CONCORDANCE OF MYCOBACTERIUM TUBERCULOSIS DETECTION GENEXPERT MTB/RIF AND GENEXPERT MTB/RIF ULTRA

Indonesia experienced a high tuberculosis (TB) burden in 2020, with 845,000 new cases and 116,400 deaths due to the disease. Laboratory diagnostic modalities, including culture and acid-fast bacilli (AFB) testing, have several limitations. The GeneXpert MTB/RIF with Real-Time Polymerase Chain Reaction (RT-PCR) method is recommended by the World Health Organization (WHO) to address the limitations of AFB microscopy and culture. The detection limit (LoD) of 116       Colony Form Unit (CFU)/mL has a sensitivity that is not better than culture (10-100 CFU/mL). GeneXpert MTB/RIF Ultra comes with a LoD of 16 CFU/mL, with additional gene targets in addition to rpoB and multicopy sequences on IS6110 and IS1810 to overcome this limitation. This study aims to analyze the concordance of MTB detection Gene Xpert MTB/RIF and Ultra in diagnosing pulmonary TB and rifampicin resistance. Patients diagnosed with TB at Dr. Soetomo General Hospital and Community Health Centr in September 2022-January 2023 with clinical symptoms and positive AFB and or RT-PCR TB examination. Sensitivity and positive predictive value (PPV) tests were conducted using Medcalc software, and the concordance test employed the Kappa value. 72 subjects, 62.5% male. The Kappa coefficient of GeneXpert MTB/RIF and Ultra for MTB detection was one, and rifampicin resistance was 0.9. The sensitivity and PPV of Ultra were 97.6% and 70.7%. There was strong agreement between GeneXpert MTB/RIF and Ultra for the detection of MTB and rifampicin resistance. The sensitivity value of Ultra was 97.6% and the PPV was 70.7%.