Abstract
Background: GeneXpert MTB/RIF assay is efficient and reliable technique for the rapid diagnosis of extra pulmonary TB (EPTB), especially in smear negative cases. For rifampicin resistance detection, it provides accurate results and can allow rapid initiation of MDR-TB treatment.
Objectives: The aim of the study is to evaluate Gene Xpert MTB/RIF assay for rapid detection of Mycobacterium tuberculosis and rifampicin resistance in extra pulmonary samples.
Materials and Method: This study was done in the department of Microbiology, Indira Gandhi Institute of Medical Sciences, Patna during the period of February to July 2016. Extra pulmonary samples were collected from clinically suspected cases of extra pulmonary tuberculosis and were subjected for Z-N staining, fluorescent microscopy and Gene Xpert MTB/RIF assay.
Result: 123 extra pulmonary samples included 21 pus, 28 pleural fluids, 14 ascitic fluids, 7 CSF, 16 lymph nodes, 6 synovial fluid, 15 bronchoalveolar lavage (BAL) and 16 endometrial samples. Out of these, 20.3% patients were GeneXpert MTB/RIF Assay positive, 5.6% were positive on fluorescent microscopy and 4.0 % were ZN positive. Rifampicin resistance was found in pus sample, pleural fluid, and lymph node sample.
Conclusion: Gene Xpert MTB/RIF assay is rapid method for diagnosis of extra pulmonary tuberculosis as compared to conventional methods. Because of its simplicity, rapidity and sensitivity, this seems to be a very gorgeous tool for diagnosis of extra pulmonary tuberculosis from clinical samples.
Keywords: Extra pulmonary tuberculosis, Mycobacterium tuberculosis, Gene Xpert MTB/RIF assay, Rifampicin resistance.
References
- Central TB Division,Ministry of Health and Family Welfare, Government of India.2016. INDEX-TB GUIDELINES - Guidelines on extra-pulmonary tuberculosis for India
- Doris Hillemann et al, Rapid Molecular Detection of Extra pulmonary Tubercu-losis by the Automated Gene Xpert MTB/RIF System. 4, 2011, 1202–1205.
- Centers for Disease Control and Prevention. Updated guidelines for the use of nucleic acid amplification tests in the diagnosis of tuberculosis. MMWR Morb. Mortal. Wkly Rep. 2009; 58:7– 10. [PubMed: 19145221]
- Lawn SD, Nicol MP. Xpert(R) MTB/RIF assay: development, evaluation and implementation of a new rapid molecular diagnostic for tuberculosis and rifampicin resistance. Future Microbiol. 2011;6: 1067–1082. [PubMed: 21958145]
- Boehme CC, Nabeta P, Hillemann D, et al. Rapid molecular detection of tuberculosis and rifampin resistance. N. Engl. J. Med. 2010; 363:1005–1015. [PubMed: 20825313]
- Tuberculosis diagnostics automated DNA test. www.who.int/tb/featu-res_archive/xpert_factsheet.pdf
- Boehme, C. C., et al. 2010. Rapid molecular detection of tuberculosis and rifampin resistance. N. Engl. J. Med. 363:1005–1015.
- Greco, S., M. Rulli, E. Girardi, C. Piersimoni, and C. Saltini. 2009. Diagnostic accuracy of in-house PCR for pulmonary tuberculosis in smear-positive patients: meta-analysis and metaregr-ession. J. Clin. Microbiol. 47:569– 576.
- Ling, D. I., L. L. Flores, L. W. Riley, and M. Pai. 2008. Commercial nucleicacid amplification tests for diagnosis of pulmonary tuberculosis in respiratory specimens: meta-analysis and meta-regression. PLoS One 3:e1536.
- Stephen D, Alimuddin IZ. Diagnosis of Extra pulmonary Tuberculosis Using the Xpert MTB/RIF Assay. 10(6), 2012, 631-635.
- Sajed AN, Butt AS, Srwar A, Akhtar R, Ahmad I, Mukhtar MN, et al. Rapid detection of Mycobacterium tuberculosis and Rifampicin Resistance in extra pulmonary samples using Gene Xpert MTB / RIF assay. IOSR Journal of Dental and Medical Sciences 2014;13(11):50–3.
- Scott LE, Beylis N, Nicol M, Nkuna G, Molapo S, Berrie L, et al. Diagnostic Accuracy of Xpert MTB / RIF for Extrapulmonary Tuberculosis Specimens : Establishing a Laboratory Testing Algorithm for South Africa. Journal of Clinical Microbiology.2014;52(6):1818–23.
Corresponding Author
Dr Swati Salila
Junior Resident, Dept of Microbiology,
Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
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