Abstract
In the era of rapid diagnosis of TB and Drug resistance Cartridge Based Nucleic Acid Amplification Technique (CBNAAT) came with a future of early and easy diagnosis for TB. However Microscopic examination of sputum sample still is the most commonly used screening test and Lowenstein Jensen (LJ) culture method considered as a gold standard technique. Hence a study was planned to see the Concordance and efficacy of CBNAAT with smear Microscopy at TMC and Dr BRAM teaching Hospital Hapania Tripura from January to December 2017.
Material and Methods: CBNNAT and smear microscopy of 278 TB suspected patients were done ion the department of Microbiology.
Results: Smear positive cases CBNAAT positivity was 95.91% and smear negative cases 10.48%. Concordance of two techniques (CBNAAT and Microscopy) for the diagnosis of Tuberculosis was noticed to be 90.64% . 74.55% of cases were found to be negative by CBNAAT. Total 72 cases were positive for MTb and 4 cases were Rifampicin resistance.
Conclusion: CBNAAT positive result suggest but negative result do not exclude TB. CBNAAT does not eliminate the need of conventional microscopy however LJ should be establish soon that are required to monitor the CBNAAT negative cases and to detect resistance to drugs other than Rifampicin.
Keywords: CBNAAT , Sputum Microscopy, Drug resistance.
References
- Editoreal: Recent Changes in Technical and Operational Guidelines for Tuberculosis Control Programme in India – 2016: A Paradigm Shift in Tuberculosis Control. The Journal of Association of Chest Physicians, Jan-Jun 2017 , Volume 5, Issue 1.
- R Dewan, S Anuradha, A Khanna, S Garg, S Singla, P Ish, S Agarwal,A Narayana H, M Hanif, H Singh, S Uppal. Role of cartridge-based nucleic acid amplification test (CBNAAT) for early diagnosis of pulmonary tuberculosis in HIV. JIACM 2015; 16(2): 114-7
- Monika Agrawal, Ashish Bajaj, Vinay Bhatia, Sarjana Dutt. Comparative Study of GeneXpert with ZN Stain and Culture in Samples of Suspected Pulmonary Tuberculosis.JCDR2016;10(5):9-12
- Mostaza J L, Garcia N, Fernandez S, Bahamonde A, Fuentes M I, Palomo M J. Analysis and predictor of delay in suspicion and treatment among hospitalized patients with pulmonary tuberculosis. An Med Interna. 2007; 24(10): 478-83.
- Munir M K, Anwer N, Iqbal R, Nosheen S, Rehman S, Salam A A. Comparision of Genotype MTBDRplus testing kit with conventional method for drug susceptibility testing of isoniazid and rifampicin in tuberculosis patients. Pak J Med Res. 2014; 53 (2): 25-30
- Pragya Rani, Anil Kumar Bilolikar, Vishala CSarma, Udayasri B, Sukrutha Gopal Reddy, Prasanna Lakshmi Kakarla et al. A comparative study of AFB smear and GeneXpert MTB/ RIF assay in pulmonary and extrapulmonary specimens and Detection of rifampicin resistance in a tertiary care hospital. Journal of Medical and scientific research.2017;5(4):115-120
- World Health Organization: Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: Xpert mtb/rif system. Policy statement 2011. http://whqlibdoc.who. int/publications/2011/9789241501545_eng.pdf.
- Van Rie A, Page-Shipp L, Scott L, Sanne I, Stevens W. Xpert(®) MTB/RIF for point-of-care diagnosis of TB in high-HIV burden, resource-limited countries: hype or hope? Expert Rev Mol Diagn. 2010;10(7):937–46.
- Bowles EC, Freyée B, van Ingen J, Mulder B, Boeree MJ, van Soolingen D. Xpert MTB/RIF®, a novel automated polymerase chain reaction–based tool for the diagnosis of tuberculosis. Int J Tuberc Lung Dis. 2011;15:988–89.
- Malbruny B, Le Marrec G, Courageux K, Leclercq R, Cattoir V. Rapid and efficient detection of Mycobacterium tuberculosis in respiratory and non-respiratory samples. Int J Tuberc Lung Dis. 2011;15:553–55.
- Marlowe EM, Novak-Weekley SM, Cumpio J, Sharp SE, Momeny MA, Babst A, et al. Evaluation of the Cepheid Xpert MTB/RIF assay for direct detection of Mycobacterium tuberculosis complex in respiratory specimens. J Clin Microbiol. 2011;49:1621–23.
- Miller MB, Popowitch EB, Backlund MG, Ager EP. Performance of Xpert MTB/RIF RUO assay and IS6110 real-time PCR for Mycobacterium tuberculosis detection in clinical samples. J Clin Microbiol. 2011;49: 3458–62.
- Steingart KR, Schiller I, Horne DJ, Pai M, Boehme CC, et al. Xpert MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults. Cochrane Database Syst Rev. 2014; 21(1): CD009593.
- Buchelli Rmirez H L, Gracia-Clemente M M, Alvarez-Alvarez C, Palacio-Gutierrez J J, Pando-Sandoval A,Gagatek S, Arias-Guillen M, Quenzada-Loaiza C A, Casan-Clara. Impact of the Xpert MTB/RIF molecular test on the late diagnosis of pulmonary Int J Tuberc Lung Dis. 2014;18(4): 435-37.
- Kamboj S S, Goel M M, Tandon P I. Correlation study of histopathology and bacteriology in patients of tubercular lymphadenitis.Indian J Chest Dis Allied Sci. 1994; 36: 187-91.
- Pierre Le Palud P, Cattoir V, Malbruny B, Magnier R, Campbell K, Oulkhouir Y, et al. Retrospective observational study of diagnostic accuracy of the Xpert® MTB/ RIF assay on fiberoptic bronchoscopy sampling for early diagnosis of smear-negative or sputum-scarce patients with suspected tuberculosis. BMC Pulm Med. 2014;14 (1):137.
- Lee HY, Seong MW, Park SS, Hwang SS, Lee J, Park YS, et al. Diagnostic [22] accuracy of Xpert® MTB/RIF on bronchoscopy specimens in patients with suspected pulmonary tuberculosis. Int J Tuberc Lung Dis. 2013;17(7):917–21.
- Comparison of Ziehl Neelsen Microscopy with GeneXpert for Detection of MycobacteriumTuberculosis. Muhammad Kashif Munir, Sana Rehman, Muhammad Aasim, Rizwan Iqbal,Saqib Saeed. IOSR-JDMS. 2015:14(11):56-60
- Siddiqi S. H., Ruesch-Gerdes S. MGIT procedure manual for BACTEC MGIT 960 TB system. Becton Dickinson, Franklin Lakes, NJ. 2006
- Williams D, Waguespack C, Eisenach K, Crawford J, Portaels F, Salfinger M et al. Characterization of Rifampin Resistance in Pathogenic Mycobacteria. Antimicrob Agents Chemother. 1994; 38: 2380–86.
Corresponding Author
Dr Niladri Sekhar Das
TMC and DR BRAM Teaching Hospital, Hapania Agartala, Tripura, India
Phone No 8974816077, Email This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v7i4.171
