标准化治疗方案治疗MDR-TB 26例近期疗效分析

目的评价全球基金结核病项目标准化耐多药肺结核治疗方案对耐多药肺结核(MDR-TB)的疗效。方法观察26例MDR-TB采用标准化耐多药肺结核治疗方案后1个月、6月、12月的痰菌计数、病灶吸收、体重指数变化。结果在治疗后6个月,痰菌计数、病灶吸收、体重指数均较前改善,统计有差异性(P<0.05)。结论全球基金结核病项目标准化耐多药肺结核治疗方案对MDR-TB的近期疗效好,值得进一步临床观察及病例积累。

血清sIL-2R水平对MDR-TB的临床意义及IL-2治疗的研究

目的探讨血清 sIL-2R 水平对耐多药肺结核(MDR-TB)的临床意义及免疫增强剂的疗效。方法将130例耐多药肺结核患者随机分为2组,均以力克肺疾为基础并与临床上尚可供配伍的抗痨药物3种以上组成联合治疗方案,总疗程为18个月。Ⅰ组患者在抗痨基础上最初6个月加用白细胞介素-Ⅱ(IL-2)。观察2组病例的血清白细胞介素-Ⅱ受体水平下降情况、痰菌阴转率、空洞好转率和远期复发率。结果疗程结束时,Ⅰ组和Ⅱ组痰菌阴转率分别为87.5%、72.7%,2组比较 P<0.05。空洞缩小或闭合率分别为70.7%、44.4%(P<0.05)。治疗6个月时血清白细胞介素-Ⅱ受体Ⅰ组与Ⅱ组分别为321±38.4U/ml 和382±61.5U/ml(P<0.01)。随访18个月痰菌复阳率Ⅰ组为11.1%,Ⅱ组为23.9%(P<0.05)。结论 MDR-TB 患者存在免疫功能低下,采用 IL-2长程间歇治疗,不良反应较轻,可明显提高疗效,降低远期复发率。

重庆市新结防模式下MDR-TB患者治疗现状及经济负担调查研究

本研究评估重庆市在新结防模式下MDR-TB患者的治疗现状及经济负担,为MDR-TB控制提供决策依据。研究表明患者接受正规治疗的比例较高,医保覆盖率也较高,但也还存在相关卫生服务可及性差、治疗副反应普遍、患者经济负担较重等问题。后续应加强重点人群和弱势人群MDR-TB的筛查,提升相关卫生服务的可及性,同时需要加强对患者的经济支持。

Pre-Extensively Drug Resistant Tuberculosis (Pre-XDR-TB) among Pulmonary Multidrug Resistant Tuberculosis (MDR-TB) Patients in Bangladesh

Background & Objectives: Emergence of drug resistant Tuberculosis (TB) is a major obstacle in the TB control programme of Bangladesh. This study was carried out to detect pre-extensively drug resistant TB (pre-XDR-TB) cases among the multidrug resistant TB (MDR-TB) patients in Bangladesh, as the early detection of pre-XDR-TB can guide clinicians in the appropriate modification of MDR-TB treatment regimen with effective drugs to prevent treatment failure. Methodology: A total of 68 MDR-TB cases were enrolled in this study. Multiplex Real-time PCR was done to detect pre-XDR-TB cases directly from sputum samples of MDR-TB patients. Results: Out of 68 MDR-TB cases 11 (16.18%) cases were detected as pre-XDR-TB. The resistant profile of the 11 pre-XDR-TB revealed 9 (81.82%) cases of fluoroquinolone (FLQ) resistant pre-XDR-TB and 2 (18.18%) cases of injectable second line (ISL) agent resistant pre-XDR-TB. Out of 11 pre-XDR-TB cases 7 (63.64%) cases had history of taking treatment for MDR-TB regularly, 1 (9.09%) case had history of taking treatment for MDR-TB irregularly and 3 (27.27%) cases had no history of taking treatment for MDR-TB. Conclusion: This study encountered a high rate of pre-XDR-TB cases along with a significant number of primarily resistant bacilli which is of concern in the management of MDR-TB. It is evident that Bangladesh is in urgent need to device strategies for rapid and early detection of pre-XDR-TB in order to prevent treatment failure of MDR-TB cases and also to halt the progression of MDR-TB cases to extensively drug resistant TB (XDR-TB), which is not only difficult but also very expensive to treat.

