International Journal of Health Research and Medico Legal Practice

Open Access Open Access  Restricted Access Subscription Access

Detection of Pulmonary Tuberculosis Using Cartridge Based Nucleic Acid Amplification Test (CBNAAT) and Fluorescent Microscopy


Affiliations
1 Department of Microbiology, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India
 

Background: With the advent of advanced laboratory methods for diagnosis of Pulmonary Tuberculosis (PTB), its detection now is increasingly relied upon rapid diagnostic methods like Cartridge based nucleic acid amplification test (CBNAAT) and Fluorescent Microscopy (FM). No study has been published regarding the effectiveness of CBNAAT and FM. This study aims to better the understanding of these methods for detection of PTB. The objective of the study was to compare CBNAAT and FM for detection of Mycobacterium tuberculosis (MTB) using sputum samples. Methods: A cross-sectional study was performed among 200 study population. 3 sputum samples from each patient were subjected to CBNAAT and 2 slide smears were prepared for Aura mine-O stained FM. Statistical analysis was done using SPSS 23 by Chi square test. P value less than 0.05 was taken as significant difference for this study. Result: Thirty-three (17%) patients were positive by FM and 58 (29%) by CBNAAT for MTB. Statistical analysis was done and the difference in positive yield was highly significant with P value <0.0001. Six (10%) patients were detected as Rifampicin resistance by CBNAAT out of which 2 were missed by FM. Among HIV patients 7(17%) were detected for MTB by CBNAAT and 1(2.5%) by FM. Conclusion: CBNAAT is a better method of detection as compared to FM in diagnosis of PTB.

Keywords

Gene Xpert MTB/RIF Cepheid, MDR-TB, Fluorochrome Stain, LED Fluorescent Microscope.
User
Notifications
Font Size

  • World Health Organisation. Global TB report 2015. France, World Health Organisation; 2015; 20:14-15.

  • World Health Organization. Rapid implementation of the Xpert MTB/RIF Diagnostic Test: Technical and Operational ‘‘How-to’’ Practical Considerations. Geneva, World Health Organization, 2011.

  • Rattan A, Kalia A, Ahmad N. Multidrug-resistance mycobacterium tuberculosis molecular perspective. Emerge Infect Dis 1988;4(2):195-209.

  • Cuevas LE, Al-Sonboli N, Lawson L, Yassin MA, Arbide I, Al-Aghbari N, et al. LED fluorescence microscopy for the diagnosis of pulmonary tuberculosis: a multi-country cross-sectional evaluation. PLoS Medicine 2011 Jul 12;8(7):1001-57.

  • Steingart KR, Henry M, Ng V, Hopewell PC, Ramsay A, Cunningham J, et al. Fluorescence versus conventional sputum smear microscopy for tuberculosis a systematic review. The Lancet Infectious Diseases 2006;6:570-81.

  • Laifangbam S, Singh HL, Singh NB. A comparative study of fluorescent microscopy, ziehl-neelsen staining and culture for the diagnosis of pulmonary tuberculosis. KUMJ 2009 Jul-Sep;7(27):226-30.

  • World Health Organization. Fluorescent light-emitting diode (LED) microscopy for diagnosis of tuberculosis: policy statement. Geneva, Switzerland. WHO; 2011. [cited November 30, 2017]; Available from: http://www.who.int/tb/dots/laboratory/who_policy_led_microscopy_july10.pdf

  • Supriya L, Lokhendro SH, Sulochana DK. Detection of mycobacterium tuberculosis by three methods and their correlation to chest X-ray findings and CD4 T-lymphocyte counts in human immunodeficiency virus- pulmonary tuberculosis confection. J Med Soc 2013 Sep-Dec;27(3):203-7.

  • Revised National Tuberculosis Control Programme. Manual for sputum smear fluorescence microscopy. New Delhi. Central Tb division Director General of Health Services: p.4-12. [cited November 30, 2017]; Available from https://tbcindia.gov.in/WriteReadData/l892s/7890638455Flourescence_Microscopy%20Manual.pdf

  • Reza LW, Satyanarayna S, Enarson DA, Kumar AM, Sagili K, Kumar S, et al. LED-fluorescence microscopy for diagnosis of pulmonary tuberculosis under programmatic conditions in india. PLoS One 2013 Oct 9;8(10):755-66.

