Experience and Efficiency of Laboratory Diagnosis of Tuberculosis with PCR Detector System GeneXpert in Belgorod Region

Abstract

Purpose of the study. To assess the effectiveness of, and to develop an optimal model for the laboratory diagnosis of tuberculosis using automated PCR detector system GeneXpert. Materials and methods. The efficiency of a technique to identify the causative agent of tuberculosis in an automated PCR analyzer GeneXpert compared to routine bacteriological methods is analyzed as well as the survey coverage rates of patients and the proportion of TB cases diagnosed in GeneXpert. Results. In the Belgorod region an effective organizational model to identify TB, including MDR, in an automatic PCR analyzer GeneXpert occurred. Coverage of the survey of newly diagnosed patients with pulmonary tuberculosis and relapse exceeded 70%; using GeneXpert revealed more than half of all cases of tuberculosis of smear. Term identify Mycobacterium tuberculosis in GeneXpert averaged 2.3 days from the start of examination of the patient. The efficiency of detection of tuberculosis pathogen is slightly lower than in culture, and is 50.4% of newly diagnosed patients with pulmonary tuberculosis and 69.0% have relapses. The sensitivity and specificity of the pathogen resistance to rifampicin in the sputum of patients with newly diagnosed pulmonary tuberculosis in GeneXpert compared to routine bacteriological methods reach 90-95%. Summary and Conclusions. The introduction of TB services Belgorod region the technique to identify the causative agent of tuberculosis and to determine its susceptibility to rifampicin using automated PCR analyzer the GeneXpert, the development of an optimal model of appliance use allowed in a short time, up to 4 days, with high specificity to provide an etiological diagnosis most epidemiologically dangerous new cases of pulmonary tuberculosis and relapse among patients in the area.