scholarly journals Bacteriological analysis of induced sputum for the diagnosis of pulmonary tuberculosis in the clinical practice of a general tertiary hospital

2009 ◽  
Vol 35 (11) ◽  
pp. 1092-1099 ◽  
Author(s):  
Sabrina Bollmann Garcia ◽  
Christiano Perin ◽  
Marcel Muller da Silveira ◽  
Gustavo Vergani ◽  
Sérgio Saldanha Menna-Barreto ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Pulmonary Tuberculosis ◽  
Diagnostic Yield ◽  
Laboratory Data ◽  
Induced Sputum ◽  
Smear Microscopy ◽  
Sputum Induction ◽  
Cross Sectional ◽  
Pulmonary Tb ◽  
Bacteriological Analysis

OBJECTIVE: To determine the diagnostic sensitivity of bacteriological analyses in induced sputum (IS) for the diagnosis of pulmonary tuberculosis (TB) and to identify the clinical characteristics associated with the confirmed diagnosis, as well as to determine the diagnostic yield of bronchoscopy carried out when IS tests negative for AFB in smear microscopy. METHODS: A retrospective, cross-sectional study of patients suspected of having active pulmonary TB and referred to our clinic for sputum induction. We consecutively reviewed the laboratory data of all patients submitted to sputum induction between June of 2003 and January of 2006, as well as their electronic medical records. In addition, the results of the bacteriological analysis of bronchoscopic specimens collected from the patients whose AFB tests were negative in IS were reviewed. RESULTS: Of the 417 patients included in the study, 83 (19.9%) presented IS samples that tested positive for TB (smear microscopy or culture). In the logistic regression analysis, radiological findings of cavitation (OR = 3.8; 95% CI: 1.9-7.6) and of miliary infiltrate (OR = 3.7; 95% CI: 1.6-8.6) showed the strongest association with the diagnosis of pulmonary TB. In 134 patients, bronchoscopy was carried out after negative AFB results in IS and added 25 (64.1%) confirmed diagnoses of pulmonary TB. CONCLUSIONS: In our clinical practice, the frequency of confirmed diagnosis of pulmonary TB using IS (19.9%) was lower than that previously reported in controlled trials. Cavitation and miliary infiltrate increase the diagnostic probability of pulmonary TB using IS. The use of bronchoscopy when IS tests negative for AFB significantly increases sensitivity in the diagnosis of pulmonary TB.

scholarly journals Role of induced sputum with hypertonic saline in the early diagnosis of no / inadequate sputum or sputum smear negative suspected cases of pulmonary tuberculosis

2017 ◽  
Vol 5 (11) ