“Procedure“

Disusun Untuk Memenuhi Tugas Toefl and Academic Writing

Dosen Pengampu : Muhammad Muayyad Billah, S.Tr. Gz, M. Gz, Dietisien

Disusun Oleh:

Muhammad Alwi Sutomi 5120025

Riswan Bintang Pratama 5120042

FAKULTAS KESEHATAN

PROGRAM STUDI D-IV TEKNOLOGI LABORATORIUM MEDIK

INSTITUT KESEHATAN RAJAWALI

TAHUN AJARAN 2023/2024

 PROCEDURE BTA/TCM GeneXpert

Page : 3

STANDARD OPERATIONAL PROCEDURES

Definition GeneXpert is an automatic molecular examination to detect
Mycobacterium tuberculosis. This test uses catridge based on the
Nucleic Acid Amplification Test (NAAT) to detect cases of TB and
resistance to the antibiotic rifampicin.
Objective As a basis for the implementation of measures to conduct a quick
molecular test Gen Expert.
Procedure A. Tools
1. Biosafety Cabinet
2. Catridge
3. GeneXpert System
4. Gloves
5. Label
6. Pippete sterile transfer
7. Tissue
8. Vortex
B. Materials
1. Buffer GeneXpert
2. Disinfectant, 10% hypochlorite solution
3. Sputum samples in pots
C. Procedures
 Preparations Samples
1. Each catridge must be labeled with an identity. The
identity of the specimen can be sticky or written on the
side of the catrid.
2. Open the pot cover and add the sample buffer with a
comparison of 1 part sample volume and 2 parts sample
tamper volume available. Two samples should not use the
 same buffer.
3. If the sputum volume is 4 ml, then it is recommended to
divide the specimen into 2 parts. One part is used for
GeneXpert MTB/RIF examination, and the other one is
stored in a new sputum pot as a reserve.
4. Close the sputum pot again, then rub it until the mixture of
sputum and the buffer sample becomes homogeneous.
5. Leave for 10 minutes at room temperature.
6. Shake the mixture again and leave it standing for 5
minutes.
7. If there is still a clot, rub it again to make the mixture of
sputum and the buffer sample perfectly homogeneous, and
leave for 5 minutes at room temperature.
8. Open the caterpillar cover. Insert the sample mixture into
the cathride using a pipette of 2 ml by flowing through the
wall of the cathride to prevent the passage of bubbles that
may cause errors.
9. Slowly close the catheter and insert it into the GeneXpert
engine.
10. Operate GeneXpert.
 Turn on the machine and operate the software
1. Turn on the computer and the machine. Run the
GeneXpert DX software.
2. Click "Create Test".
3. Scan the barcode on the katrid or select "Manual Entry" if
the scanner cannot be used.
4. In the "Create Test" tab "Patient ID", "Sample 1". The
module section will be automatically loaded.
5. Click "Start Test".
6. The light will blink on the selected module. Insert the
katrid and close the module door until it is perfect and
marked "Click".
7. The inspection will take two hours, and when it's done, the
lights will automatically turn off.
8. Open the module door, remove the catridge and throw it
into the infectious trash.
 Read Results
1. Click "View Result".
2. Click "View Test".
3. Click "Select Test to Be Viewed" → "OK".
4. To create a review report, click "Report".
5. The results can be interpreted as follows:
a) Detected MTB' when there are two probes gives Ct
values within the valid limit and delta Ct min (the
smallest Ct difference between probing pairs) <2.0.
b) Rifampicin Resistant is not detected when the max Ct
delta (difference between the earliest and most recent
probes) is ≤ 4.0.
c) Rifampicin Resistant Detected' when delta Ct max>
4.0.
6. Rifampicin Resistant Indeterminate' when two conditions
are found as follows:
a) The Ct value on the probe exceeds the maximum valid
value (or value 0).
b) The Ct value on the earliest probe appears (valid Ct
values max delta Ct max cut-off 4.0).
c) No MTB' detected when there is only one or no
positive probe.