DIAGNOSTIC ACCURACY OF GENEXPERT ASSAY AND COMPARISON WITH SMEAR AFB ON BRONCHIAL WASHINGS IN SPUTUM NEGATIVE SUSPECTED PULMONARY TUBERCULOSIS

Objective: To determine diagnostic accuracy of GeneXpert Assay and compare it with smear microscopy for AFB in terms of sensitivity, specificity on bronchial washings/bronchoalveolar lavage samples in sputum smear negative suspected tuberculosis. Study Design: A prospective cross sectional analyt...

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Autores principales:	Mahmood Iqbal Malik, Taymmia Ejaz, Jamal Ahmed, Komal Arshad, Yousaf Jamal, Zeenat Zohfreen
Formato:	article
Lenguaje:	EN
Publicado:	Army Medical College Rawalpindi 2019
Materias:	bronchoalveolar lavage fluid/microbiology bronchoscopy Medicine R Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/b223bd6f64944465a212a159bc3ef22a
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spelling	oai:doaj.org-article:b223bd6f64944465a212a159bc3ef22a2021-11-11T04:51:24ZDIAGNOSTIC ACCURACY OF GENEXPERT ASSAY AND COMPARISON WITH SMEAR AFB ON BRONCHIAL WASHINGS IN SPUTUM NEGATIVE SUSPECTED PULMONARY TUBERCULOSIS0030-96482411-8842https://doaj.org/article/b223bd6f64944465a212a159bc3ef22a2019-08-01T00:00:00Zhttps://www.pafmj.org/index.php/PAFMJ/article/view/3214/2323https://doaj.org/toc/0030-9648https://doaj.org/toc/2411-8842Objective: To determine diagnostic accuracy of GeneXpert Assay and compare it with smear microscopy for AFB in terms of sensitivity, specificity on bronchial washings/bronchoalveolar lavage samples in sputum smear negative suspected tuberculosis. Study Design: A prospective cross sectional analytical study. Place and Duration of Study: Pulmonology Department, Pak Emirates Military Hospital Rawalpindi, from Jul to Dec 2018. Materials and Methods: Patients older than 12 years with suspected sputum negative tuberculosis were included in the study. Bronchoscopy findings were noted, bronchoalveolar lavage fluid/bronchial washings were taken. Samples were sent for AFB smear; GeneXpert Assay and Cultures. Data was analyzed in SPSS version 23. Results: A total of 224 patients were included in the study. 151 (67.4%) were males and 73 (32.6%) females. Mean age was 48.25 ± SD 18.21. Flexible bronchoscopy was diagnostic for tuberculosis in overall 42.4% (95/224) cases. Smear microscopy for AFB was positive in 53 (23.7%) cases, GeneXpert in 82 (36.6%) cases, culture in 66 (29%) cases while 6 cases (2.7%) showed rifampicin resistance on GeneXpert RIF resistance assay. Sensitivity, specificity, PPV and NPV of smear microscopy were 69.6%, 95.5%, 86.7%, 88.3% respectively whereas for GeneXpert they were 86.36%, 84.1%, 69.5%. 93.66% respectively; when compared to culture considered as gold standard. GeneXpert assay activity had statistically significant (p-value<0.01) association with smear and culture positivity. Conclusion: GeneXpert assay had higher sensitivity than AFB smear microscopy and it is a rapid and effective tool on bronchial washings, reducing the time constraint associated with culture based diagnosis and determining Rifampin Resistance simultaneously.Mahmood Iqbal MalikTaymmia EjazJamal AhmedKomal ArshadYousaf JamalZeenat ZohfreenArmy Medical College Rawalpindiarticlebronchoalveolar lavage fluid/microbiologybronchoscopyMedicineRMedicine (General)R5-920ENPakistan Armed Forces Medical Journal, Vol 69, Iss 4, Pp 857-862 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	bronchoalveolar lavage fluid/microbiology bronchoscopy Medicine R Medicine (General) R5-920
