Abstract：
OBJECTIVE: GeneXpert Mycobacterium tuberculosis/rifampicin (MTB/RIF) is a conceptually helpful tool for establishing tuberculosis (TB) disease. Negative results from the GeneXpert test do not exclude the possibility of diagnosing non-tuberculous mycobacteria lung disease (NTMLD) as a chronic pulmonary disease. When a patient is diagnosed on a clinical basis, and there is no bacteriological evidence of TB, it is necessary to consider NTM as one of the causes of disease with TB-like symptoms. The prevalence of non-tuberculous mycobacteria (NTM) disease is rising globally, but its diagnosis is still delayed and often misdiagnosed as multidrug-resistant TB (MDR-TB). This study highlights the implication of negative GeneXpert MTB/RIF results in suspected TB patients who conducted mycobacteria culture and detected the incidence of NTMLD.
METHODS: In this experimental study, the performance of GeneXpert MTB/RIF-negative results with those of mycobacteria cultures and lung abnormalities among suspected TB patients in a referral hospital in Indonesia were evaluated. From January to August 2022, 100 sputum samples from suspected chronic pulmonary TB patients with GeneXpert MTB/RIF assay-negative results were cultured in Lowenstein-Jensen medium, and the implication among negative GeneXpert result MTB/RIF assay.
RESULTS: 7% were confirmed to have MTB and 1% had NTM by culture assay. Moreover, 34% were diagnosed with clinical TB and treated with anti-TB drugs.
CONCLUSIONS: For patients with negative assay results of GeneXpert MTB/RIF regarding clinically suspected chronic TB infection, further diagnostic tests to determine the causative agents of the lung abnormalities should be carried out.
METHODS: In this experimental study, the performance of GeneXpert MTB/RIF-negative results with those of mycobacteria cultures and lung abnormalities among suspected TB patients in a referral hospital in Indonesia were evaluated. From January to August 2022, 100 sputum samples from suspected chronic pulmonary TB patients with GeneXpert MTB/RIF assay-negative results were cultured in Lowenstein-Jensen medium, and the implication among negative GeneXpert result MTB/RIF assay.
RESULTS: 7% were confirmed to have MTB and 1% had NTM by culture assay. Moreover, 34% were diagnosed with clinical TB and treated with anti-TB drugs.
CONCLUSIONS: For patients with negative assay results of GeneXpert MTB/RIF regarding clinically suspected chronic TB infection, further diagnostic tests to determine the causative agents of the lung abnormalities should be carried out.
摘要：
目的：GeneXpert结核分枝杆菌/利福平（MTB/RIF）在概念上是建立结核病（TB）疾病的有用工具。GeneXpert试验的阴性结果不排除将非结核性分枝杆菌肺病（NTMLD）诊断为慢性肺病的可能性。当患者在临床基础上被诊断时，没有结核病的细菌学证据，有必要将NTM视为具有TB样症状的疾病的原因之一。非结核分枝杆菌(NTM)病的患病率在全球范围内呈上升趋势,但它的诊断仍然延迟，并且经常被误诊为耐多药结核病（MDR-TB）。这项研究强调了GeneXpertMTB/RIF阴性结果在进行分枝杆菌培养并检测NTMLD发生率的可疑结核病患者中的意义。
方法：在本实验研究中，在印度尼西亚一家转诊医院的疑似TB患者中,评估了GeneXpertMTB/RIF阴性结果与分枝杆菌培养和肺部异常结果的表现.从2022年1月至8月，在Lowenstein-Jensen培养基中培养了100例GeneXpertMTB/RIF检测阴性的疑似慢性肺结核患者的痰液样本，以及阴性GeneXpert结果MTB/RIF测定之间的意义。
结果:通过培养测定证实7%具有MTB,1%具有NTM。此外，34%被诊断为临床结核病，并接受抗结核药物治疗。
结论：对于临床疑似慢性结核感染的GeneXpertMTB/RIF检测结果阴性的患者，应进行进一步的诊断测试，以确定肺部异常的病原体。
方法：在本实验研究中，在印度尼西亚一家转诊医院的疑似TB患者中,评估了GeneXpertMTB/RIF阴性结果与分枝杆菌培养和肺部异常结果的表现.从2022年1月至8月，在Lowenstein-Jensen培养基中培养了100例GeneXpertMTB/RIF检测阴性的疑似慢性肺结核患者的痰液样本，以及阴性GeneXpert结果MTB/RIF测定之间的意义。
结果:通过培养测定证实7%具有MTB,1%具有NTM。此外，34%被诊断为临床结核病，并接受抗结核药物治疗。
结论：对于临床疑似慢性结核感染的GeneXpertMTB/RIF检测结果阴性的患者，应进行进一步的诊断测试，以确定肺部异常的病原体。
