PT  - JOURNAL ARTICLE
AU  - Farah Idrees
AU  - Muhammad Irfan
AU  - Kauser Jabeen
AU  - Rumina Hasan
TI  - Genotype MTBDR &lt;em&gt;plus&lt;/em&gt; Line Probe Assay as a rapid tool for the diagnosis of smear-negative tuberculosis in bronchoalveolar lavage fluid in Pakistan
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P2693
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P2693.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P2693.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - Background: The Genotype Line probe assay (MTBDR Plus) has been validated in sputum for rapid diagnosis of tuberculosis (TB) and isoniazid and rifampicin resistance. Its utility in bronchoalveolar lavage (BAL) especially in smear negative cases is unclear.Objective:To evaluate the accuracy of the MTBDR Plus in BAL in sputum scarce/smear negative patients.Methods:Cross sectional study (Jan-Dec 2013) at Aga Khan University, Karachi Pakistan. Suspected pulmonary TB patients who underwent bronchoscopy were selected. Specimens on which both culture and MTBDR Plus was performed were analyzed. Sensitivity and specificity of MTBDR Plus with culture as reference method was determined.Results:Of the 154 patients, 34 had culture-confirmed TB. MTBDR Plus was positive in 20/34 patients [Sensitivity 59% (95% CI: 41% to 75%) &amp;amp; Specificity 95% (95%CI: 89% to 98%)].A significantly lower proportion was detected by smear compared with MTBDR Plus (29.4% versus 59%; p&amp;lt;0.001). All smear positive (Sm+) /culture positive (CS+) cases were MTBDR Plus positive. The sensitivity and specificity of MTBDR Plus in Sm+/CS+ cases was 100 % and 100% and in Sm-/CS+ cases was 42% and 95% respectively. 114 of 120 culture negative patients were also MTBDR Plus negative. Two cases of MDR TB were identified by MTBDR Plus.Conclusion:MTBDR Plus detected TB cases more accurately and rapidly in BAL than smear with early detection of MDR TB. The use of MTBDR Plus in BAL for TB diagnosis will lead to early and appropriate treatment of such cases in our setting.