A Nomogram Predictive Model for Drug-Resistant Tuberculosis Detection by GeneXpert MTB/RIF Assay in Paediatric Patients

Objective: To develop and validate a clinical-imaging integrated nomogram predictive model for DR-TB risk in pediatric patients (≤18 years), and to evaluate the diagnostic performance of the GeneXpert MTB/RIF assay in this context. Methods: This retrospective study included 223 patients with TB aged ≤18 years hospitalised between 1 July 2018 and 31 December 2023. Drug resistance profiles were analysed, and the clinical/imaging features of DR-TB were compared with those of drug-susceptible TB (DS-TB). Multivariate logistic regression was used to identify DR-TB risk factors. Results: < 0.001). No significant differences in T-lymphocyte subsets were found between the DR-TB and DS-TB groups. Conclusion: In children and adolescents, TB is more common in older individuals and consists primarily of new cases. The nomogram model has good predictive value for DR-TB risk. Key predictors include retreatment, smoking, right middle lobe involvement and cavity formation. The GeneXpert MTB/RIF assay is a potential early screening tool for DR-TB. Further validation with larger samples is needed.