be more accurate than AFB. [ 7 ]…”

Utilidad de GeneXpert MTB/RIF en el diagnóstico de tuberculosis frente a la baciloscopia - Utility of GeneXpert MTB/RIF in the Diagnosis of Tuberculosis Compared to Sputum Smear Microscopy

“…Estos resultados enfatizan la necesidad de continuar con la investigación y evaluación del desempeño diagnóstico de GeneXpert MTB/RIF, así como de las nuevas versiones que se introducen en el mercado 15,16,17 . Es vital considerar las variables demográficas, clínicas y microbiológicas específicas de poblaciones como la ecuatoriana para optimizar el uso de herramientas diagnósticas en la lucha contra la tuberculosis, facilitando así una detección más precisa y un manejo adecuado de esta enfermedad a nivel global 18,19,20…”

Advances in single-cell sequencing technology in microbiome research

“…In the field of microbiology, gene chip technology has been used in the study of microbial functional genomics, biological pathogenic mechanisms, infectious disease diagnosis, environmental microbial detection, etc . 50 , 51 , 52 For example, gene chip technology that helps improve the diagnostic efficiency of the detection of drug-resistant Mycobacterium tuberculosis in clinical sputum samples could be directly used in the diagnosis of drug-resistant tuberculosis. 53 …”