Andini Bilindade, Wiwit Probowati, Widaninggar Rahma Putri

Perbandingan Hasil Pemeriksaan Tuberkulosis Metode GeneXpert dan Ziehl-Neelsen di Rumah Sakit X Yogyakarta

Introduction

Perbandingan hasil pemeriksaan tuberkulosis metode genexpert dan ziehl-neelsen di rumah sakit x yogyakarta. Bandingkan GeneXpert & Ziehl-Neelsen untuk deteksi TB paru di RS X Yogyakarta. Studi ini mengungkap GeneXpert lebih sensitif dalam mengidentifikasi kasus tuberkulosis dari sputum.

Abstract

Tuberculosis is an infectious disease caused by the bacterium Mycobacterium tuberculosis. The tuberculosis (TB) detection methods used are the GeneXpert method and the Ziehl-Neelsen method. GeneXpert identifies the rpoB hotspot gene bacteria in Mycobacterium tuberculosis by analyzing deoxyribonucleic acid (DNA), while the TB detection method with Ziehl-Neelsen staining is a microscopic examination used to detect acid-fast bacilli (AFB), namely Mycobacterium tuberculosis bacteria. The purpose of this study was to determine the sensitivity, specificity and positive predictive value of the nucleic acid amplification test (GeneXpert) using sputum samples in patients with suspected pulmonary tuberculosis and compare it with microscopic examination (Ziehl-Neelsen staining) of Acid-Fast Bacilli (AFB). The method used is simple random sampling which explains the comparison between the variables of the GeneXpert and Ziehl-Neelsen examination results in pulmonary tuberculosis patients using a cross-sectional approach, namely where data is obtained from the pulmonary TB population at Hospital X Yogyakarta from 2021-2024 according to the variables studied. Based on the TCM results which are greater than the BTA results, these results indicate a significant difference between the GeneXpert method and the Ziehl-Neelsen method in terms of examination results. The results obtained from the examination using the TCM/GeneXpert and Ziehl-Neelsen methods show a higher detection rate of GeneXpert than Ziehl-Neelsen in identifying TB cases.

Review

This study presents a timely and important comparison of two fundamental methods for tuberculosis (TB) diagnosis: the rapid molecular GeneXpert assay and the traditional Ziehl-Neelsen microscopy. Given the global burden of TB and the continuous need for accurate and efficient diagnostic tools, evaluating the performance of these methods in a real-world clinical setting like Hospital X Yogyakarta is highly relevant. The stated objective to determine the sensitivity, specificity, and positive predictive value of GeneXpert against Ziehl-Neelsen, particularly using sputum samples from suspected pulmonary TB patients, directly addresses a critical gap in understanding their comparative utility for improving patient management and public health outcomes. The methodology employs a sound cross-sectional approach with simple random sampling, drawing data from a three-year period (2021-2024). This design is appropriate for comparing the diagnostic performance of the two methods within a defined patient population. The abstract clearly outlines the technical basis of each method, highlighting GeneXpert's DNA-based detection of the *rpoB* gene versus Ziehl-Neelsen's microscopic identification of acid-fast bacilli. The preliminary results strongly indicate a significant difference between the two methods, with GeneXpert demonstrating a higher detection rate for TB cases. While this finding is compelling, the abstract would greatly benefit from the inclusion of the specific calculated sensitivity, specificity, and positive predictive values to quantitatively substantiate these claims and allow for a more detailed assessment of GeneXpert's diagnostic superiority. The finding that GeneXpert offers a higher detection rate than Ziehl-Neelsen has considerable implications for clinical practice, particularly in improving diagnostic accuracy and potentially reducing diagnostic delays in resource-limited settings. A higher detection rate means more patients can be accurately diagnosed and initiated on treatment sooner, which is crucial for both individual patient outcomes and controlling disease transmission. For the full paper, a detailed discussion on the operational aspects, including turnaround time, cost-effectiveness, and the need for specific infrastructure or training associated with GeneXpert, would provide valuable context for implementation strategies. Furthermore, exploring the clinical impact of this improved detection on patient management decisions and treatment outcomes would significantly enhance the study's overall contribution.

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