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Initial experience with GeneXpert MTB/RIF assay in the Arkansas Tuberculosis Control Program.

Naveen Patil1, Hamida Saba2, Asween Marco3

  • 1Arkansas Department of Health ; University of Arkansas for Medical Sciences.

The Australasian Medical Journal
|June 20, 2014
PubMed
Summary

The GeneXpert MTB/RIF assay rapidly diagnoses tuberculosis (TB) and detects Rifampin resistance, improving upon traditional methods. This new assay significantly reduces diagnosis time, aiding in quicker patient isolation and treatment initiation.

Keywords:
AFBGeneXpert MTB/RIF assayTuberculosis

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Area of Science:

  • Medical Diagnostics
  • Infectious Disease Control
  • Molecular Biology

Background:

  • Tuberculosis (TB) remains a major global health threat, with diagnosis often challenging.
  • The GeneXpert MTB/RIF assay offers a novel solution for rapid TB diagnosis and Rifampin (RIF) resistance detection.
  • Arkansas Tuberculosis Control Program adopted GeneXpert MTB/RIF to enhance diagnostic capabilities.

Purpose of the Study:

  • To implement and evaluate the GeneXpert MTB/RIF assay in the Arkansas Tuberculosis Control Program.
  • To assess the assay's performance in rapid diagnosis and RIF resistance detection.
  • To analyze factors influencing smear-negative, culture-positive TB cases and illustrate GeneXpert's impact.

Main Methods:

  • GeneXpert MTB/RIF assay was performed on sputum samples from June 2012 to June 2013.
  • Traditional Mycobacterium tuberculosis culture and susceptibility testing (MGIT 960, LJ slants) were used for comparison.
  • Surveillance data (Jan 2009-June 2013) analyzed for smear-negative, culture-positive cases.

Main Results:

  • GeneXpert MTB/RIF identified all culture-positive TB cases, including three missed by culture.
  • The assay detected all six smear-negative, culture-positive TB cases.
  • Case reports demonstrated GeneXpert's role in reducing time to diagnosis.

Conclusions:

  • GeneXpert MTB/RIF assay enables rapid TB diagnosis, significantly shortening the time to diagnosis.
  • The assay aids in timely isolation of TB suspects and efficient ruling out of the disease.
  • Implementation in Arkansas demonstrated the assay's value in improving TB control efforts.