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| Year:
2026 |
Month:
January
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Volume:
15 |
Issue:
1 |
Page:
MO08 - MO11 |
A Comparative Study of Smear Microscopy with GeneXpert MTB/RIF Assay for Rapid Detection of Mycobacterium tuberculosis and Rifampicin Resistance in a Tertiary Care Hospital: A Cross-sectional Study
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Correspondence
Anamika Vyas, Shefali Malavav, Megha Gupta,
Dr. Megha Gupta,
Department of Microbiology, Geetanjali Medical College and Hospital, Udaipur-313003, Rajasthan, India.
E-mail: megsgrt@gmail.com :
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Introduction: Tuberculosis (TB), primarily caused by Mycobacterium tuberculosis, remains a major global health threat, further intensified by the emergence of drug-resistant strains. Rapid molecular diagnostic tools such as the GeneXpert MTB/RIF assay have significantly improved early detection of TB and identification of rifampicin resistance, offering faster and more accurate results than conventional methods.
Aim: To compare smear microscopy with the GeneXpert MTB/RIF assay for the rapid detection of Mycobacterium tuberculosis and simultaneous detection of rifampicin resistance.
Materials and Methods: A cross-sectional study was conducted over one year (September 2022 to September 2023) at Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India. A total of 314 clinical specimens (233 pulmonary and 81 extrapulmonary) were tested using both Ziehl–Neelsen (ZN) staining and the GeneXpert MTB/RIF assay. Specimens were processed according to standard protocols for both diagnostic methods. Demographic details such as age and gender were recorded. Statistical analysis was performed using the Chi-square test, with a p-value <0.001 was considered statistically significant.
Results: Among the 314 samples, males constituted the majority (204; 65%), and the most affected age group was 51-70 years (133; 42.36%). Using GeneXpert, 87 (27.7%) samples tested positive for M. tuberculosis, whereas smear microscopy detected only 60 (19.1%). Among pulmonary samples (n=233), GeneXpert detected MTB in 81 (35%) cases, while smear microscopy detected 58 (25%). Among extrapulmonary samples (n=81), GeneXpert detected MTB in 6 (7%) cases, whereas smear microscopy detected only 1 (1%). Of the total samples, 59 (19%) were positive by both methods, 28 (9%) were positive only by GeneXpert, and 1 (0.3%) sample was positive only by smear. GeneXpert demonstrated a 6% higher diagnostic yield for extrapulmonary TB compared with smear microscopy. Rifampicin resistance was identified in 10 (11%) of the 87 GeneXpert-positive samples, indicating the presence of potential multidrug-resistant TB.
Conclusion: The GeneXpert MTB/RIF assay is more sensitive than smear microscopy for detecting MTB in both pulmonary and extrapulmonary samples. It enables rapid diagnosis and simultaneous detection of rifampicin resistance, which is essential for the timely initiation of appropriate therapy.
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