Examining Diagnostic Efficacy: GeneXpert Versus Traditional Staining Techniques With Culture in the Diagnosis of Tuberculosis

Introduction The tuberculosis (TB) diagnosis involves various methods, such as microscopic examination, culture-based methods, molecular techniques, chest X-rays, serological tests, and interferon-gamma release assays. These methods help identify and confirm TB and its resistance to rifampicin, balancing speed and accuracy for prompt treatment initiation and effective disease management. Aims and objectives To assess the diagnostic accuracy of GeneXpert, Ziehl-Neelsen staining, and fluorescence staining compared to culture media in TB-suspected patients. Materials and methods We analysed 416 patient samples for TB over one year using GeneXpert, Ziehl-Neelsen staining, fluorescence staining, and Löwenstein-Jensen (LJ) medium. Only samples with a suspicion of TB were included in the study. The samples received without clinical history and requests for all four tests were excluded. Results A total of 416 patient samples were categorised into pulmonary and extrapulmonary samples. GeneXpert detected 62 positive cases for TB, out of which 53 were rifampicin-sensitive, seven were rifampicin-indeterminate, and two were rifampicin-resistant. The indeterminate samples were further evaluated using the line probe assay (LPA), of which six were rifampicin-sensitive, and one was rifampicin-resistant. Fluorescent staining detected 44 cases, Ziehl-Neelsen staining detected 40 cases, and LJ culture medium detected 65 cases. Conclusion GeneXpert is superior to staining methods for detecting TB. GeneXpert, combined with microscopy and culture, can enhance TB and multi-drug resistant tuberculosis (MDR-TB) detection and aid in early treatment initiation.