• Ann Transl Med · Mar 2020

    GeneXpert® MTB/RIF assay with transbronchial lung cryobiopsy for Mycobacterium tuberculosis diagnosis.

    • Olivia Sánchez-Cabral, Cira Santillán-Díaz, Ángel Paul Flores-Bello, Mildred Ivannia Herrera-Ortega, José Luis Sandoval-Gutiérrez, Patricio Santillán-Doherty, and Dina Martínez-Mendoza.
    • Interventional Pulmonology Unit, National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, Mexico.
    • Ann Transl Med. 2020 Mar 1; 8 (6): 351.

    BackgroundEarly tuberculosis (TB) diagnostic is one of the critical steps to TB control. GeneXpert MTB/RIF has been widely proven for a prompt TB diagnosis. The use of GeneXpert MTB/RIF assay with transbronchial lung cryobiopsy samples may increase diagnostic accuracy. We aim to assess the diagnostic of TB with GeneXpert MTB/RIF assay with transbronchial lung cryobiopsy.MethodsPatients with suspected diagnosis of TB and negative smear microscopies, with TB culture and GeneXpert MTB/RIF assay with transbronchial lung cryobiopsy were included in this cross-sectional study. Participants were enrolled from 2016 to 2018 at National Institute of Respiratory Diseases, Mexico.ResultsWe included 54 patients (77.8% males) aged 30 to 65 years. The sensitivity of the GeneXpert MTB/RIF assay with transbronchial lung cryobiopsy was 81.3% (95% CI, 62.1-100%), with a specificity of 100% (95% CI, 100-100%) and a negative predictive value of 92.7% (95% CI, 84.7-100%). Twenty-two patients of the total population have HIV, the sensitivity of the test in these patients was 87.5% (95% CI, 64.6-100%). Also, 28 patients with a peripheral localized lesion which had a solid pattern were identified (51.9%). The sensitivity in patients with peripheral localized lesions was 88.9% (68.4-100%).ConclusionsThe GeneXpert MTB/RIF assay with transbronchial lung cryobiopsy test is as efficient as broncho alveolar lavage for TB diagnosis. Transbronchial lung cryobiopsy increases a major diagnostic opportunity when the nature of illness is malignant. Transbronchial lung cryobiopsy is efficient in HIV patients, especially in patients with peripheral localized lesion.2020 Annals of Translational Medicine. All rights reserved.

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