Background Tuberculosis (TB) remains a significant public health challenge, particularly in developing countries, where delayed diagnosis contributes to ongoing transmission. Ziehl-Neelsen (ZN) smear microscopy, commonly used for TB diagnosis, has limitations in sensitivity, especially in cases of extrapulmonary tuberculosis (ETB). The GeneXpert (MTB)/rifampicin (RIF) assay, a molecular diagnostic tool, offers rapid and accurate detection of MTB and RIF resistance. This study aimed to compare the diagnostic efficacy of GeneXpert MTB/RIF with ZN staining in detecting pulmonary tuberculosis (PTB) and ETB. Methods A prospective study was conducted over two years (April 2022 to April 2024) at a tertiary care teaching hospital in India. A total of 319 clinical samples from patients with suspected PTB and ETB were analyzed. Samples underwent ZN staining and GeneXpert MTB/RIF assay. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated using mycobacterial culture as the gold standard. The chi-square test was employed to compare diagnostic accuracy, with a p-value of <0.05 considered statistically significant. Results Of the 319 samples, ZN staining was positive in 18.2% of cases, while GeneXpert was positive in 21.6%. GeneXpert demonstrated a perfect sensitivity of 100% and a specificity of 98.81%, compared to ZN staining's sensitivity of 84.85% and specificity of 99.21%. GeneXpert showed superior performance in detecting TB in both pulmonary and extrapulmonary samples, with a statistically significant difference (p<0.001). Additionally, GeneXpert identified six cases of RIF resistance. Conclusion The GeneXpert MTB/RIF assay outperforms ZN staining in diagnosing TB, offering higher sensitivity and comparable specificity. Its ability to detect RIF resistance adds significant clinical value. Despite its cost, the integration of GeneXpert into routine diagnostic workflows, particularly in high TB prevalence areas, is recommended to enhance early detection and treatment, thereby reducing TB transmission.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558030 | PMC |
| http://dx.doi.org/10.7759/cureus.71402 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
National early warning score 2 plus non-invasive capnography and perfusion index to estimate poor outcomes in emergency departments.
Am J Emerg Med
January 2025
Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain; Emergency Department, Hospital Clínico Universitario, Gerencia Regional de Salud de Castilla y León, Valladolid, Spain.
Background: The study of the inclusion of new variables in already existing early warning scores is a growing field. The aim of this work was to determine how capnometry measurements, in the form of end-tidal CO2 (ETCO2) and the perfusion index (PI), could improve the National Early Warning Score (NEWS2).
Methods: A secondary, prospective, multicenter, cohort study was undertaken in adult patients with unselected acute diseases who needed continuous monitoring in the emergency department (ED), involving two tertiary hospitals in Spain from October 1, 2022, to June 30, 2023.
The Association of Modified 5-Item Frailty Index on Perioperative Cochlear Implant Speech Perception.
Otol Neurotol
February 2025
Department of Surgery, Section of Otolaryngology-Head and Neck Surgery, University of Chicago Medicine, Chicago, Illinois.
Objective: This study aims to evaluate the potential association of perioperative hearing outcomes with frailty by Modified 5-Item Frailty Index (mFI-5).
Design: Retrospective cross-sectional study.
Setting: Single-institutional study conducted at a tertiary care hospital between January 2018 and January 2022.
Introduction: Effective antimicrobial stewardship programs require data on antimicrobial consumption (AMC) and utilization (AMU) to guide interventions. However, such data is often scarce in low-resource settings. We describe the consumption and utilization of antibiotics at a large tertiary-level hospital in Uganda.
View Article and Find Full Text PDFBackground: Financial toxicity is the detrimental impact of health care costs that must be mitigated to achieve universal health coverage. Catastrophic health expenditure (CHE) is widely used to measure financial toxicity but does not capture patient perspectives of unaffordable health care costs. Financial hardship (FH), a patient-reported outcome measure, is currently underutilized but may be an important adjunct metric.
View Article and Find Full Text PDFAcute kidney injury in critically ill COVID-19 patients in a tertiary hospital: short and long-term kidney and patient outcomes.
J Bras Nefrol
January 2025
Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil.
Introduction: Acute kidney injury (AKI) in the setting of COVID-19 is associated with worse clinical and renal outcomes, with limited long-term data.
Aim: To evaluate critically ill COVID-19 patients with AKI that required nephrologist consultation (NC-AKI) in a tertiary hospital.
Methods: Prospective single-center cohort of critically ill COVID-19 adult patients with NC-AKI from May 1st, 2020, to April 30th, 2021.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!