An audit of sputum smear microscopy, Gene Xpert and DST in a Tertiary care hospital in patients of suspected MDR/XDR-TB


  • Muhammad Wajahat Tariq
  • Muhammad Azam Mushtaq
  • Shahid Pervaiz
  • Tahir Khan
  • Humayoun Ghulam Murtaza
  • Sarmad Ali Naqvi


Tuberculosis, Diagnosis, Microbiological techniques


Objective: To audit the results of sputum smear microscopy & gene expert and DST in NMU, Hospital Multan.Patients and Methods: The gene expert MTB-Rif assay is available in the department of Pulmonology NMU Hospital Multan from November 2011, It is working in collaboration with National TB control program (NTP). As per NTP guidelines, it is advisable to high risk groups only & not as a primary diagnostic tool. These high risk groups include retreatment cases, treatment after default, treatment failure & even in new cases who are high risk e.g DM, HIV, Long standing use of steroids, those having malignant disease, health care providers & contacts of MDR-XTR TB patients. Since November 2011 about 13000 tests have been performed, sputum smear microscopy have already being performed for years & is being continued in the presence of gene expert as well. In selected cases, where gene expert MTB is detected & Rif resistance is also present and the patient are either non affording these cases are funded by NTP for culture and DST. It is considered worthwhile to simply audit the results of sputum smear microscopy, gene expert & DST and share this data of our PMDT clinic.RESULTS: A total of 12924 gene experts were performed. MTB were detected in 5100, Rif resistance were detected in 789, sputum smear was positive in 4502 & negative in 8422 cases. The gene expert showed error in 478 cases out of them 200 were re-checked which showed expert positive in 98 cases & Rif resistance in 12 cases.CONCLUSION: The gene expert MTB Rif-asaay is an effective & revolutionary tool to diagnose the MDR TB patients and it minimizes the time to start MDR treatment. Our unit is being benefited very effectively from this game-changer and that’s why we wanted to share our data & perspective.






Original Article