Efficacy study of Real-time PCR and standard method for Mycobacterium tuberculosis and its multi drug-resistance diagnosis at Nakhonpathom Hospital
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Keywords:
Tuberculosis, multi drug-resistant tuberculosis, real-time PCR, standard method, Rifampicin drug (RIF), Isoniazid drug (INH)Abstract
Tuberculosis (TB) is one of the causes of death in the world and is a major problem in Thailand. Culture is a standard method for diagnosis of tuberculosis and multi drug-resistant tuberculosis (MDR-TB) but still have limitations. Currently, the molecular technique is high sensitivity and specificity which is a more popular method for testing. Therefore, the purpose of this study was to evaluate the effectiveness of tuberculosis and multi drug-resistant tuberculosis diagnosis using real-time PCR method compared to the standard method. Sputum specimens from 151 patients evaluating the effectiveness of tuberculosis diagnosis and first line anti-tuberculosis drug resistance such as Rifampicin (RIF) and Isoniazid (INH) testing compared with culture method and drug susceptibility testing. A sensitivity of tuberculosis diagnosis, RIF resistance, and INH resistance using real-time PCR method compared to culture method was 97.26, 100 and 100 respectively. The result of tuberculosis diagnosis, RIF resistance and INH resistance with a specificity was 94.87, 100 and 95.24 respectively. A positive predictive value was 94.67, 100 and 72.73 and a negative predictive value of 97.37, 100 and 100 respectively. The inconsistent results from two methods for the diagnosis of tuberculosis and drug resistance INH found 6 and 3 samples, respectively. This study suggests that the real-time PCR technique is a method that provides accurate, reliable and fast for tuberculosis and its drug-resistant diagnosis for the benefit of diagnosis in patients with TB.
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