Abstract:
Objective To analyze the application of Gen-XpertMTB/RIF and fluorescence PCR melting curve method in rapid diagnosis of drug-resistant tuberculosis were analyzed.
Methods All of 850 TB patients admitted to Shaanxi Provincial Tuberculosis Prevention and Treatment Hospital from January to December 2019 were included, and were tested for phenotypic drug sensitivity and Gen-XpertMTB/RIF. Fluorescent PCR dissolution curve method was performed on rifampicin (RFP)-resistant patients in Gen-XpertMTB/RIF positive samples. Using the drug susceptibility method as the gold standard, the diagnostic value, cost-effectiveness ratio (C/E) and testing time of Gen-XpertMTB/RIF for TB patients′RFP resistance were analyzed; the diagnostic value, C/E and testing time of Gen-XpertMTB/RIF combined with fluorescent PCR melting curve method for multi-drug resistance (MDR) and pre-extensive drug resistance (Pre-XDR) were analyzed.
Results The diagnostic accuracy of Gen-XpertMTB/RIF for RFP resistance in TB patients was 94.59% (804/850). Gen-XpertMTB/RIF and drug susceptibility method had good consistency in the diagnosis of RFP resistance in TB initial treatment and retreatment patients. The accuracy of Gen-XpertMTB/RIF combined with fluorescent PCR dissolution curve to diagnose MDR in TB patients was 98.71% (839/850), and the consistency of the diagnosis of MDR in TB patients with initial treatment and retreatment with the drug susceptibility method was good. The C/E and diagnosis time of Gen-XpertMTB/RIF for the diagnosis of RFP resistance were lower than that of the drug susceptibility method. The C/E of Gen-XpertMTB/RIF combined with MeltPro in the diagnosis of MDR and Pre-XDR was higher than that of drug sensitivity method, and the diagnosis time was lower than that of drug sensitivity method.
Conclusion Gen-XpertMTB/RIF used in the detection of RFP resistance in TB patients, and the Gen-XpertMTB/RIF combined with fluorescent PCR melting curve method used in the detection of MDR and Pre-XDR in TB patients, both have high consistency with the drug sensitivity method and can significantly shorten the detection time, buy time for clinicians to diagnose and treat drug-resistant tuberculosis, thereby helping to reduce the spread of drug-resistant tuberculosis and the incidence of drug-resistant tuberculosis.
Key words:
Drug-resistant tuberculosis,
Fluorescence PCR dissolution curve,
Gen-XpertMTB/RIF,
Phenotypic drug sensitivity,
Cost-effectiveness ratio,
Rapid diagnosis
Li Liu, Ning Zhang, Kewen Wang, Sha Yao, Kangli Yang, Jilong Ma. Application of Gen-XpertMTB/RIF and fluorescence PCR melting curve method in rapid diagnosis of drug-resistant tuberculosis[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2022, 15(02): 161-165.