الفهرس 
Pulmonary TuberculosisOnly 14 pages are availabe for public view
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Abstract
TB is an infectious disease caused by the bacillus Mycobacterium tuberculosis. It can affect lung causing pulmonary TB or other organs causing extrapulmonary TB. It can be concidered as a major cause of morbidity and mortality worldwide. TB is the ninth leading cause of death worldwide and the leading cause from a single infectious agent, ranking above HIV/AIDS.
Prevention of TB involves early detection and treatment of cases, so delay in diagnosis increases the risk of transmission and development of MDR-TB.
A definitive diagnosis of TB is made by identifying M. tuberculosis in a clinical sample, which can take four to eight weeks which consider a long time to initiate antituberculous drugs.
The most important advance in TB diagnosis is the introduction of GeneXpert MTB/RIF, which identifies MTB and rifampicin resistance from samples in about only 2 hours.
Aim of this work is to assess GeneXpert in diagnosis of Tuberculosis and Rifampicin resistance in comparing to conventional methods (direct smear and culture on Lowenstein Jensen medium) in patients coming to Zagazig chest hospital.
The present study was conducted upon 100 Patients, who presented at our Zagazig chest hospital with manifestations that highly suggest pulmonary TB.
In this study, 80% of the patients were males and 20% were females. The mean of age was 43.3 years. It was noticed that the special habits of patients in this study were smoking and drug addiction. .
In this study, the most frequently clinical findings were productive cough more than 2 weeks, constitional symptoms as fever, weight loss and appetite loss.
According to culture onLJ media patients were classified to 2 groups:
-patients have TB infection.
-patients haven’t TB infection.
In the current study there was no statistical significant difference between the studied 2 groups regarding Sex, age, special habits, clinical findings or x- ray picture. In this study, there are no statistical significant differences between 2 groups in laboratory findings of comorbidities except that patients have TB infection, have lower values of hemoglobin and RBCs.
In this study, positivity of ZN stain was 55%. And also, sensitivity and specificity of ZN stain were 78.8% and 91.2% respectively.
In this study, positivity of GeneXpert was about 66% and sensitivity and specificity of GeneXpert in diagnosis of tuberculosis were 95.5% and 91.2% respictivily.
In this study, among 66 positive cases detected by culture, about 80% of cases were sensitive to all 4 drugs (isoniazid, rifampicin, streptomycin, and ethambutol), about 13.8% of cases were resistant to all 4 drugs and about 6.15% of cases were resistant to isoniazid and rifampicin were detected by DST.
In this study about 92% of resistant cases were males and about 8% of cases were females. In this study, acquired resistance was 84.6% and primary resistance was 15.4%.
In this study sensitivity and specificity of Xpert MTB/RIF in detection of rifampicin resistance were 92.3% and 100% respectively.