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      저자 : Fahad M. Al-Onazi (검색결과 1 건)
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        GeneXpert MTB/RIF Testing in the Management of Patients with Active Tuberculosis; A Real Life Experience from Saudi Arabia

        Ali S. Omrani,Mohammed F. Al-Otaibi,Souad M. Al-Ateah,Fahad M. Al-Onazi,Kamran Baig,Noura A. El-Khizzi,Ali M. Albarrak 대한감염학회 2014 Infection and Chemotherapy Vol.46 No.1

        Background: GeneXpert MTB/RIF is a real-time PCR assay with established diagnostic performance in pulmonary and extra-pulmonaryforms of tuberculosis. The aim of this study was to assess the contribution of GeneXpert MTB/RIF assay to the management ofpatients with any form of active tuberculosis in a single large tertiary center in Saudi Arabia, with a special focus on the impact ontime to start of antituberculous therapy compared with Ziehl-Neelsen (ZN) smears and mycobacterial cultures. Materials and Methods: Clinical, radiological and laboratory records for all patients who were commenced on antituberculous therapybetween March 2011 and February 2013 were retrospectively reviewed. Results: A total of 140 patients were included, 38.6% of which had pulmonary tuberculosis. GeneXpert MTB/RIF was requested for only39.2% of patients and was the only reason for starting antituberculous therapy for only 12.1%. The median time to a positive GeneXpertMTB/RIF result was 0 days (IQR 3) compared with 0 day (IQR 1) for smear microscopy (P > 0.999) and 22 days (IQR 21) for mycobacterialcultures (P < 0.001). No patients discontinued antituberculous therapy because of a negative GeneXpert MTB/RIF result. Conclusions: In a setting wherein physicians are highly experienced in the diagnosis and treatment of tuberculosis, GeneXpertMTB/RIF was remarkably under-utilized and had only a limited impact on decisions related to starting or stopping antituberculoustherapy. Cost-effectiveness and clinical utility of routine testing of all smear-negative clinical samples submitted for tuberculosisinvestigations by GeneXpert MTB/RIF warrant further study.

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