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Category: Volume 06 Issue 10 October 2018
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Title: A Case Study of Rifampicin Resistance in Newly Detected Sputum Negative Pulmonary Tuberculosis Patients by CBNAAT

Authors: G Nivetha, S Sudharsan, S Manoj Kumar, R Aswinth

 DOI: https://dx.doi.org/10.18535/jmscr/v6i10.176

Abstract

Background: Tuberculosis is the most common communicable disease causing morbidity and mortality worldwide. India is the country with the highest burden of MDR –TB. The WHO has endorsed CBNAAT in December 2010, an automated real time PCR based rapid diagnostic test, simultaneously detecting mycobacterium tuberculosis and rifampicin resistance within two hours.1,2,3 WHO has recommended in 2013, the use CBNAAT in sputum AFB negative pulmonary tuberculosis, extra pulmonary tuberculosis, paediatric tuberculosis and in immune compromised patients like HIV and diabetes mellitus.4,5,6  Various studies shows the prevalence of MDR/RR TB in previously treated patients.

Aim of the Study: This study was done to detect the rifampicin resistance in newly detected sputum AFB negative pulmonary tuberculosis patient through CBNAAT.

Material and Methods: This study includes 140 cases of Presumptive pulmonary tuberculosis patients who were smear negative during the period during the period between Nov 2016 to April 2018 in all presumptive pulmonary tuberculosis patients who attended OP or got admitted in Rajah Muthiah medical college and hospital, Chidambaram. These patients were enrolled and CBNAAT was provided.

Results: Out of these 140 cases, MTB was detected in 54 cases (38.6%) and in rest of the 86 cases MTB not detected. Among 54 cases, 2 were rifampicin resistance and rest of them were rifampicin sensitive. These 2 rifampicin resistance was diagnosed in newly detected pulmonary tuberculosis patients. This study shows the prevalence of 3.7% MDR-TB in primary pulmonary tuberculosis.

Conclusion: This study shows that CBNAAT is more superior to sputum microscopy by detecting additional pulmonary tuberculosis cases and drug resistance which are missed by sputum AFB stain within few hours. We concluded that all sputum AFB negative presumptive pulmonary tuberculosis patients should undergo novel technique like CBNAAT and LPA to diagnose the undetected TB and DR – TB.

Keywords: Sputum AFB negative, CBNAAT, New case, Rifampicin resistance

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Corresponding Author

Dr G. Nivetha

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