Comparación de la prueba molecular GeneXpert MTB/RIF ultra en la detección de Mycobacterium tuberculosis frente al Cultivo y Baciloscopía en pacientes con sospecha de tuberculosis, atendidos en el Hospital Regional Docente de Trujillo durante octubre 2021- abril 2022
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Date
2025
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Universidad Nacional de Trujillo
Abstract
La presente investigación tuvo como objetivo realizar una Comparación de la prueba molecular GeneXpert MTB/RIF ultra en la detección de Mycobacterium tuberculosis frente al Cultivo y Baciloscopía en pacientes con sospecha de tuberculosis, atendidos en el Hospital Regional Docente de Trujillo, durante octubre 2021- abril 2022. La investigación fue retrospectiva, descriptiva y de corte transversal llegando a encontrar un total de 270 muestras procesadas por los 3 métodos GeneXpert MTB/RIF ultra, Cultivo y Baciloscopía en simultáneo. Los datos fueron obtenidos de los registros físicos y virtuales del programa de control de la tuberculosis del mismo hospital. Se encontró que el mayor porcentaje de muestras que ingresan son pulmonares con 81 % y un 19 % extrapulmonares. El porcentaje de mayor positividad a M. tuberculosis fue obtenido por el método GeneXpert MTB/RIF ultra con 20 % a diferencia del Cultivo y Baciloscopía con 9 % y 6 % respectivamente. GeneXpert presentó una mayor sensibilidad con 83.3% mientras que la Baciloscopía solo un 33.3 %; en cuanto a la especificidad la Baciloscopía alcanzó el más alto valor con 93.7 %. El estadístico Chi cuadrado, nos confirmó que entre los métodos: GeneXpert- Baciloscopía y GeneXpert-Cultivo hay diferencia significativa entre los resultados, es decir el método influye en la detección de M. tuberculosis, a diferencia de lo obtenido entre el método Baciloscopía-Cultivo donde no existe esta diferencia. El índice Kappa de Cohen nos arroja que existe una concordancia baja entre los métodos: GeneXpert- Baciloscopía (K 0.33) y Cultivo-Baciloscopía (K 0.36), a diferencia de lo encontrado entre los métodos GeneXpert-Cultivo que reporta una concordancia Moderada (K 0.45). En base a nuestro estudio concluimos que GeneXpert debería ser el método de primera elección para todos los pacientes con sospecha de TBC sin excepción, favoreciendo un diagnóstico rápido y oportuno, acortando así los tiempos de espera en la obtención de resultados, en especial en pacientes con tuberculosis extrapulmonar, considerada una patología de alto riesgo.
The objective of this investigation was to make a comparison of the GeneXpert MTB/RIF ultra-molecular test in the detection of Mycobacterium tuberculosis versus Culture and Bacilloscopy in patients with suspected tuberculosis, treated at the Trujillo Regional Teaching Hospital, during October 2021 - April 2022. The research was retrospective, descriptive and cross-sectional, finding a total of 270 samples processed by the 3 methods GeneXpert MTB/RIF ultra, Culture and Bacilloscopy simultaneously. The data was obtained from the physical and virtual records of the tuberculosis control program of the same hospital. It was found that the highest percentage of samples entering are pulmonary with 81% and extrapulmonary 19%. The highest percentage of positivity to M. tuberculosis was obtained by the GeneXpert MTB/RIF ultra-method with 20% as opposed to Culture and Bacilloscopy with 9% and 6% respectively. GeneXpert showed a higher sensitivity with 83.3% while Bacilloscopy only 33.3 %; in terms of specificity, Bacilloscopy reached the highest value with 93.7 %. The Chi square statistic confirmed that there is a significant difference between the results of the GeneXpert-Bacilloscopy and GeneXpert-Culture methods, that is, each method influences the detection of M. tuberculosis, unlike what is obtained with the Bacilloscopy-culture method where this difference does not exist. Cohen's Kappa index shows that there is a low agreement between the GeneXpert-Bacilloscopy (K 0.33) and Culture-Bacilloscopy (K 0.36) methods, unlike what is found between the GeneXpert-Culture methods which reports a Moderate agreement (K 0.45). Based on our study, we conclude that GeneXpert should be the method of first choice for all patients with suspected TB without exception, facilitating a rapid and timely diagnosis, thus shortening the waiting time for results, especially in patients with extrapulmonary tuberculosis, considered a high-risk pathology.
The objective of this investigation was to make a comparison of the GeneXpert MTB/RIF ultra-molecular test in the detection of Mycobacterium tuberculosis versus Culture and Bacilloscopy in patients with suspected tuberculosis, treated at the Trujillo Regional Teaching Hospital, during October 2021 - April 2022. The research was retrospective, descriptive and cross-sectional, finding a total of 270 samples processed by the 3 methods GeneXpert MTB/RIF ultra, Culture and Bacilloscopy simultaneously. The data was obtained from the physical and virtual records of the tuberculosis control program of the same hospital. It was found that the highest percentage of samples entering are pulmonary with 81% and extrapulmonary 19%. The highest percentage of positivity to M. tuberculosis was obtained by the GeneXpert MTB/RIF ultra-method with 20% as opposed to Culture and Bacilloscopy with 9% and 6% respectively. GeneXpert showed a higher sensitivity with 83.3% while Bacilloscopy only 33.3 %; in terms of specificity, Bacilloscopy reached the highest value with 93.7 %. The Chi square statistic confirmed that there is a significant difference between the results of the GeneXpert-Bacilloscopy and GeneXpert-Culture methods, that is, each method influences the detection of M. tuberculosis, unlike what is obtained with the Bacilloscopy-culture method where this difference does not exist. Cohen's Kappa index shows that there is a low agreement between the GeneXpert-Bacilloscopy (K 0.33) and Culture-Bacilloscopy (K 0.36) methods, unlike what is found between the GeneXpert-Culture methods which reports a Moderate agreement (K 0.45). Based on our study, we conclude that GeneXpert should be the method of first choice for all patients with suspected TB without exception, facilitating a rapid and timely diagnosis, thus shortening the waiting time for results, especially in patients with extrapulmonary tuberculosis, considered a high-risk pathology.
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GeneXpert, Cultivo, Baciloscopía, Sensibilidad, Especificidad, índice Kappa