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C. Mycobacterium tuberculosis complex and rifampicin resistance detection by Gene
Xpert MTB/RIF assay

Indication:

i) Confirmation of diagnosis of MDRTB MICROBIOLOGY

1. Retreatment case (failure/relapsed/defaulter).
2. Contacts of MDRTB and symptomatic.
3. Symptomatic foreigners from heavy burden MDRTB country.
4. HIV patients not responding to primary TB treatment.
5. Smear negative TB not responding to primary TB treatment.
6. Patient suspected of having MDRTB (adult or children).

ii) Diagnosis of TB in special situation
1. Symptomatic paediatric cases.
2. Extrapulmonary TB.

Acceptable specimens:

Sputum, respiratory secretions, bronchial lavage, sterile body fluids/aspirate, CSF and
tissue.

1. Collect appropriate specimens and place in sterile container.
2. Send specimens to the laboratory.
3. Blood-stained sample will be rejected.

Note:
• All cases must be discussed with Chest Physician prior to Gene Xpert ordering.
• Please inform Clinical Microbiologist (Dr. Roesnita or Dr. Nadiyah) before
sending sample to the laboratory.
• Sample for MTB culture need to be send together with gene xpert request
using different sample and form.

2.6 Sterile body fluid C&S (excluding CSF, urine and blood)

1. Clean needle puncture site with 2% chlorhexidine in 70 % alcohol. Let it dry.
2. Aseptically perform percutaneous aspiration to obtain pleural, pericardial,
peritoneal or synovial fluid.
3. Collect fluid into a sterile screw-cap container.
4. For anaerobic culture send specimen immediately to yield better result.

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