Abstract:

Objective To evaluate the application role of Xpert MTB/RIF in tuberculosis（TB）diagnosis in high altitude localities. Methods The clinical specimens of 1 759 cases of clinically suspected TB were collected from June 2016 to October 2018 in Tibet Autonomous Region People's Hospital. All the specimens were determined for Mycobacterium tuberculosis（MTB） by smear acid-fast staining（both fluorescence staining and modified Ziehl-Neelsen staining） microscopy and Xpert MTB/RIF. The positive rates of the 2 methods were compared. Results Of the 1 759 suspected cases,100（5.7%） cases were positive for smear acid-fast staining microscopy,and 254（14.4%） cases were positive for Xpert MTB/RIF. The positive rate of Xpert MTB/RIF was higher（χ²=628.24,P<0.05）. Rifampicin resistance was determined by Xpert MTB/RIF in 37（2.1%） specimens. For 100 smear-positive specimens and 1 659 smear-negative specimens,Xpert MTB/RIF got positive results of 100 specimens and 154 specimens,respectively. The age group of 18-24 years old had the highest positive rates of the 2 methods and the highest rate of rifampicin resistance,followed by the age group of <18 years old. There was no statistical significance in the positive rate of the 2 methods and rifampicin resistance between males and females. Conclusions Xpert MTB/RIF is a useful assay for the rapid diagnosis of tuberculosis in high altitude localities,considering that the results can be given in the same day of sample collection,and it is superior in sensitivity than microscopy.

Key words: Tuberculosis, Xpert MTB/RIF, Rifampicin resistance, Early diagnosis, High altitude locality