Abstract

Nadeem Sharif*, Gull-e-Rana Khan, Mahmood Ahmad, Muhammad Ahmad Nawaz Ghouri, Abid Ali, Mirza Zaheer Ud Din Babar Baig and Maham Nasrullah

ABSTRACT

Background and aim of study: Tuberculosis is deadliest communicable disease which infects populations globally and it is most common cause of pleural effusions. The aim of the study is to find diagnostic utility of Gene Xpert among suspected tuberculous pleural effusion patients. Materials: This study was conducted from January, 2019 to October, 2019 in Tertiary Care Hospital of Lahore, Pakistan. 200 pleural fluid specimens were processed for AFB smear microscopy (ZN and Auramine stain), AFB cultures (LJ and MGIT), Xprt MTB/RIF assay and Drug Susceptibility Testing. Results: Among 200 pleural effusion patients, 3(1.5%) were positive on AFB smear microscopy, 61(30.5%) were positive on AFB cultures and 17(8.5%) were positive on Gene Xpert. Sensitivity of Gene Xpert and AFB smear was 5% and 20% respectively against AFB culture. /200 were positive on liquid culture while /200 were positive on solid culture. Contamination rate of liquid culture was more as compared to solid culture. DST was performed on culture positive specimens which was compared with Gene Xpert rifampicin resistance results. Conclusion: Due to pucibacilary nature of pleural effusion specimens, conventional methods like AFB smear and culture have low sensitivity. Gene Xpert can be useful for MDR tuberculosis cases for early, accurate diagnosis and it guide for proper treatment. Both conventional and rapid diagnostic modalities should be performed for best isolation of Mycobacterium tuberculosis.