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Category: Volume 07 Issue 04 April 2019
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Title: To Study the Comparative yield of Zn Staining v/s CBNAAT (Gene Xpert) in Clinically Diagnosed cases of Tubercular Pleural Effusion

Authors: Jain G, Jain VK, Mishra M, Maan L, Garg A, Bhardwaj G

 DOI: https://dx.doi.org/10.18535/jmscr/v7i4.166

Abstract

Background: India accounts for a quarter of global TB burden in which 15-20% are extra-pulmonary TB. Tubercular pleural effusion is the most common extra pulmonary TB after Tubercular lymphadenitis. Tubercular effusion remains mostly undiagnosed due to pauci-bacillary nature. Early detection of Tuberculosis and Drug Resistance is the priority in diagnosis for early disease management and reduce morbidity. Molecular biological tests specially CBNAAT is one of the important method for early and rapid diagnosis of mycobacterium tuberculosis in specimen/tissue having pauci-bacillary nature with good sensitivity and specificity.

Materials and Methods: This is a retrospective study conducted in Department of Respiratory Medicine, MGMCH Jaipur in 150 patients of clinically diagnosed cases of tubercular pleural effusion between August 2016 to July 2018. In addition to detailed clinical history/examination and radio imagine Pleural fluid for routine Biochemical examination reports evaluated for  protein, sugar ADA and cell cytology,  suspecting tubercular in nature were taken in our study. In all these cases AFB by ZN staining and CBNAAT done and comparative reports evaluated.

Results: A total of 150 cases of clinically diagnosed tubercular pleural effusion, MTB was Detected by ZN staining in 11(7.33%) and CBNAAT in 38(25.33%) cases. CBNAAT yield was significantly more as compare with ZN Staining. Among 38 cases who were positive for CBNAAT only 11 cases were positive for ZN Staining showing poor yield of ZN Staining.

Conclusion: CBNAAT is newly emerging and highly sensitive and specific technique for early and rapid diagnosis of Tubercular Pleural effusion including resistant pattern of Rifampicin in view of MDR as compared to ZN staining.

Keywords: MTB,CBNAAT, ZN staining, MDR, ADA.

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Corresponding Author

Dr Lokesh Maan

Assistant Professor, Department of Respiratory Medicine, Mahatma Gandhi Medical College & Hospital, Jaipur (Rajasthan) 302022, India

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