1. Home
  2. Vol 2, No 1 (2018)
  3. Susilawati

Evaluasi MetodeGeneXpert MTB/RIF dengan SampelRaw Sputum untuk Mendeteksi Tuberkulosis Paru

Tri Nugraha Susilawati, Leli Saptawati, Kusmadewi Eka Damayanti, Riska Larasati

Abstract


Tuberkulosis (TB) merupakan penyakit menular yang masih menjadi masalah utama di Indonesia dan dunia. Tantangan utama dalam mendiagnosis TB secara konvensional yaitu rendahnya sensitivitas deteksi pada pemeriksaan mikroskopis dan lamanya waktu yang diperlukan untuk kultur. Penelitian ini bertujuan untuk mengevaluasi metode GeneXpert MTB/RIF untuk mendeteksi Mycobacterium tuberculosis dengan sampel dahak langsung di RSUD Dr. Moewardi (RSDM), Surakarta. Analisis observasional dengan pendekatan kohort retrospektif menggunakan data sekunder hasil pemeriksaan GeneXpert MTB/RIF pada sampel dahak langsung di Laboratorium Mikrobiologi Klinik RSDM pada tahun 2012-2015. Sampel didapatkan dari pasien yang memenuhi kriteria suspek multidrug-resistant tuberculosis (MDR-TB) dan sampel tersebut telah dikultur di Balai Laboratorium Kesehatan (BLK), Jawa Tengah. Data dianalisis dengan OpenEpi versi 3, Epi Info 7, dan MedCalc. Pada penelitian ini didapatkan sensitivitas, spesifisitas, nilai duga positif dan negatif (NDP dan NDN) serta akurasi metode GeneXpert MTB/RIF sebesar 93,62%, 27,17%, 68,89%, 71,21%, dan 69,21%. Prevalensi TB paru pada sampel yang diperiksa sebesar 63,27%. Rendahnya spesifisitas GeneXpert MTB/RIF mengindikasikan perlunya kultur sebagai baku emas. Namun demikian, perlu standarisasi pemrosesan sampel dahak dalam segi teknik dan waktu pengambilan sampel disertai data klinis yang memadai untuk melihat riwayat terapi yang telah diberikan pada pasien.

Keywords


tuberkulosis; GeneXpert MTB/RIF; dahak langsung; kultur

Full Text:

PDF

References


Yruela I, Contreras-Moreira B, Magalhães C, Osório NS, Gonzalo-Asensio J. Mycobacterium tuberculosis complex exhibits lineage-specific variations affecting protein ductility and epitope recognition. Genome Biol Evol. 2017;8(12): 3751-3764.

Goldman E, and Green LH. Practical handbook of microbiology. 2nd ed. Boca Raton: CRC Press; 2009.

Piatek AS, Van Cleeff M, Alexander H, Coggin WL, Rehr M, Van Kampen S, et al. GeneXpert for TB diagnosis: planned and purposeful implementation. Glob Health Sci and Pract. 2013;1(1):18-23.

Dharan NJ, Amisano D, Mboowa G, Ssengooba W, Blakemore R, Kubiak RW, et al. Improving the sensitivity of the Xpert MTB/RIF assay on sputum pellets by decreasing the amount of added sample reagent: A laboratory and clinical evaluation. J Clin Microbiol. 2015;53(4):1258-1263.

Agrawal M, Bajaj A, Bhatia V, Dutt S. Comparative study of GeneXpert with ZN stain and culture in samples of suspected pulmonary tuberculosis. J Clin Diagnostic Res. 2016;10(5): 09-12.

Guenaoui K, Harir N, Ouardi A, Zeggai S, Sellam F, Bekri F, et al. Use of GeneXpert Mycobacterium tuberculosis/rifampicin for rapid detection of rifampicin resistant Mycobacterium tuberculosis strains of clinically suspected multi-drug resistance tuberculosis cases. Ann Transl Med. 2016;4(9):168.

World Health Organization (WHO). Global Tuberculosis Report 2016. Geneva. 2016.

Helb D, Jones M, Story E, Boehme C, Wallace E, Ho K, et al. Rapid detection of Mycobacterium tuberculosis and rifampin resistance by use of on-demand, near-patient technology. J Clin Microbiol. 2010;48(1):229-237.

Lawn SD dan Nicol MP. Xpert ® MTB/RIF assay: development, evaluation and implementation of a new rapid molecular diagnostic for tuberculosis and rifampicin resistance. Future Microbiol. 2011;6(9):1067-1082.

Nikam C, Kazi M, Nair C, Jaggannath M, Manoj MM, Vinaya R V., et al. Evaluation of the Indian TrueNAT micro RT-PCR device with GeneXpert for case detection of pulmonary tuberculosis. Int J Mycobacteriol. 2014;3(3):205-210.

Cepheid®. Xpert® MTB/RIF package insert ref GXMTB/RIF-US-10. 2015;(Feb):1-48. Available from: URL:http://www.cepheid.com/manageddownloads/xpert-mtb-rif-english-package-insert-301-1404-rev-b-february-2015.pdf.

Zeka AN, Tasbakan S, Cavusoglu C. Evaluation of the GeneXpert MTB/RIF assay for rapid diagnosis of tuberculosis and detection of rifampin resistance in pulmonary and extrapulmonary specimens. J Clin Microbiol. 2011;49(12):4138-4141.

Ghariani A, Jaouadi T, Smaoui S, Mehiri E, Marouane C, Kammoun S, et al. Diagnosis of lymph node tuberculosis using the GeneXpert MTB/RIF in Tunisia. Int J Mycobacteriol. 2015;4(4):270-275.

Steingart KR, Schiller I, Horne DJ, Pai M, Boehme CC, Dendukuri N. Xpert® MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults. Cochrane Database Syst Rev. 2014;1(1): 1-166.

Pandey S, Congdon J, McInnes B, Pop A, Coulter C. Evaluation of the GeneXpert MTB / RIF assay on extrapulmonary and respiratory samples other than sputum : a low burden country experience. Pathology. 2017;49(1):70-74.

Marlowe EM, Novak-Weekley SM, Cumpio J, Sharp SE, Momeny MA, Babst A, et al. Evaluation of the cepheid xpert MTB/RIF assay for direct detection of mycobacterium tuberculosis complex in respiratory specimens. J Clin Microbiol. 2011;49(4):1621-1623.

Schrader C, Schielke A, Ellerbroek L, Johne R. PCR inhibitors - occurrence, properties and removal. J Appl Microbiol. 2012;113(5):1014-1026.

Neyrolles O, Quintana-murci L. Sexual Inequality in Tuberculosis. PLoS Med. 2009;6(12): e1000199.




DOI: http://dx.doi.org/10.7454/epidkes.v2i1.2074

Refbacks

  • There are currently no refbacks.