Role of Bronchial Washing Gene Xpert in smear negative cases of suspected pulmonary tuberculosis

Introduction: Diagnosis of Pulmonary Tuberculosis in 60-80% of patients is not confirmed by routine tests of sputum microscopy. It is imperative to confirm diagnosis of TB in these patients. Bronchoscopy with bronchial washing is needed for smear negative patients to establish early diagnosis and hence avoid empiric treatment of TB who do not have the disease. Objective: To determine the frequency of mycobacterium tuberculosis detection, in bronchial washing in smear negative cases of suspected pulmonary tuberculosis. Methodology: A descriptive cross-sectional study was conducted at a tertiary care teaching hospital, Dow University of Health Sciences, Karachi, during July 2016 to December 2016. Smear negative patients with suspicion of pulmonary tuberculosis were selected and underwent for bronchoscopy, detailed examination of bronchial tree was performed, and bronchial washing collected for testing of mycobacterium tuberculosis with Gene Xpert. Results: A total of 120 patients were included. In this study 55 (45.8%) patients were female and 65 (54.2%) were male with mean and standard deviation of age was 39.9 ±14.7 years. Bronchial washing Gene Xpert for mycobacterium tuberculosis was detected in 83 (69.2%) smear negative cases of suspected pulmonary tuberculosis patients. Conclusion: Bronchial washing Gene Xpert has an excellent diagnostic yield for detection of mycobacterium tuberculosis in smear negative cases of suspected pulmonary tuberculosis.