Smear-Negative Multidrug-Resistant Tuberculosis a Significance Hidden Problem for MDR-TB Control: An Analysis of Real World Data

Purpose: The drug resistance pattern in tuberculosis (TB) is still under investigated. We analyzed the clinical data from the patients with smear positive TB and applied the model to predict the patients with smear-positive TB. Materials and Methods: Medical records information of 6977 cases was included from 11,950 inpatients from January 2009 to November 2013. The cases data were divided into a training set, test set and prediction set. Logistic regression analysis was applied to the training set data to establish a prediction classification model, the effect of which was then evaluated using the test set by receiver operating characteristic (ROC) analysis. The model was then applied to the prediction set to identify incidence of snMDR-TB. Results: Sixteen factors which correlate with MDR-TB-including frequency of hospitalization, province of origin, anti-TB drugs, and complications, were identified from the comparison between SP-TB and spMDR-TB. The area under the ROC curve (AUC) of the prediction model was 0.752 (sensitivity = 61.3%, specificity = 83.3%). The percentage of all inpatients with snMDR-TB (snMDR-TB/Total) was 28.7% ± 0.02%, while that of all SN-PTB with snMDR-TB (snMDR-TB/SN-PTB) was 26.5% ± 0.03%. The ratio of snMDR-TB to MDR-TB (snMDR-TB/MDR-TB) was 2.09 ± 0.33. Conclusion: snMDR-TB as an important source of MDR-TB is a significant hidden problem for MDR-TB control and can be identified by the prediction model. A kind of vicious circle with a certain delay effect exists between snMDR-TB and MDR-TB. To better control MDR-TB, it is necessary to pay greater attention to snMDR-TB, conduct further research and develop targeted therapeutic strategies.

肺结核患者的MDR-TB知识知晓率调查

目的了解肺结核患者的MDR-TB知识知晓率情况,为有针对性开展健康教育工作提供参考。方法对肺科门诊跟踪治疗管理的肺结核患者进行询问式问卷调查。结果共调查159例肺结核患者,小学及以下学历占67.2%,"什么是MDR-TB"的知晓率为55.9%,"慢性排菌者/初治失败者/复发患者/密切接触MDR-TB患者的涂阳肺结核患者应怀疑得了MDR-TB"的知晓率为13.8%,"产生MDR-TB的原因"的知晓率为26.4%,"如何治疗MDR-TB"的知晓率为15.1%,"MDR-TB能治好吗"的知晓率为30.2%,"如何预防MDR-TB"的知晓率为23.9%。结论肺结核患者的MDR-TB知识知晓率低,应加强MDR-TB的宣传教育。

Descriptive Epidemiology of Multidrug Resistance Tuberculosis (MDR-TB) in Bangladesh

Background: The number of reported MDR-TB cases has been increasing in recent years. Objectives: To describe the epidemiological profile of MDR-TB cases in Bangladesh. Design: This was a descriptive cross-sectional study. Settings: The study was conducted among the multi drug resistant tuberculosis patient admitted in the National Institute of Diseases of the Chest and Hospital (NIDCH) Dhaka, Bangladesh. Samples: 148 confirmed cases of MDR-TB. Materials and Methods: Hospital admitted MRD-TB cases were randomly chosen from the above mentioned hospital. Semi-structured and pretested questionnaire were introduced by researcher. Clinical and treatment data i.e. duration of TB drug intake, report of sputum, X-ray and blood test etc. were extracted from the hospital record. Results: Study found, majority of the participants (56.1%) were in the age group of 16 - 30 years. 64.2% of the study subjects were married. Majority of the participants education were whether under primary or primary level. 24.3% participant’s family member and 14.5% of neighbor were having TB. Most common comorbidity were diabetes, pulmonary infection, hearing loss, psychiatric symptoms, chest pain, joint pain etc. 63.5% respondent had high degree of AFB for sputum positivity and more than 98% had positive finding in X-ray chest. On an average ESR was low and also few cases of extremely low ESR were found. 71.6% were under twenty four months regimen. Conclusion: We can conclude that, many possible factors for MDR-TB. There is an urgent need for further study to confirm the exact factors in Bangladesh and address those immediately.

Combination of the MODS Assay with the Sensititre^TMMYCOTB Plate for Rapid Detection of MDR- and XDR-TB

We combined the new SensititreTM MYCOTB test with the MODS assay for detection of MDR- and XDR-TB. Categorical agreement of the MODS assay with the critical concentrations at 3 days of incubation was highest for INH (91.4%) and RIF (100%) and at 5 days 86.7% and 94.6% for the fluoroquinolones and aminoglycosides, respectively. By combining these two methods, it is possible to identify MDR-TB in as little as 3 days and XDR- or pre-XDR-TB within 5 days.