spellingShingle	bronchoalveolar lavage fluid/microbiology bronchoscopy Medicine R Medicine (General) R5-920 Mahmood Iqbal Malik Taymmia Ejaz Jamal Ahmed Komal Arshad Yousaf Jamal Zeenat Zohfreen DIAGNOSTIC ACCURACY OF GENEXPERT ASSAY AND COMPARISON WITH SMEAR AFB ON BRONCHIAL WASHINGS IN SPUTUM NEGATIVE SUSPECTED PULMONARY TUBERCULOSIS
description	Objective: To determine diagnostic accuracy of GeneXpert Assay and compare it with smear microscopy for AFB in terms of sensitivity, specificity on bronchial washings/bronchoalveolar lavage samples in sputum smear negative suspected tuberculosis. Study Design: A prospective cross sectional analytical study. Place and Duration of Study: Pulmonology Department, Pak Emirates Military Hospital Rawalpindi, from Jul to Dec 2018. Materials and Methods: Patients older than 12 years with suspected sputum negative tuberculosis were included in the study. Bronchoscopy findings were noted, bronchoalveolar lavage fluid/bronchial washings were taken. Samples were sent for AFB smear; GeneXpert Assay and Cultures. Data was analyzed in SPSS version 23. Results: A total of 224 patients were included in the study. 151 (67.4%) were males and 73 (32.6%) females. Mean age was 48.25 ± SD 18.21. Flexible bronchoscopy was diagnostic for tuberculosis in overall 42.4% (95/224) cases. Smear microscopy for AFB was positive in 53 (23.7%) cases, GeneXpert in 82 (36.6%) cases, culture in 66 (29%) cases while 6 cases (2.7%) showed rifampicin resistance on GeneXpert RIF resistance assay. Sensitivity, specificity, PPV and NPV of smear microscopy were 69.6%, 95.5%, 86.7%, 88.3% respectively whereas for GeneXpert they were 86.36%, 84.1%, 69.5%. 93.66% respectively; when compared to culture considered as gold standard. GeneXpert assay activity had statistically significant (p-value<0.01) association with smear and culture positivity. Conclusion: GeneXpert assay had higher sensitivity than AFB smear microscopy and it is a rapid and effective tool on bronchial washings, reducing the time constraint associated with culture based diagnosis and determining Rifampin Resistance simultaneously.
format	article
author	Mahmood Iqbal Malik Taymmia Ejaz Jamal Ahmed Komal Arshad Yousaf Jamal Zeenat Zohfreen
author_facet	Mahmood Iqbal Malik Taymmia Ejaz Jamal Ahmed Komal Arshad Yousaf Jamal Zeenat Zohfreen
author_sort	Mahmood Iqbal Malik
title	DIAGNOSTIC ACCURACY OF GENEXPERT ASSAY AND COMPARISON WITH SMEAR AFB ON BRONCHIAL WASHINGS IN SPUTUM NEGATIVE SUSPECTED PULMONARY TUBERCULOSIS
title_short	DIAGNOSTIC ACCURACY OF GENEXPERT ASSAY AND COMPARISON WITH SMEAR AFB ON BRONCHIAL WASHINGS IN SPUTUM NEGATIVE SUSPECTED PULMONARY TUBERCULOSIS
title_full	DIAGNOSTIC ACCURACY OF GENEXPERT ASSAY AND COMPARISON WITH SMEAR AFB ON BRONCHIAL WASHINGS IN SPUTUM NEGATIVE SUSPECTED PULMONARY TUBERCULOSIS
title_fullStr	DIAGNOSTIC ACCURACY OF GENEXPERT ASSAY AND COMPARISON WITH SMEAR AFB ON BRONCHIAL WASHINGS IN SPUTUM NEGATIVE SUSPECTED PULMONARY TUBERCULOSIS
title_full_unstemmed	DIAGNOSTIC ACCURACY OF GENEXPERT ASSAY AND COMPARISON WITH SMEAR AFB ON BRONCHIAL WASHINGS IN SPUTUM NEGATIVE SUSPECTED PULMONARY TUBERCULOSIS
title_sort	diagnostic accuracy of genexpert assay and comparison with smear afb on bronchial washings in sputum negative suspected pulmonary tuberculosis
publisher	Army Medical College Rawalpindi
publishDate	2019
url	https://doaj.org/article/b223bd6f64944465a212a159bc3ef22a
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DIAGNOSTIC ACCURACY OF GENEXPERT ASSAY AND COMPARISON WITH SMEAR AFB ON BRONCHIAL WASHINGS IN SPUTUM NEGATIVE SUSPECTED PULMONARY TUBERCULOSIS

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