Abstract: Objective The positive detection rate of Mycobacterium tuberculosis ribonucleic acid (TB-RNA) detection was compared with that of traditional methods, and the clinical value of Mycobacterium tuberculosis ribonucleic acid (TB-RNA) detection in monitoring the efficacy of drug-resistant pulmonary tuberculosis patients was explored. Method A total of 117 patients with drug-resistant pulmonary tuberculosis who were hospitalized in the tuberculosis Department of Guangxi Chest Hospital from November 2022 to May 2024 were selected. The positive detection rates of TB-RNA, smear and solid culture were compared at baseline and from 1 to 6 months after treatment. Kappa test was used to evaluate the consistency of TB-RNA and smear results with solid culture results. Result Using clinical diagnosis as a reference standard, the positive detection rate of sputum specimens for TB-RNA testing was higher than that of solid cultures and smears at baseline and during the treatment period of 1-6 months.Among them, there was a statistically significant difference between the baseline and the treatment period of 1 month, 2 month, 4 month and 5 month (P<0.05). At baseline and during 1, 2 and 4 months of treatment, the difference was statistically significant compared with solid culture (P<0.05).Using the results of solid culture and strain identification as reference standards, the sensitivity and negative predictive value of TB-RNA were higher than that of smear at baseline and during 1, 2 and 4 months of treatment. Kappa concordance between TB-RNA and solid culture results was higher than smear. Conclusion TB-RNA has good efficacy in monitoring the efficacy of drug-resistant pulmonary tuberculosis. At present, although it cannot completely replace traditional methods, TB-RNA is more suitable for long-term efficacy monitoring of drug-resistant pulmonary tuberculosis.

Key words: Mycobacterium tuberculosis ribonucleic acid, Drug-resistant pulmonary tuberculosis, Efficacy detection, Kappa analysis, Clinical value