The Prediction Factors of Pre-XDR and XDR-TB among MDR-TB Patients in Northern Thailand

Background: Molecular diagnosis based on the detection of mutations conferring genetic drug resistance is useful for early diagnosis and treatment of Pre-XDR and XDR-TB patients. However, the study of mutation as a marker to predict Pre-XDR and XDR-TB is rare. Methods: Thirty-four Mycobacterium tuberculosis (MTB) isolates from MDR, Pre-XDR and XDR-TB patients in the upper north of Thailand, who had been identified for drug susceptibility using the indirect agar proportion method from 2005-2012, were examined for genetic site mutations of katG, inhA, and ahpC for isoniazid (INH) drug resistance, rpoB for rifampicin (RIF) drug resistance, gyrA for ofloxacin (OFX), and rrs for kanamycin (KAN). Associations between resistant genes and Pre-XDR and XDR-TB in the MDR patients were performed using exact probability tests. Univariable logistic regression was used to quantify the strength of association between the gene mutation with Mycobacterium tuberculosis and the prevalence of Pre-XDR and XDR-TB in the MDR patients. Results: The mutations in the region of the rpoB gene at codon 445 (C445T) in the Pre-XDR or XDR-TB patients were significantly 20.6 times more prevalent among the MDR-TB patients. The inhA gene mutation at codon 114 (T114G) was also significantly 8.1 times more prevalent. Conclusion: The findings can be used to predict the odds of Pre-XDR and XDR-TB in MDR-TB patients, as a guide for prevention and treatments.

血清胱抑素C在MDR-TB患者化疗中的临床应用

目的探讨血清胱抑素C(CysC)在耐多药结核(MDR-TB)患者化学治疗中的临床应用。方法对MDR-TB患者按照化疗时间不同分7组检测血清CysC,来判断患者化疗过程中氨基糖甙类注射剂及高尿酸血症对患者肾功能损伤情况,同时将7个组的血清肌酐(Scr)、尿素(Urea)、尿酸(UA)的浓度作为观察指标来测定。结果七组的血清CysC、Scr、UA的差异有显著性意义(P<0.05),血清Urea的差异无显著性意义(P>0.05),但与治疗前组相比血清CysC的浓度的变化较Scr的浓度变化出现早;在MDR-TB患者化疗过程中血清SCr、Urea无一例异常,血清UA在治疗不同时期大多数患者间或或者持续升高,血清CysC有两例在治疗2个月后出现异常,经调减注射剂剂量后恢复正常。结论血清CysC是监测MDR-TB患者化疗过程中早期肾功能损伤更敏感的指标。

Factors Associated with Mortality among Multidrug Resistant Tuberculosis MDR/RR-TB Patients in Democratic Republic of Congo

Background: Tuberculosis remains a very common infectious disease in Democratic Republic of Congo (DRC). The resistance to drugs worsens the prognosis and the outcome of patients affected tuberculosis and increase their mortality. Objective: To identify factors associated with death among Multidrugs resistant tuberculosis (MDR/RR TB) patients referred to the referential hospital, Centre d’Excellence Damien (CEDA). Materials and Methods: A retrospective cohort study of patients attending health care to the Center CEDA, a referral center for management of MDR/RR-TB in DR Congo. This study included all MDR/RR-TB patients referred from February 1st, 2015 to February 29th, 2017. A multivariate COX regression was performed to identify factors associated with mortality in the target population. Kaplan Meier method described the survival of patients and the comparison of curves was performed by the test of log Rank. Results: 199 patients were included in our study. Male gender was predominant with a sex ratio of 1.3. The mean age of patients was 35.8 ± 13.9 years. Among them, 18 (15.1%) were died. The major complications were Chronicles pulmonary Heart failure (p = 0.035), Chronic respiratory insufficiency (p = 0.004), depression (p = 0.044), undernutrition (p = 0.033), alcohol addiction (p = 0.006) and high smoking (p = 0.019). In multivariated analysis, factors associated to the death were alcohol addiction (HRa = 12.64, 95% CI 2.36 - 14.55, p = 0.003), asthenia (HRa = 4.75, 95% CI 1.56 - 14.50, p < 0.001), pulmonary consolidation (HRa = 10.01 95% CI 2.34 - 12.86, p = 0.02), some chest X-ray abnormalities such as signs of pulmonary fibrosis (HR = 4.7, 95% CI 2.78 - 28.94, p = 0.002) and the Chronic respiratory insufficiency (HRa = 3.77, 95% CI 1.37 - 10.43, p = 0.010). Conclusion: The present retrospective cohort study revealed that structural and functional pulmonary alteration emerged as the main factors associated with mortality among MDR/RR TB patients in Kinshasa. National Tuberculosis Programs should take into account those parameters while defining mortality reduction strategy.

