Objective: To evaluate the efficacy of the interferon-gamma release assay (IGRA) combined with GeneXpert MTB/RIF (Xpert) in the diagnosis of urinary tuberculosis. Methods: A total of 105 patients with clinically suspected urinary tuberculosis who visited the Affiliated Hospital of Youjiang Medical University for Nationalities from January 2022 to June 2024 were selected. Urine acid-fast bacillus smear, Mycobacterium tuberculosis culture, IGRA, and Xpert were performed on all patients. The diagnostic efficacy of each method was compared. Results: In this study, there were 59 positive cases (59/105, 56.2%) and 46 negative cases (46/105, 43.8%) of urinary tuberculosis. Among them, 19 cases (19/59, 32.2%) were confirmed by Mycobacterium tuberculosis culture, and the remaining 40 cases (40/59, 67.8%) were diagnosed through clinical comprehensive judgment. The detection rate of IGRA combined with Xpert (53/59, 89.8%) was significantly higher than that of smear (17/59, 28.8%), Mycobacterium tuberculosis culture (19/59, 32.2%), IGRA (39/59, 66.1%), and Xpert (46/59, 78.0%), and the differences were statistically significant (all P < 0.0125). The sensitivity, accuracy, and negative predictive value of Xpert combined with IGRA were higher than those of other methods (all P < 0.0125). The specificity of Xpert combined with IGRA was higher than that of smear (P < 0.0125), but there was no statistically significant difference compared with the other three methods (all P > 0.0125). The positive predictive value of Xpert + IGRA combined detection was higher than that of smear (P < 0.003) and single IGRA (P < 0.0125), but there was no statistically significant difference compared with culture and single Xpert (all P > 0.0125). In addition, the sensitivity of combined detection in 40 cases with negative culture but clinically confirmed was 87.1%. Conclusion: The preliminary results show that IGRA combined with Xpert has high diagnostic efficacy in the diagnosis of urinary tuberculosis. However, these conclusions are limited by the single-center and small sample size, and need to be verified by large-scale prospective studies.
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