The predictive value of Xpert MTB/RIF detection in bronchoalveolar lavage fluid for the release of isolation from airborne infection in patients with suspected pulmonary tuberculosis
LU Qiong
WANG Wanru
DONG Zhen
Abstract：Objective To evaluate the predictive efficacy of the Xpert Mycobacterium tuberculosis/rifampicin test(Xpert MTB/RIF)for bronchoalveolar lavage fluid(BALF)in discontinuation airborne infection isolation(AII)for hospitalized patients with suspected pulmonary tuberculosis(PTB).Methods A total of 184 AII patients admitted to Tuberculosis Provincial Tuberculosis Prevention and Control Hospital(the Fifth People's Hospital of Shaanxi Province)for suspected PTB from November 2022 to January 2024 were prospectively included.At the time of AII cessation(based on receipt of discharge notification),patients were divided into PTB group(n=35)and non PTB group(n=149)according to the positive or negative Mycobacterium tuberculosis(MTB)culture results of the last BALF sample.The results of sputum smear microscopy of acid fast bacteria(AFB),MTB culture of BALF samples,and real-time fluorescence quantitative nucleic acid amplification(Xpert MTB/RIF)detection for rifampicin resistance were collected.Accuracy in predicting AII cessation=non-PTB patients/patients with BALFXpert MTB/RIF negative test×100(%).Results With MTB culture as the gold standard,the specificity and positive predictive value of 3 consecutive AFB smear of sputum samples and Xpert MTB/RIF of BALF samples were 100%.The sensitivity of Xpert MTB/RIF detection in BALF samples(77.14%vs.71.43%)and negative predictive value(94.90%vs.93.71)were slightly higher than 3 consecutive AFB smears of sputum samples,respectively.Compared with three consecutive sputum smear tests,BALF Xpert MTB/RIF significantly shortened the test time(24 h vs.59 h,P=0.000).Among all the patients,a total of 8(4.35%)patients had hypoxemia events,12(6.52%)patients had fever after bronchoscopy,but no patients had postoperative pneumonia.Conclusion A negative BALF Xpert MTB/RIF test can be used as a reliable basis for the safe release of AII in suspected PTB patients,significantly shortening the isolation time.
Keywords：bronchoalveolar lavage fluidXpert MTB/RIFsuspected pulmonary tuberculosisairborne infection isolation
Publication Date：2025-08-30
Online Publishing Date：2025-08-28(First online date of this platform, not the publication date of the document)
Pages：5( 358-362 )