Identifying Factors that Affect the Probability of Being Cured from MDR-TB Disease, KwaZulu-Natal, South Africa: A Competing Risks Analysis

Setting: Four decentralised sites are located in rural areas and one centralised hospital in KwaZulu-Natal province, South Africa. Objective: To analyse risk factors associated with multidrug-resistant tuberculosis (MDR-TB) using competing risks analysis. Understanding factors associated with MDR-TB and obtaining valid parameter estimates could help in designing control and intervention strategies to lower TB mortality. Method: A prospective study was performed using a competing risk analysis in patients receiving treatment for MDR-TB. The study focused on 1542 patients (aged 18 years and older) who were diagnosed of MDR-TB between July 2008 and June 2010. Time to cure MDR-TB was used as the dependent variable and time to death was the competing risk event. Results: The Fine-Gray regression model indicated that baseline weight was highly significant with sub-distribution hazard ration (SHR) = 1.02, 95% CI: 1.01 - 1.02. This means that weight gain in a month increased chances of curing MDR-TB by 2%. Results show that lower chances to cure MDR-TB were among patients between 41 to 50 years compared to those patients who were between 18 to 30 years old (SHR = 0.80, 95% CI: 0.61 - 1.06). The chances of curing MDR-TB in female patients were low compared to male patients (SHR = 0.84, 95% CI = 0.68 - 1.03), however this was not significant. Furthermore, HIV negative patients had higher chances to cure MDR-TB (SHR = 1.07, 95% CI: 0.85 - 1.35) compared to HIV positive patients. Patients who were treated in the decentralised sites had lower chances to be cured of MDR-TB (SHR = 0.19, 95% CI: 0.07 - 0.54) as compared to patients who were treated in the centralised hospital. Conclusion: Identifying key factors associated with TB and specifying strategies to prevent them can reduce mortality of patients due to TB disease, hence positive treatment outcomes leading to the goal of reducing or end TB deaths. Urgent action is required to improve the coverage and quality of diagnosis, treatment and care for people with drug-resistant TB.

One-month immunotherapy trial in treatment-failed TB patients

reatment failed TB patients have very limited chances of survival. Open label trial of daily oral pill of V-5 Immunitor (V5) was conducted in 48 treatment-failed TB patients on palliative support consisting of isoniazid (H) and rifampicin (R). The subjects had the following forms of TB;cavitary: disseminated: MDR-TB: DR-TB: TB/HIV at 35:13:7:4:1 ratio. After 1 month 62.5% of V5-treated patients experienced negative sputum smear conversion (P 2 respectively (P < 0.0001). Two patients (4.2%) died from illicit drug- and alcohol-abuse related causes. No adverse effects or reactivation of disease due to immune intervention were seen at any time. V5 is safe and in combination with a simple two-drug regimen was highly effective as an immune adjunct to produce favorable outcome among treatment-failed and/ or drug-resistant TB patients.

β-内酰胺酶抑制剂治疗耐多药肺结核初步研究

目的评价β-内酰胺酶抑制剂对耐多药肺结核的临床作用。方法将60例复治耐多药肺结核患者随机分为治疗组与对照组(各30例),据痰菌药敏及个体化等原则,均给予强化期2个月/巩固期4个月方案抗痨,治疗组在强化期加用安灭菌口服。观察痰菌、胸部X-ray及药物不良反应等。结果治疗组2个月末痰菌阴转率为21.43%(6/28),优于对照组为6.67%(2/30),P<0.05;而6个月末为42.86%(12/28),与对照组26.67%(8/30)无显著性差异,P>0.05。强化期增加该药未见不良反应叠加。结论β-内酰胺酶抑制剂与抗生素的等摩尔复合剂(安灭菌片)长期应用,安全、低毒,有益于痰菌阴转,但仍需进一步的大样本、足疗程的临床试验证实。

