scholarly journals ENHANCED DIAGNOSTIC YIELD OF AURAMINE-O STAINING AND MYCOBACTERIA GROWTH INDICATOR TUBE OVER ZIEHL-NEELSEN STAINING AND LOWENSTEIN JENSEN MEDIA IN EXTRA-PULMONARY TUBERCULOSIS

2014 ◽  
Vol 3 (28) ◽  
pp. 7787-7791
Author(s):  
Kawal Preet Kaur ◽  
Bharti Arora
Keyword(s):  
Pulmonary Tuberculosis ◽  
Diagnostic Yield ◽  
Extra Pulmonary Tuberculosis ◽  
Indicator Tube ◽  
Lowenstein Jensen ◽  
Auramine O ◽  
Extra Pulmonary ◽  
Growth Indicator

scholarly journals An Early Morning Sputum Sample Is Necessary for the Diagnosis of Pulmonary Tuberculosis, Even with More Sensitive Techniques: A Prospective Cohort Study among Adolescent TB-Suspects in Uganda

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Willy Ssengooba ◽  
David P. Kateete ◽  
Anne Wajja ◽  
Eric Bugumirwa ◽  
Gerald Mboowa ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Sputum Sample ◽  
Early Morning ◽  
Sputum Culture ◽  
World Health ◽  
Smear Microscopy ◽  
Indicator Tube ◽  
Lowenstein Jensen ◽  
Health Organization ◽  
Growth Indicator

The World Health Organization (WHO) recommends collection of two sputum samples for tuberculosis (TB) diagnosis, with at least one being an early morning (EM) using smear microscopy. It remains unclear whether this is necessary even when sputum culture is employed. Here, we determined the diagnostic yield from spot and the incremental yield from the EM sputum sample cultures among TB-suspected adolescents from rural Uganda. Sputum samples (both spot and early-morning) from 1862 adolescents were cultured by the Lowenstein-Jensen (LJ) and Mycobacterium Growth Indicator Tube (MGIT) methods. For spot samples, the diagnostic yields for TB were 19.0% and 57.1% with LJ and MGIT, respectively, whereas the incremental yields (not totals) of the early-morning sample were 9.5% and 42.9% (P<0.001) with LJ and MGIT, respectively. Among TB-suspected adolescents in rural Uganda, the EM sputum culture has a high incremental diagnostic yield. Therefore, EM sputum in addition to spot sample culture is necessary for improved TB case detection.

scholarly journals Comparison of diagnostic yield of GeneXpert MTB/RIF assay and ZN (Ziehl-Neelsen) staining in serosal fluids from HIV and non-HIV patients with extra-pulmonary tuberculosis

2017 ◽  
Vol 5 (7) ◽  
pp. 2952
Author(s):  
Mahim Mittal ◽  
Ritesh Kumar
Keyword(s):  
Pulmonary Tuberculosis ◽  
Clinical Diagnosis ◽  
Ascitic Fluid ◽  
Diagnostic Tool ◽  
Clinical Presentation ◽  
Diagnostic Yield ◽  
Extrapulmonary Tuberculosis ◽  
Hiv Patients ◽  
Extra Pulmonary Tuberculosis ◽  
Extra Pulmonary

