GENEXPERT ® TECHNOLOGY A BREAKTHROUGH FOR DIAGNOSIS OF TUBERCULOUS PERICARDITIS AND PLEURITIS IN LESS THAN TWO HOURS

ABSTRACT: BACKGROUND: Diagnosis of Tubercles Pericarditis and Pleuritis remains the greatest challenge for clinicians. WHO has recommended GeneXpert MTB/RIF assay as a screening test for substitution of conventional methods for the initial diagnosis and prognosis of the extra pulmonary and pulmonary...

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Main Authors: Hamid Mahmood, Talmeez Zaib, Zafar Hayat Maken
Format: Article
Language:English
Published: University of Faisalabad 2018-09-01
Series:Journal of University Medical & Dental College
Subjects:
Online Access:http://jumdc.com/index.php/jumdc/article/view/86
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author Hamid Mahmood
Talmeez Zaib
Zafar Hayat Maken
author_facet Hamid Mahmood
Talmeez Zaib
Zafar Hayat Maken
author_sort Hamid Mahmood
collection DOAJ
description ABSTRACT: BACKGROUND: Diagnosis of Tubercles Pericarditis and Pleuritis remains the greatest challenge for clinicians. WHO has recommended GeneXpert MTB/RIF assay as a screening test for substitution of conventional methods for the initial diagnosis and prognosis of the extra pulmonary and pulmonary tuberculosis in developing countries. OBJECTIVE: To find out the diagnostic validity of GeneXpert assay for detection of Myco-bacterium tuberculosis in the pericardial and pleural effusion samples, keeping MTB culture as “Gold Standard”. MATERIAL AND METHODS: The total number of 286 samples of effusions (pericardial 128, pleural 158) were received, and processed for Zn smear microscopy, LJ culture, GeneXpert MTB/RIF assay according to standard protocols. Efficacy for the detection of MTB was evaluated comparatively. RESULTS: Out of 286 effusions samples AFB was detected by Zn smear in 11 (3.8%) samples while GeneXpert detected MTB in 43 (15.0%) and LJ culture 51 (17.8%). Zn smear showed sensitivity 18.2% , specificity , 98.1% , Positive predictive value 81.8% , Negative predictive value 85.4 % , in comparison GeneXpert showed high sensitivity 84.3%, specificity 100%, with Positive predictive value 100% and Negative predictive value 96.7%. CONCLUSION: GeneXpert assay is an innovative tool in resource limited settings for prompt detection of MTB along with drug résistance. It is definitely an attractive point of care testing, with high sensitivity and specificity along with turnout time of two hours, which facilitates timely diagnoses and appropriate management of tuberculous Pleuritis and Pericarditis.
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spelling doaj.art-a900f7c617264b13997eac386b3daf192022-12-21T18:34:43ZengUniversity of FaisalabadJournal of University Medical & Dental College2221-78272310-55422018-09-0193GENEXPERT ® TECHNOLOGY A BREAKTHROUGH FOR DIAGNOSIS OF TUBERCULOUS PERICARDITIS AND PLEURITIS IN LESS THAN TWO HOURSHamid Mahmood 0Talmeez Zaib1Zafar Hayat Maken 21Professor of Bio Chemistry, Amna Inayat Medical College, Kishawar Fazal Teaching Hospital, SheikhupuraAssistant Professor, Amna Inayat Medical College, Sheikhupura.Assistant Professor, Federal Medical & Dental College, Islamabad.ABSTRACT: BACKGROUND: Diagnosis of Tubercles Pericarditis and Pleuritis remains the greatest challenge for clinicians. WHO has recommended GeneXpert MTB/RIF assay as a screening test for substitution of conventional methods for the initial diagnosis and prognosis of the extra pulmonary and pulmonary tuberculosis in developing countries. OBJECTIVE: To find out the diagnostic validity of GeneXpert assay for detection of Myco-bacterium tuberculosis in the pericardial and pleural effusion samples, keeping MTB culture as “Gold Standard”. MATERIAL AND METHODS: The total number of 286 samples of effusions (pericardial 128, pleural 158) were received, and processed for Zn smear microscopy, LJ culture, GeneXpert MTB/RIF assay according to standard protocols. Efficacy for the detection of MTB was evaluated comparatively. RESULTS: Out of 286 effusions samples AFB was detected by Zn smear in 11 (3.8%) samples while GeneXpert detected MTB in 43 (15.0%) and LJ culture 51 (17.8%). Zn smear showed sensitivity 18.2% , specificity , 98.1% , Positive predictive value 81.8% , Negative predictive value 85.4 % , in comparison GeneXpert showed high sensitivity 84.3%, specificity 100%, with Positive predictive value 100% and Negative predictive value 96.7%. CONCLUSION: GeneXpert assay is an innovative tool in resource limited settings for prompt detection of MTB along with drug résistance. It is definitely an attractive point of care testing, with high sensitivity and specificity along with turnout time of two hours, which facilitates timely diagnoses and appropriate management of tuberculous Pleuritis and Pericarditis.http://jumdc.com/index.php/jumdc/article/view/86GeneXpert MTB/RIF assayPleural effusionspericardial effusionLJ culture
spellingShingle Hamid Mahmood
Talmeez Zaib
Zafar Hayat Maken
GENEXPERT ® TECHNOLOGY A BREAKTHROUGH FOR DIAGNOSIS OF TUBERCULOUS PERICARDITIS AND PLEURITIS IN LESS THAN TWO HOURS
Journal of University Medical & Dental College
GeneXpert MTB/RIF assay
Pleural effusions
pericardial effusion
LJ culture
title GENEXPERT ® TECHNOLOGY A BREAKTHROUGH FOR DIAGNOSIS OF TUBERCULOUS PERICARDITIS AND PLEURITIS IN LESS THAN TWO HOURS
title_full GENEXPERT ® TECHNOLOGY A BREAKTHROUGH FOR DIAGNOSIS OF TUBERCULOUS PERICARDITIS AND PLEURITIS IN LESS THAN TWO HOURS
title_fullStr GENEXPERT ® TECHNOLOGY A BREAKTHROUGH FOR DIAGNOSIS OF TUBERCULOUS PERICARDITIS AND PLEURITIS IN LESS THAN TWO HOURS
title_full_unstemmed GENEXPERT ® TECHNOLOGY A BREAKTHROUGH FOR DIAGNOSIS OF TUBERCULOUS PERICARDITIS AND PLEURITIS IN LESS THAN TWO HOURS
title_short GENEXPERT ® TECHNOLOGY A BREAKTHROUGH FOR DIAGNOSIS OF TUBERCULOUS PERICARDITIS AND PLEURITIS IN LESS THAN TWO HOURS
title_sort genexpert r technology a breakthrough for diagnosis of tuberculous pericarditis and pleuritis in less than two hours
topic GeneXpert MTB/RIF assay
Pleural effusions
pericardial effusion
LJ culture
url http://jumdc.com/index.php/jumdc/article/view/86
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AT talmeezzaib genexperttechnologyabreakthroughfordiagnosisoftuberculouspericarditisandpleuritisinlessthantwohours
AT zafarhayatmaken genexperttechnologyabreakthroughfordiagnosisoftuberculouspericarditisandpleuritisinlessthantwohours