Evaluation of Xpert MTB/XDR Test for Drug Susceptibility in Multidrug-Resistant Tuberculosis Patients in Peshawar.

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    • Subject Terms:
      PAKISTAN
    • Abstract:
      Background: Drug-resistant tuberculosis (DR-TB) is difficult to treat, and its timely diagnosis is an important factor in successful treatment outcomes. Modern technology has made it possible to diagnose DR-TB more quickly than before when it took a long time to identify the presence of resistance Mycobacterium. Objective: To evaluate the efficacy of the Xpert MTB/XDR to test the susceptibility of MTB towards anti-TB drugs by using sputum samples from infected people. Methodology: A cross-sectional study was conducted at the Programmatic Management of Drug-Resistant TB Unit (PMDT), Lady Reading Hospital, Peshawar, from March 2021 to March 2023. This study included samples from patients identified as rifampicin-resistant patients. The Xpert® MTB/XDR test's diagnosis accuracy was compared to that of the MGIT960, the reference drug susceptibility testing (DST) techniques, and the Hain Genotype® MTBDR plus and MDRsl assays (LPA). Results: The present study included 180 patients. These patients were divided into three groups for study purposes based on technique used, i.e., Pre-LPA or DST, Post-LPA, and Ten color Xpert MTB/XDR, and followed up for their culture conversion. Gene-Xpert MTB/RIF showed 93% of cases were positive, and on DST all cases showed positive results. For drug resistance in DST, LPA, and Gene-Xpert MTB/XDR, 61.1% of patients were resistant to three first-line drugs, and 11.1% were resistant to the second line. The overall median time from the identification of patients suspected of MDR-TB to the initiation of treatment in DST was 93 days. In LPA it was 25 and 5 days by Ten color Gene Xpert MTB/XDR. Conclusion: This study concludes that based on the timely initiation of treatment and culture conversion reports, DST and LPA are less efficient than the Ten-color Gene Xpert MTB/XDR assay. [ABSTRACT FROM AUTHOR]
    • Abstract:
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