Background: India accounts for 23% of the global TB burden and of these 15-20% are extrapulmonary tuberculosis(EPTB). EPTB has diverse clinical presentation and often is over diagnosed because of lack of standardised diagnostic means. Yield of acid fast bacilli (AFB) from EPTB settings is very low and alternate facilities are nearly non-existent routinely. GeneXpert MTB/RIF has been recommended as a diagnostic tool for sputum samples. It has been also recommended for serosal fluids from HIV patients only. This study was done to compare the yield of GeneXpert MTB/RIF assay and ZN (Ziehl Neelsen) staining among HIV and non-HIV patients with suspected serosal TB.Methods: GeneXpert MTB/RIF assay and ZN staining was done in all serosal fluid samples in which a clinical diagnosis of serosal TB had been made by conventional methods.Results: A total of 81 extra pulmonary samples (21 from HIV and 60 from non-HIV patients) were processed in this study, which included 48 CSF, 19 pleural fluids and 14 ascitic fluid. Out of these, 34.5% (28/81) patients were both GeneXpert MTB/RIF as well as ZN stain positive whereas only 13.58%(11/81) patients were ZN stain positive. 4/21 (19.05%) samples from HIV patients were ZN stain positive and 9/21(42.85%) were GeneXpert positive. 7/60 (11.66%) samples from non-HIV patients were ZN stain positive and 19/60 (31.66%) were GeneXpert positive.Conclusions: GeneXpert MTB/RIF is more sensitive than ZN staining in EPTB. The yield in both HIV and non-HIV patients is the same.

scholarly journals Comparison of BACTEC MGIT with conventional methods for detection of Mycobacteria in clinically suspected patients of extra pulmonary tuberculosis in a tertiary care hospital

2017 ◽  
Vol 5 (8) ◽  
pp. 3530
Author(s):  
Deepali Saini ◽  
Amit Singh ◽  
Adesh Kumar ◽  
Rajani Rawat ◽  
Rajesh K. Verma ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Tertiary Care ◽  
Positive Culture ◽  
Public Health Problem ◽  
Contamination Rate ◽  
Care Hospital ◽  
Important Public Health Problem ◽  
Extra Pulmonary Tuberculosis ◽  
Lowenstein Jensen ◽  
Extra Pulmonary

Background: Tuberculosis is an important public health problem in India and globally.  Extra pulmonary tuberculosis (EPTB) constitutes for approximately 15 to 20 per cent of all cases of tuberculosis in immunocompetent patients and accounts for more than 50 per cent of the cases in HIV- positive individuals. Main problem with the extra-pulmonary tuberculosis is the paucibacillary nature of the specimen, which makes the diagnosis difficult and delay the treatment. With this in background, this study aimed at the isolation of Mycobacteria from clinical specimens of patients suspected of extra pulmonary tuberculosis using BACTEC MGIT, Lowenstein Jensen (LJ) media and direct acid-fast bacilli smear examination.Methods: A total of 66 samples were processed for direct AFB smear examination, and culture on MGIT and LJ media. Acid fast staining of the specimens was done using the Ziehl-Neelsen method.Results: Among 66 specimens, MGIT gave a higher yield of mycobacteria (46.9%), lower contamination rate (3%) and shorter time to positive culture as compared to LJ media.Conclusions: MGIT gives higher yield and faster results.

CORRELATION OF CYTOMORPHOLOGY WITH ZN AND AR POSITIVITY ON FNAC IN THE DIAGNOSIS OF EXTRA PULMONARY TUBERCULOSIS

2021 ◽  
pp. 7-8
Author(s):  
Sana Umar ◽  
Syed Shamshad Ahmad ◽  
Kafil Akhtar ◽  
Zuber Ahmad
Keyword(s):  
Pulmonary Tuberculosis ◽  
Diagnostic Yield ◽  
Extrapulmonary Tuberculosis ◽  
Invasive Procedure ◽  
Epithelioid Cell ◽  
Chi Square ◽  
Extra Pulmonary Tuberculosis ◽  
Epithelioid Cell Granuloma ◽  
Extra Pulmonary ◽  
Low Sensitivity

