Abstract :
Introduction: Extrapulmonary Tuberculosis is infection of mycobacterium tuberculosis involving organ
other than lung. It account for 15-20% of all TB cases. Various combined approach used for diagnosis
of Extrapulmonary TB. GeneXpert MTB/RIF System is cartridge based nucleic acid amplification test to
detect tuberculosis and rifampicin resistance in two hours.
Materials and Methods: This hospital based prospective study was carried out for period of 6 months
with objective:-1) To evaluate the efficacy of GeneXpert MTB/RIF for the diagnosis of extrapulmonary
tuberculosis (EPTB) by comparing it with composite reference standard which include smear microscopy,
clinical findings at time of presentation and three months follow up and radiological investigations.2) To
look for Rifampicin Resistance by GeneXpert.
Results: Out of total of 168 enrolled patients 135 patients met the criteria of composite reference standard
(CRS). Among total 135 CRS ve EPTB Cases, 23 were paediatric (below 12 years of age) and 112 were
Adults. Smear Microscopy was positive in 18 patients while GeneXpert gave positive results in 38 patients
(8 paediatric and 30 adult patients). Rifampicin resistance was detected in 4 patients. Pleural effusion is the
most commonly obtained sample followed by CSF, lymphnode, ascitic, urine, other fluid.
Conclusions: Sensitivity of GeneXpert is more as compared to smear microscopy. GeneXpert showed
better sensitivity in CSF, tissue, lymphnode, pleural and urine. So early microbiological diagnosis and
Rifampicin drug sensitivity in Extrapulmonary sample lead to early treatment initiation of Tuberculosis and
decrease morbidity and mortality due to tuberculosis. RNTCP has also recommended use of GeneXpert in
suspected TB in Extrapulmonary sites.
Keyword :
GeneXpert, Extrapulmonary Tuberculosis, Smear Microscopy, Sensitivity.