GENEXPERT ® TECHNOLOGY A BREAKTHROUGH FOR DIAGNOSIS OF TUBERCULOUS PERICARDITIS AND PLEURITIS IN LESS THAN TWO HOURS

Abstract

ABSTRACT:
BACKGROUND: Diagnosis of Tubercles Pericarditis and Pleuritis remains the greatest challenge for clinicians. WHO has recommended GeneXpert MTB/RIF assay as a screening test for substitution of conventional methods for the initial diagnosis and prognosis of the extra pulmonary and pulmonary tuberculosis in developing countries. OBJECTIVE: To find out the diagnostic validity of GeneXpert assay for detection of Myco-bacterium tuberculosis in the pericardial and pleural effusion samples, keeping MTB culture as “Gold Standard”. MATERIAL AND METHODS: The total number of 286 samples of effusions (pericardial 128, pleural 158) were received, and processed for Zn smear microscopy, LJ culture, GeneXpert MTB/RIF assay according to standard protocols. Efficacy for the detection of MTB was evaluated comparatively. RESULTS: Out of 286 effusions samples AFB was detected by Zn smear in 11 (3.8%) samples while GeneXpert detected MTB in 43 (15.0%) and LJ culture 51 (17.8%). Zn smear showed sensitivity 18.2% , specificity , 98.1% , Positive predictive value 81.8% , Negative predictive value 85.4 % , in comparison GeneXpert showed high sensitivity 84.3%, specificity 100%, with Positive predictive value 100% and Negative predictive value 96.7%. CONCLUSION: GeneXpert assay is an innovative tool in resource limited settings for prompt detection of MTB along with drug résistance. It is definitely an attractive point of care testing, with high sensitivity and specificity along with turnout time of two hours, which facilitates timely diagnoses and appropriate management of tuberculous Pleuritis and Pericarditis.