BACKGROUND: FNAC is a minimally invasive procedure with a signicant diagnostic role in extrapulmonary tuberculosis. ZN Stain for demonstration of mycobacterium tuberculosis is extensively used. However, it has low sensitivity. Fluorochrome stain like Auramine- Rhodamine (AR) appear to be more likely to detect tubercular bacilli than ZN stain and also reduces the examination time. To study the OBJECTIVES: correlation of cytomorphology of extrapulmonary tuberculosis(EPTB) obtained on FNAC with ZN and AR positivity. MATERIALMETHODS: A total of 250 patients were taken, that were referred to the Department of Pathology, Jawaharlal Nehru Medical College, AMU, Aligarh from October 2015 to November 2017. Samples were collected by FNA and smears prepared were stained with H&E, ZN and AR stain. Smears were observed for positivity of Acid Fast Bacilli (AFB). Culture was taken as gold standard. RESULTS: The most common site of extra pulmonary tuberculosis was cervical lymph node seen in 76.4% cases and the most common cytomorphological pattern on FNAC was epithelioid cell granuloma with necrosis seen in 86.4% cases. The sensitivity of AR stain in picking up AFB was found to be 63.4% and the specicity was 81.9%, whereas ZN stain had a low sensitivity of 45.3% but had a high specicity of 87.9%. Statistically signicant difference between the two stains was seen on applying chi square test (p<0.001). Cohen's kappa coefcient for ZN vs AR stain was 0.65 and the strength of agreement between the two stains was substantial CONCLUSION: AR stain is more sensitive than ZN stain in diagnosing extrapulmonary tuberculosis and on combining it with cytomorphology it can help increase the diagnostic yield.

scholarly journals Performance of Xpert® MTB/RIF among tuberculosis outpatients in Lilongwe, Malawi

2017 ◽  
Vol 6 (2) ◽  
Author(s):  
Tarsizio Chikaonda ◽  
Nelson Nguluwe ◽  
Brian Barnett ◽  
Runa H. Gokhale ◽  
Robert Krysiak ◽  
...  
Keyword(s):  
Predictive Value ◽  
Diagnostic Yield ◽  
Fluorescent Microscopy ◽  
Cross Reactivity ◽  
Smear Microscopy ◽  
Indicator Tube ◽  
Or Groups ◽  
Lowenstein Jensen ◽  
Culture Positive ◽  
Growth Indicator

Background: Xpert® MTB/RIF is a molecular test for the detection of Mycobacterium tuberculosis and rifampicin resistance. It is considered to be a great advance over smear microscopy and culture. However, there is very little information regarding the performance characteristics of Xpert MTB/RIF in Malawi.Objective: We aimed to evaluate the performance of Xpert MTB/RIF in a Malawian setting.Methods: Stored sputum pellets were processed on Xpert MTB/RIF between June 2012 andMay 2014. Results were compared to mycobacteria growth indicator tube and Löwenstein-Jensen cultures, LED fluorescent microscopy and GenoType® MTBDRplus assay. Rifampicinresistance was confirmed by DNA sequencing.Results: Of the 348 specimens with valid Xpert MTB/RIF results, 129/348 (37%) were smearpositive and 198/348 (57%) were culture-positive. Xpert MTB/RIF demonstrated a sensitivity of 93.8% (95% CI 89.4% – 96.8%) and specificity of 97.4% (95% CI 93.5% – 99.3%), with a positive predictive value of 97.8% (95% CI 94.6% – 99.4%) and a negative predictive value of 92.6% (95% CI 87.4% – 96.1%). Xpert MTB/RIF correctly identified 185/186 (99.5%) rifampicin sensitive and 2/2 (100%) rifampicin-resistant M. tuberculosis strains. Mutations were notdetected by sequencing in one isolate which was rifampicin resistant on Xpert MTB/RIF butsensitive on MTBDRplus. Four non-tuberculous mycobacteria grew from four smear-negativespecimens, namely, M. avium (n = 1) and M. intracellulare (n = 3). No cross-reactivity wasobserved with any of the non-tuberculous mycobacteria when using Xpert MTB/RIF.Conclusion: When fully implemented, Xpert MTB/RIF may have an impact on patient care inMalawi. The increased diagnostic yield of Xpert MTB/RIF over smear microscopy can increaselaboratory-confirmed tuberculosis detection and ensure that treatment is given to appropriateindividuals or groups.

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