GeneXpert MTB/RIF For The Rapid Diagnosis And Rifampin Resistance Detection Of Tracheobronchial Tuberculosis

Objective: Delayed diagnosis and treatment of tuberculosis contribute to poor outcomes,especially for tracheobronchial tuberculosis(TBTB),which typically leads to tracheobronchial stenosis.Finding rapid and accurate diagnostic tools for TBTB is crucial.The Gene Xpert MTB/RIF was recommended by the World Health Organization(WHO)as a standard molecular-biological diagnostic technique for Mycobacterium tuberculosis(MTB).The aim of this study was to evaluate the efficacy of the Gene Xpert MTB/RIF for the diagnosis of TBTB and for the evaluation of resistance to rifampin(RIF).Methods: Bronchial brushings from TBTB patients were prospectively assessed with the Gene Xpert MTB/RIF.The diagnostic yields of auramine O-stained sputum smears and bronchial brush smears were obtained,and the results were compared with the cultures of sputum for MTB.Results: In 55 confirmed cases of TBTB,the sensitivities of sputum smear,bronchial brush smear,sputum culture,and tissue culture to diagnose TBTB were 12.7%,32.7%,34.5% and 60.1%,respectively.For bronchial brushings,our data showed sensitivities of54.5%,and a specificity of 100% for the Gene Xpert MTB/RIF,and these results were superior to those of sputum smears,bronchial brush smears,and sputum culture.The Gene Xpert MTB/RIF for bronchial brushings showed complementarity in its diagnostic performance.Resistance to RIF was identified in 20%(6/30)of Gene Xpert MTB-positive cases.Conclusions:The Gene Xpert MTB/RIF may enable more rapid TBTB diagnosis and determination of RIF resistance,which are crucial for timely treatment.