The predictive factors for positive molecular-genetic assay in patients with pulmonary tuberculosis from chisinau city

Abstract

Background: One of the most important tuberculosis control action is the early detection, especially of multidrug-resistant tuberculosis. Cultural methods remain the golden standard for pulmonary tuberculosis diagnosis. The microscopic identification of acid-fast-bacilli in sputum is still a worldwide used method for TB detection. The low sensibility of conventional microscopic methods endangers the actual epidemiological situation. Starting with 2012, the genetic-molecular technology – Xpert MTB/RIF Assay - was implemented in the Republic of Moldova. The assessment of initial experience of Xpert MTB/RIF Assay is compulsory for improving the early case detection. The aim of the study is the assessment of extrinsic factors predictable in positive Xpert MTB/RIF patients. Material and methods: A retrospective, selective, descriptive and case-control study was performed. There were enrolled 361 new pulmonary tuberculosis patients, diagnosed and hospitalized in the Muncipal Clinical Hospital of Phthysiopneumology of Chisinau in the period of 01.01.2014 - 01.01.2015. The patients were disributed into 2 groups: I - 174 patients with positive Xpert MTB/RIF Assay result; II - 187 patients with negative Xpert MTB/RIF Assay result. Investigations were performed according to the National Clinical Protocol – 123 Tuberculosis in adults. results: The male gender was predominating above the female gender in both groups: 67,8% vs 32,2% in the 1st group and 55,6% vs 44,4% in the 2nd group. According to the economical status, disadvantaged patients were predominating in the 1st group (71,3%), as compared with the 2nd group (50.8%), with the degree of concludence, p<0,001. The hystory of household TB contact was predominating in the 1st group – 17,2% vs 9,1% in the 2nd group, (p<0.05). Conclusions: The implementation of Xpert MTB/RIF Assay improves the early TB detection and the prompt initiation of an adequate treatment regimen, according to the susceptibility testing results.