Abstract
PURPOSE: Mycobacterium tuberculosis (MTB) infection poses a significant global health challenge, with conventional diagnostic methods like acid-fast smear and culture techniques exhibiting limitations in sensitivity and efficiency. This retrospective study examined 4098 clinical samples from China-Japan Friendship Hospital between March 2018 and March 2019, focusing on the diagnostic performance of GeneXpert MTB/RIF across different specimen types. METHODS: The study encompassed various sample types, including bronchoalveolar lavage fluid (BALF), sputum, lung tissues, hydrothorax, and others. All samples were performed via acid-fast-straining, GeneXpert MTB/RIF and culture. RESULTS: GeneXpert MTB/RIF demonstrated superior sensitivity (81.46%) and specificity (98.98%) in respiratory specimens compared to tissues (62.50%) and hydrothorax (46.15%). Notably, in acid-fast-straining-negative samples, GeneXpert MTB/RIF showed sensitivity and specificity of 73.43% and 98.8%, respectively, and reduced false negatives of acid-fast staining. Furthermore, the study explored Cycler Threshold (CT) values, revealing associations with bacterial load and sample types. CONCLUSION: The findings highlight the importance of considering sample types in MTB diagnosis and underscore the potential of GeneXpert MTB/RIF as a valuable diagnostic tool, especially in respiratory specimens, contributing to improved tuberculosis management strategies. Additionally, the study recommended direct GeneXpert MTB/RIF testing of hydrothorax samples instead of acid-fast staining, further enhancing diagnostic accuracy and efficiency.