AccScience Publishing / EJMO / Online First / DOI: 10.36922/EJMO025160130
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ORIGINAL RESEARCH ARTICLE

Analysis of the detection efficacy of Xpert MTB/RIF, Lowenstein–Jensen medium culture, and fluorescence smear microscopy methods for Mycobacterium tuberculosis diagnosis

Ying Dong1 ,  Changcheng Zhao1 ,  Xiaodan Zha1 ,  Lunshan Lu2 ,  Chun Liu2,3 ,  Ying Wang4 ,  Yu Huang3,5* ,  Frankliu Gao6
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1 Department of Clinical Laboratory, The First Affiliated Hospital, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
2 Department of Tuberculosis Clinic, The First Affiliated Hospital, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
3 Center for Medical Imaging, The Second Affiliated Hospital, Bengbu Medical University, Bengbu, Anhui, China
4 Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
5 Department of Medical Imaging Equipments, School of Medical Imaging, Bengbu Medical University, Bengbu, Anhui, China
6 Department of Information Systems and Operations Management, Michael G. Foster School of Business, University of Washington, Seattle, Washington, United States of America
EJMO, 025160130 https://doi.org/10.36922/EJMO025160130
Received: 17 April 2025 | Revised: 26 May 2025 | Accepted: 23 June 2025 | Published online: 18 July 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Objectives: Tuberculosis (TB) remains a major global health threat, necessitating accurate, rapid, and cost-effective diagnostic methods to improve early detection and control of the disease. The traditional methods for detecting Mycobacterium tuberculosis (MTB) in clinical testing are fluorescence smear microscopy (FSM) and Lowenstein–Jensen medium culture (LJMC) methods. With the development of molecular diagnostics, the Xpert MTB/rifampicin assay (Xpert) has become increasingly used. This study compared Xpert with traditional FSM and LJMC using sputum specimens to study the application value in the diagnosis of TB.

Methods: A total of 342 examination reports were included. Sputum samples from all study subjects were tested using FSM, LJMC, and Xpert methods.

Results: The Xpert method showed a significantly higher positive rate than FSM, and a slightly higher rate than LJMC.

Conclusion: Among all sputum samples from suspected or confirmed TB patients, Xpert detected all cases that were positive by FSM, while both Xpert and LJMC missed positives found by each other. FSM also detected a small number of positives not detected by LJMC. Overall, Xpert had the highest positive detection rate, and FSM the lowest. Although FSM is the fastest and least expensive (costing only one-seventh of Xpert), it demonstrated the lowest sensitivity, with its positive rate being roughly half that of Xpert or LJMC.

Keywords
Acid-fast bacilli
Fluorescence smear microscopy
Lowenstein–Jensen medium culture
Mycobacterium tuberculosis
Rifampicin resistance
Xpert Mycobacterium tuberculosis/Rifampicin assay
Funding
This work was funded by Hefei Municipal Health Commission of Anhui Province of China (Grant No. Hwk2022zc051), the Yangtze River Delta Science and Technology Innovation Community Joint Basic Research Project of China (Grant No. 2024CSJZN1200), and the National Natural Science Foundation of China (Grant No. 82300261).
Conflict of interest
The authors declare no competing interests.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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