Comparative Diagnostic Accuracy of Xpert MTB/RIF and Geno Type Mtbdrplus Line Probe Assay for Tuberculous Pleural Effusion Diagnosis

Document Type

Conference Proceeding

Publication Date

5-2024

Publication Title

American Journal of Respiratory and Critical Care Medicine

Abstract

RATIONALE: Tuberculous pleural effusion (TPE) poses diagnostic challenges due to the paucibacillary nature of pleural fluid. New diagnostic tools are required for accurate and rapid TPE diagnosis. This study aimed to compare the diagnostic accuracy of Xpert MTB/RIF and Geno Type MTBDRplus in diagnosing TPE. METHODS: A prospective cross-sectional study was conducted at Aga Khan University Hospital, Karachi, Pakistan. Patients exhibiting suspected TPE, based on history, exudative lymphocytic nature of effusion, and raised adenosine deaminase levels, were recruited over a two year duration. Pleural fluid samples underwent testing for AFB smear, culture, Xpert MTB/RIF, and MTBDRplus. RESULTS: Ninety-nine patients (mean age: 50.4 ± 20.3 years) were enrolled. AFB culture was positive in 14 cases (14.14%). Using AFB culture as the gold standard, the sensitivity of Xpert MTB/RIF was 57.14% (95% CI: 28.86-82.34%) with a specificity of 97.65% (95% CI: 91.76-99.71%). The sensitivity of MTBDRplus was 35.71% (95% CI: 12.76- 64.86%) with a specificity of 98.82% (95% CI: 93.62-99.90%). Xpert MTB/RIF demonstrated significantly higher sensitivity for TPE compared to MTBDRplus (p = 0.013), while specificity was similar between the two tests. CONCLUSIONS: Xpert MTB/RIF exhibited greater sensitivity in detecting TPE compared to MTBDRplus and AFB smear microscopy. These findings suggest that Xpert MTB/RIF holds promise as a valuable tool for early TPE diagnosis. However, further evaluation through a multicenter, large-sample study is warranted to validate its efficacy for early TPE diagnosis. Future research should explore specific aspects such as the cost-effectiveness and clinical outcomes associated with implementing Xpert MTB/RIF as a primary diagnostic tool for TPE.

Volume

209

Issue

Suppl

First Page

A4878

Comments

International Conference of the American Thoracic Society, May 17-22, 2024, San Diego, CA

DOI

10.1164/ajrccm-conference.2024.209.1_MeetingAbstracts.A4878

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