Diagnosis of Extra Pulmonary Tuberculosis By Using Xpert® MTB/RIF Assay (CBNAAT) And MGIT Liquid Culture.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 9
Abstract
Background: Globally, India Is A Home For More Than 25% Of Global Tuberculosis (TB) Burden. The Sensitivity Of Smear Microscopy And Its Inability To Detect Drug Resistance Limits Its Impact On TB Control. Early And Accurate Diagnosis Is The First Critical Step In Controlling TB. The Control Of TB Is Hampered By Diagnostic Methods With Sub-Optimal Sensitivity, Particularly For The Detection Of Drug Resistant Forms And In Patients With Human Immunodeficiency Virus (HIV) Infection. Early Detection Is Essential To Interrupt Transmission And Reduce The Death Rate, But The Complexity And Infrastructure Needs Sensitive Methods Which Limit Their Accessibility And Effect. Diagnosis Of Extra Pulmonary TB (EPTB) Remains Especially Challenging Since The Number Of Mycobacterium Tuberculosis (MTB) Bacilli Present In Tissues At Sites Of Disease Is Often Low And Clinical Specimens From Deep-Seated Organs May Be Difficult To Obtain. Histology Is Time-Consuming To Undertake And Establishing A Diagnosis Of TB With High Specificity Remains Difficult. Tissue Microscopy After Special Staining Is Often Negative And When Mycobacteria Are Seen, It Is Impossible To Distinguish MTB From Nontuberculous Mycobacterial Disease. The Xpert® MTB/RIF Assay (Cepheid Inc., CA, USA) Marks An Important Development In The Field Of Rapid Molecular TB Diagnostics Keeping This View The Study Was Under Taken To Diagnose Extra Pulmonary Tuberculosis In Patients Admitted In Govt General Hospital. Aim And Objectives: 1 To Diagnose Extra Pulmonary Tuberculosis By Gene Xpert®, Florescent Microscopy And Liquid Cultures 2. To Evaluate The Sensitivity and Specificity Of Gene Xpert® In Extra Pulmonary Tuberculosis And Compared With LED Fluorescent Microscopy And Liquid Culture MGIT960. 3 Liquid Cultures Were Taken As Gold Standard In Our Study. Methods: A Descriptive Study Was Conducted At Government General And Chest Hospital, Visakhapatnam AP, India During 2018 Jan To Aug 2018. The Study Population Included All The Extra Pulmonary Presumptive TB Cases Who Were Subjected For Further Investigations By CBNAAT, Fluorescent Microscopy And Liquid Culture. Results: Of The 103 Extra Pulmonary Samples, The Sensitivity And Specificity By CBNAAT Was 80.8% And 87.5% Respectively; While That For Fluorescent Microscopy Was 36.1% And 98% Respectively, When Compared With Liquid Culture Which Is The Gold Standard In Our Study. Out Of The 103 Samples CBNAAT Was Positive In 45 Of Which 3 Were Rif Resistant. Compare With Culture Result CBNAAT Had Sensitivity And Specificity Of 91.6% For FNAC Samples. Conclusion: In Our Study Gene Xpert® Had A Sensitivity Of 80.8% And Specificity Of 87.5 In Extra Pulmonary Samples. In Addition Gene Xpert® Has Detected 3 Cases Of Rif Resistance Which Is Not Possible With Florescent Microscopy. It Has A Notable Advantage Of Detecting TB Within Two Hours Which Is Acceptable To All Clinicians To Institute Early Treatment. CBNAAT Is One Of The Rapid Diagnostic Tests Available In The Country And It Should Be Routinely Used Under The Public And Private Health Sector Effectively To Detect Early, Tuberculosis In Extra Pulmonary Samples.
Authors and Affiliations
K. Suresh, Dr. Y. Vimala, Dr. Pv Ramana, Dr. P. Apparao, Dr. K. Aruna Lakshmi
Keywords
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- EP ID EP395481
- DOI 10.9790/0853-1709106570.
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