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Indian J Med Microbiol. 2018 Oct-Dec;36(4):590-593. doi: 10.4103/ijmm.IJMM_19_10.

Improved case detection using Xpert Mycobacterium tuberculosis/rifampicin assay in skeletal tuberculosis.

Author information

1
Department of Microbiology, Seth G. S. Medical College and KEM Hospital, Mumbai, Maharashtra, India.

Abstract

Background:

In India, musculoskeletal tuberculosis (TB) accounts for 10%-25% of extrapulmonary TB. Data on drug-resistant skeletal TB are lacking. At present, the diagnosis is based mainly on radiological techniques. Laboratory confirmation of skeletal TB is delayed as 6-8 weeks are required for culture results. Xpert Mycobacterium tuberculosis/rifampicin (MTB/RIF) assay is a fully automated test which simultaneously detects MTB and RIF resistance within 3 h. Hence, this study was done to compare the yield of case detection using Xpert assay in comparison with culture in specimens received from clinically suspected skeletal TB cases.

Methods:

Retrospective analysis of microscopy, culture and Xpert assay results was carried out on specimens received in laboratory from skeletal TB cases from January 2016 to December 2017.

Results:

Of the 201 patients analysed, majority of the specimens were obtained from the spine (55.72%). MTB was detected in 48.68% of tissue and 24% of pus specimens. Xpert assay was detected MTB in 67 (33.33%) specimens of which 53 (47.32%) were from the spine. Culture was detected MTB in 66 (32.83%) specimens. Xpert assay was detected two specimens more than culture. One specimen was positive by only culture. RIF-resistant MTB was detected in 10 (14.92%) specimens by Xpert assay.

Conclusion:

The spine is the most common site involved. Tissue specimen is better for early diagnosis. High RIF resistance in skeletal TB is an alarming situation. Ability of Xpert MTB/RIF assay for rapid and simultaneous detection of MTB and RIF resistance in comparison with culture makes it a useful diagnostic tool in skeletal TB.

KEYWORDS:

Skeletal tuberculosis; Xpert Mycobacterium tuberculosis/rifampicin assay; culture

PMID:
30880713
DOI:
10.4103/ijmm.IJMM_19_10

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