  • Banada PP, Sivasubramani SK, Blakemore R, Boehme C, Perkins MD, Fennelly K, et al. Containment of bio aerosol infection risk by the xpert mtb/rif assay and its applicability to point-of-care settings. J Clin Microbiol 2010;48:3551–7.

  • Helb D, Jones M, Story E, Boehme C, Wallace E, Ho K, et al. Rapid detection of mycobacterium tuberculosis and rifampicin resistance by use of on demand, near-patient technology. J Clin Microbiol 2010 Jan; 48(1):229-37.

  • Lawn Snicol M. Xpert® mtb/rif assay: development, evaluation and implementation of a new rapid molecular diagnostic for tuberculosis and rifampicin resistance. Future Microbiology 2011;6(9):1067-82.

  • Joel N, Seye A, Ben JM. Tuberculosis among older adults – time to take notice. International J of Infectious Diseases 2015;32:135-7.

  • Navinchandra MK, Kalpana PD, Vilas RT. Increased sensitivity of sputum microscopy with sodium hypochlorite concentration technique a practical experience at rntcp centre. Lung India 2011 Jan-Mar;28(1):17–20.

  • Kaur R. Epidemiology of rifampicin resistant tuberculosis and common mutations in rpob gene of mycobacterium tuberculosis a retrospective study from six districts of punjab (India) using xpert mtb/rif assay. J Lab Physicians 2016 Jul-Dec;8(2):96-100.

  • National Aids Control Organisation. Guidelines on prevention and management of TB in PLHIV at ART Centres. Dec 2016; p. 9-10.

  • Paul WW, Richard J, Wallace JR. Sensitivity of fluorochrome microscopy for detection of mycobacterium tuberculosis versus non-tuberculosis mycobacteria. J of Clinical Microbiology April 1998. p. 1046-9.


Abstract Views: 441

PDF Views: 96




  • Detection of Pulmonary Tuberculosis Using Cartridge Based Nucleic Acid Amplification Test (CBNAAT) and Fluorescent Microscopy

Abstract Views: 441  |  PDF Views: 96

Authors

Naorem Salinita
Department of Microbiology, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India
Laifangbam Supriya
Department of Microbiology, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India
Mutum Usharani
Department of Microbiology, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India
Huidrom Lokhendro Singh
Department of Microbiology, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India

Abstract


Background: With the advent of advanced laboratory methods for diagnosis of Pulmonary Tuberculosis (PTB), its detection now is increasingly relied upon rapid diagnostic methods like Cartridge based nucleic acid amplification test (CBNAAT) and Fluorescent Microscopy (FM). No study has been published regarding the effectiveness of CBNAAT and FM. This study aims to better the understanding of these methods for detection of PTB. The objective of the study was to compare CBNAAT and FM for detection of Mycobacterium tuberculosis (MTB) using sputum samples. Methods: A cross-sectional study was performed among 200 study population. 3 sputum samples from each patient were subjected to CBNAAT and 2 slide smears were prepared for Aura mine-O stained FM. Statistical analysis was done using SPSS 23 by Chi square test. P value less than 0.05 was taken as significant difference for this study. Result: Thirty-three (17%) patients were positive by FM and 58 (29%) by CBNAAT for MTB. Statistical analysis was done and the difference in positive yield was highly significant with P value <0.0001. Six (10%) patients were detected as Rifampicin resistance by CBNAAT out of which 2 were missed by FM. Among HIV patients 7(17%) were detected for MTB by CBNAAT and 1(2.5%) by FM. Conclusion: CBNAAT is a better method of detection as compared to FM in diagnosis of PTB.

Keywords


Gene Xpert MTB/RIF Cepheid, MDR-TB, Fluorochrome Stain, LED Fluorescent Microscope.

References