Contribución del uso de XPERT MTB/RIF y su costo-efectividad en el diagnóstico de tuberculosis pulmonar y la resistencia a rifampicina: una comparación con métodos diagnósticos no moleculares

Claudia Cadavid, Teresa Realpe, Gloria I. Mejía, Elsa Zapata, Mauricio Hernández, Jaime Robledo

    Producción científica: Contribución a una revistaArtículo en revista científica indexadarevisión exhaustiva

    Resumen

    Introduction: Tuberculosis is a public health problem its control requires early diagnosis and timely treatment. Xpert MTB/RIF is a real-time PCR based diagnostic technology, detects the Mycobacterium tuberculosis complex and rifampicin resistance. Objective: To determine the contribution of Xpert MTB/RIF and its cost-effectiveness in the detection of potential positive cases for tuberculosis and resistance to rifampicin in respiratory samples comparatively with diagnostic non molecular methods Materials and Methods: From 2013 to 2015, 1.574 clinical samples of patients with suspected pulmonary tuberculosis were evaluated by smear microscopy using auramina-rodamina stain, Xpert and culture in liquid medium BACTEC MGIT 960®. Results: 19,2% of the samples were positive for any of the methods used, Xpert detected M. tuberculosis in 90,4% of the positive samples and the concordancebetween Xpert and cultures had a Kappa index of 0,71 (IC95%: 0,62-0,72). Xpert identified resistance to rifampicin in 8,1% of the clinical samples studied with a sensitivity 94.1% (IC95%: 73,0-99,0%), specificity 98,4% (IC95%: 95,5-99,5%) and Kappa index 0,88 (IC95%: 0,76-1,00). Xpert had an incremental cost effectiveness ratio lower than culture (RICE). Conclusion: Xpert MTB/Rif is efficient diagnostic technique and comparable with culture in cost effectiveness for pulmonary tuberculosis diagnosis. However, culture based methods, in contrast to Xpert, may allow the isolation and identification of non tuberculosis mycobacterial species and the possibility to perform susceptibility for other antituberculous drugs.

    Título traducido de la contribuciónContribution of the use of xpert MTB/RIF and its cost-effectiveness in the diagnosis of pulmonary tuberculosis and resistance to rifampicin: A comparison with non molecular diagnostic methods
    Idioma originalEspañol
    Páginas (desde-hasta)121-127
    Número de páginas7
    PublicaciónInfectio
    Volumen26
    N.º2
    DOI
    EstadoPublicada - 2022

    Nota bibliográfica

    Publisher Copyright:
    © 2022 Asociacion Colombiana de Infectologia. All rights reserved.

    Palabras clave

    • Cost-Benefit Analysis
    • Diagnosis
    • Mycobacterium tuberculosis
    • Pulmonary tuberculosis
    • Xpert MTB/RIF
    • culture for mycobacteria

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    • Artículos de investigación con calidad Q4

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