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Diagnostic role of xpert-MTB RIF assay in osteoarticular tuberculosis:A retrospective study

World Journal of Orthopedics 2022年第3期13卷 289-296页

作者： Monalisa Mohanty Baijayantimala Mishra Mantu Jain Lubaib Karaniveed Puthiyapura Department of Microbiology AIIMS BhubaneswarBhubaneswar 751019OdishaIndia Department of Orthopaedics AIIMS BhubaneswarBhubaneswar 751019OdishaIndia

BACKGROUND Osteoarticular tuberculosis(OATB) is a severe form of extrapulmonary TB, which causes notable morbidity and warrants a high index of suspicion for prompt management. The diagnosis of OATB poses a challenge, because of the difficulty of collecting the samples and, secondarily, the paucibacillary nature of lesion, which gives poor sensitivity and reproducibility, with long turnaround time of routine/conventional laboratory tests and the requirement for invasive procedures and expertise. The xpert MTB/RIF assay has been approved by the World Health Organization as a rapid diagnostic tool for diagnosing pulmonary and extrapulmonary *** To emphasize the diagnostic efficiency of gene xpert for OATB in suspected patients in a tertiary care hospital of Eastern *** This retrospective study was conducted in the Department of Microbiology and Orthopaedics by analyzing the data of the gene xpert assay over a 3-year duration from January 2018 to February 2021. Demographic and clinical data were recorded. The diagnostic efficiency of gene xpert was evaluated against the composite reference standard(CRS).RESULTS A total of 37 cases fell into positive, probable, and possible categories of osteoarticular TB out of 112 patients included in the study by CRS;gene xpert result was positive in 35 out of the 37 different CRS categorized cases. Of the 112 cases, culture was put in 40 cases, and, of these cultures, 5 cases showed the growth of MTB. Of these, 4 cases were included in the 35 cases diagnosed by gene *** microscopy was positive in 6 out of 37 CRS categorized cases. When compared with CRS, the sensitivity of gene xpert assay, culture, and smear was found to be 94.6%, 13.5%, and 16.2%, respectively, while specificity in all the three types of tests was 100%. When kappa statistics were applied, the percentage of agreement gene xpert, culture, and microscopy with CRS was found to be 95%, 20%, and 22.6%, respectively. Follow-up of the gene xpert posit

关键词： Tuberculosis Extrapulmonary Osteoarticular gene xpert assay Composite reference standard

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