Evaluación diagnostica del desempeño de la prueba XPERT MTBD/RIF® para la detección de Tuberculosis pulmonar y extra pulmonar en pacientes del Hospital Sergio Bernales entre 2019 y 2021
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Date
2024
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Universidad Nacional de Trujillo
Abstract
En nuestro pais, la Tuberculosis se diagnostica a traves de un algoritmo con el cual se ha abordado a la enfermedad desde hace decadas y cuyas caracteristicas han permitido tomar accion oportuna con resultados aceptables, sin embargo recientemente se ha incorporado la prueba Xpert MTB/RIF®,, que es una prueba molecular, buscando mejorar la oportunidad diagnostica, principalmente en centros de atencion primaria, en este contexto el presente estudio busca evaluar el desempeño de esta prueba en comparacion con las pruebas que actualmente se tienen a disposicion. Se analizaron los registros de 857 muestras pulmonares y extrapulmonares de pacientes con TB durante en el periodo de 2019 a 2021, se analizaron indices tales como prueba de concordancia interensayo, sensibilidad y especificidad analiticaas, valores predictivos positivo y negativo, asi como razon de verosimilitud positivia y negativa frente al gold estándar que es el cultivo en medio solido. Esta prueba demostro tener un desempeño estadisticamente significativo independientemente del tipo de muestra analizada, confiriendole al actual algoritmo diagnostico mayor prontitud de resultados, reduciendo el tiempo de abordaje de pacientes multidrogoresistentes, complementando y mejorando el actual algoritmo diagnostico.
In Peru, the diagnosis of tuberculosis is based on an algorithm with which the disease has been addressed for decades and whose resuscitation has allowed timely action with acceptable results. however, the Xpert MTB/RIF® molecular test has recently been incorporated, seeking to improve the diagnostic opportunity mainly in primary care centers, in this context the present study seeks to evaluate the performance of this test compared to the tests The records of 857 pulmonary and extrapulmonary samples of patients with TB were analyzed during the period 2019 to 2021, indices such as interassay concordance test, sensitivity and analytical specificity, positive and negative predictive values, as well as a positive and negative likelihood ratio of this test against the gold standard that is the culture in solid medium. This test showed a statistically significant performance regardless of the type of sample analyzed, giving the current diagnostic algorithm greater promptness of results, reducing the time of approach of multidrug resistant patients, complementing and improving the current diagnostic algorithm
In Peru, the diagnosis of tuberculosis is based on an algorithm with which the disease has been addressed for decades and whose resuscitation has allowed timely action with acceptable results. however, the Xpert MTB/RIF® molecular test has recently been incorporated, seeking to improve the diagnostic opportunity mainly in primary care centers, in this context the present study seeks to evaluate the performance of this test compared to the tests The records of 857 pulmonary and extrapulmonary samples of patients with TB were analyzed during the period 2019 to 2021, indices such as interassay concordance test, sensitivity and analytical specificity, positive and negative predictive values, as well as a positive and negative likelihood ratio of this test against the gold standard that is the culture in solid medium. This test showed a statistically significant performance regardless of the type of sample analyzed, giving the current diagnostic algorithm greater promptness of results, reducing the time of approach of multidrug resistant patients, complementing and improving the current diagnostic algorithm
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Keywords
Xpert MTB/RIF, Concordancia interensayo, Valor predictivo, Razon de verosimilitud