Xpert-结核分枝杆菌及利福平耐药检测弱阳性结果对耐多药肺结核的诊断价值及其产生原因分析

目的:分析Xpert-结核分枝杆菌及利福平耐药检测(Xpert-MTB/RIF)弱阳性结果对耐多药肺结核(MDRTB)的诊断价值,探究肺结核患者Xpert-MTB/RIF产生弱阳性结果的可能原因。方法:选取医院2019年经XpertMTB/RIF检测患者资料,分析其患者Xpert-MTB/RIF弱阳性的抗酸染色涂片镜检、结核培养、肺部CT和临床诊断结果,比较阳性和阴性患者对耐药肺结核的诊断意义。结果:Xpert-MTB/RIF弱阳性患者的临床诊断为肺结核的发生率显著高于阴性患者(48.36%vs 29.17%),但其低于阳性患者(48.36%vs 83.78%);其检测弱阳性的肺结核患者结核分枝杆菌培养阳性率低于阳性患者(43.14%vs 79.31%),但其高于阴性患者(43.14%vs 16.67%);抗酸染色结果发现,Xpert-MTB/RIF检测弱阳性肺结核患者的阳性率低于阳性肺结核患者(27.45%vs 75.86%),但其高于阴性患者(27.45%vs 8.33%);联合CT检查结果发现,Xpert-MTB/RIF阳性和弱阳性的肺结核患者肺部存在空洞发生率高于阴性患者,而肺部病灶数的发生率也高于阴性组。结论:Xpert-MTB/RIF检测产生弱阳性结果可能与结核分枝杆菌数量和病情的严重程度相关,所以Xpert-MTB/RIF检测的弱阳性对耐药肺结核的诊断有一定的指导作用。

血清降钙素原与sTREM-1水平对多重耐药肺结核患者临床预后的相关性研究

目的探讨血清降钙素原与s TREM-1水平对多重耐药肺结核患有者早期临床疗效的相关性研究。方法连续性收录自2012年4月至2014年4月于我院就诊并被确诊为耐多药肺结核的患者160例。另纳入同期来院体检的志愿者60例。采用免疫荧光法检测血清PCT,酶联免疫吸附试验(ELISA)检测血清s TREM-1。并分析两种血清指标与耐多药肺结核的临床疗效与预后的相关性。结果在治疗前,肺结核患者血清PCT和s TREM-1水平明显高于对照组(0.19±0.08 ng/ml vs 0.03±0.01 ng/ml,181.32±34.2 ng/m L vs23.5±11.6 ng/m L)(P<0.05)。而有效组患者治疗前PCT和s TREM-1水平与无效组患者比较未见明显差异(P>0.05),经治疗后可见有效组患者在治疗后2个月和6个月两个时间点中血清PCT和s TREM-1水平明显低于无效组患者(P<0.05)。治疗后2个月时的血清PCT和s TREM-1水平具有较高的预后评价意义(AUC分别为0.82和0.86)。多因素COX分析可见白蛋白,PCT以及s TREM-1水平三者是独立的危险因素(P<0.05)。结论血清PCT和s TREM-1的水平与耐多药肺结核患者病情程度以及临床预后密切相关。

莫西沙星与左氧氟沙星治疗耐多药肺结核病的有效性和IFN-γ、IL-10分析

目的探究耐多药肺结核病患者接受莫西沙星与左氧氟沙星治疗的有效性以及对IFN-γ、IL-10水平的影响。方法将2018年1月至2019年4月100例耐多药肺结核病患者,以随机数字表法分组,对照组行左氧氟沙星治疗,试验组行莫西沙星治疗,分析两组耐多药肺结核病患者的治疗效果。结果治疗后两组患者IFN-γ水平较治疗前升高,IL-10水平较治疗前降低,且观察组改善程度显著优于对照组,P<0.05;试验组患者治疗总有效率(94.00%)高于对照组(78.00%),P<0.05;两组患者治疗后不良反应发生率差异无统计学意义(P>0.05)。结论耐多药肺结核病患者接受莫西沙星与左氧氟沙星治疗,均可获得一定的效果,但莫西沙星可更好促进患者细胞因子水平的改善,不良反应发生率低。

Drug Resistance Pattern in Pulmonary Tuberculosis Patients and Risk Factors Associated with Multi-Drug Resistant Tuberculosis

