Validation and implementation of GeneXpert MTB/RIF for diagnosis of Tuberculosis in Ecuador

• Main Authors: José Marcelo Ortíz-Jimenes, Greta Franco-Sotomayor, Martha Ramos-Ramirez
• Format: Article in Journal/Newspaper
• Language: English; Spanish
• Published: Universidad del Zulia,Facultad de Medicina,Departamento de Enfermedades Infecciosas y Tropicales 2019
• Subjects: estudios de validación; esputo; sensibilidad; especificidad; rifampicina; mycobacterium tuberculosis; Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic; Guayaquil; Rif
• Online Access: https://doaj.org/article/7c44808e755840919a5049fefbc13dbb

The objective of the study was the validation and implementation of GeneXpert MTB/RIF for routine use in the rapid detection of tuberculosis and sensitivity to rifampicin in clinical samples; for this, 1592 respiratory samples were collected and analyzed in the laboratory of Instituto Nacional de Investigación en Salud Pública Guayaquil. The analysis of the results of GeneXpert in comparison with smear microscopy showed an initial sensitivity of 99.8% and specificity of 93.2%; The analysis of discrepancies using the results of the culture as a reference method showed that the GeneXpert results considered false negatives turned out to be true negatives, the same happens with the false positives that correspond to true positives. Recalculated the sensitivity and specificity of the GeneXpert was 99.8% and 100% correspondingly. The comparison with the drugs susceptibility test showed a sensitivity of 91.4% and a specificity of 95.5% for the GeneXpert MTB/RIF system. It is concluded that the implementation of the GeneXpert system allows solution to certain problems associated with the application of conventional diagnostic methodologies, decreasing the waiting times, and increasing the sensitivity and specificity in the diagnosis of drug-resistant tuberculosis, thus generating a valuable opportunity for early diagnosis.