Introduction: Anti-tuberculosis drug resistance is a major problem in tuberculosis (TB) control programme, particularly multi-drug resistance TB (MDR-TB) in Nepal. Drug resistance is difficult to treat due to its associated cost and side effects. The objective of this study was to assess the drug resistance pattern and assess risk factor associated with MDR-TB among pulmonary tuberculosis patients attending National Tuberculosis Center. Methodology: The comparative cross sectional study was conducted at National Tuberculosis Center during August 2015 to February 2015. Early morning sputum samples were collected from pulmonary tuberculosis suspected patients and subjected to Ziehl-Neelsen staining and fluorochrome staining and culture on Lowenstein-Jensen (LJ) medium. Drug Susceptibility test was performed on culture positive isolates by using proportion method. Univariate and multivariate analysis was computed to assess the risk factors of MDR-TB. Results: Out of 223 sputum samples, 105 were fluorochrome staining positive, 85 were ZN staining positive and 102 were culture positive. Out of 102 culture positive isolates, 37.2% were resistance to any four anti-TB drugs. 11 (28.9%) were initial drug resistance and 28 (43.7%) were acquired drug resistance. The overall prevalence of MDR-TB was 11.7%, of which 2 (5.3%) were initial MDR-TB and 10 (15.6%) were acquired MDR-TB. Univariate and multivariate analysis showed female were significantly associated (P = 0.05) with MDR-TB. Conclusion: Drug resistance TB particularly MDR-TB is high. The most common resistance pattern observed in this study was resistance to both isoniazid and rifampicin. Female were found to be associated with MDR-TB. Thus, early diagnosis of TB and provision of culture and DST are crucial in order to combat the threat of DR-TB.

2010-2013年如皋市耐多药肺结核患者分析

目的通过对如皋市耐多药肺结核(MDR-TB)患者的来源及转归进行分析,探索适合该地区MDR-TB的发现策略。方法 2010-2013年收集该市所有涂阳结核病患者的痰标本,开展药敏检查,分析不同来源患者中的MDR-TB发现及转归情况。结果 4年间确诊MDR-TB患者36例,结核病患者中MDR-TB检出率为9.3%,其中86.1%的MDR-TB患者来源于MDR-TB高危人群。初治凃阳者MDR-TB检出率为1.7%,MDR-TB高危人群为34.8%,差异有统计学意义(P<0.001)。MDR-TB高危人群中,慢性排菌患者MDR-TB检出率为57.1%,复发患者为34.7%,其他复治患者为22.2%,2月或3月末未发现涂片仍阳性者。纳入治疗的MDR-TB患者治疗成功率为67.7%。不同来源的MDR-TB高危人群MDR-TB检出率及治疗成功率差异均无统计学意义(P>0.05)。结论该市MDR-TB疫情低于全国水平,MDR-TB高危人群是该市发现耐多药肺结核最主要人群。

Diagnostic Evaluation of GeneXpert MTB/RIF Assay for the Detection of Rifampicin Resistant Mycobacterium tuberculosis among Pulmonary Tuberculosis Patients in Bangladesh

Background: The emergence of multidrug resistant tuberculosis (MDR-TB) and extensively drug- resistant tuberculosis (XDR-TB) has highlighted the need for early accurate detection and drug susceptibility. Objective: The purpose of the present study was to evaluate the accuracy of GeneX-pert MTB/RIF assay for the detection of Mycobacterium tuberculosis and rifampicin resistance. Methodology: This cross sectional study was done in the Department of Microbiology at Sir Salimullah Medical College, Dhaka and National Institute of Chest Disease & Hospital (NIDCH), Dhaka during the period of January 2014 to December 2014 for a period of 1 (one) year. Sputum samples from suspected MDR-TB patients were collected by purposive sampling technique from OPD of Sir Salimullah Medical College (SSMC) and NIDCH. Microscopy, liquid culture in liquid MGIT 960 media and GeneXpert MTB/RIF were done for MTB diagnosis and detection of rifampicin resistance. MGIT 960 media were also used for determination of drug resistance. Result: Liquid culture yielded higher growth (68%) from 100 samples while GeneXpert MTB assay showed similar result (67% positive and 33% negative). Drug susceptibility test in MGIT 960 media showed that out of 68 positive cases Rifampicin resistant cases were 15 (22.05%) whereas GeneXpert MTB assay detected 14 (20.89%) were Rifampicin resistant out of 67 MTB positive samples. When compared to liquid culture the calculated sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and accuracy of GeneXpert MTB were 98.52%, 100%, 96.96%, 100% and 99%. Conclusion: GeneXpert MTB/RIF assay is high detection rate of pulmonary tuberculosis and multidrug resistant tuberculosis.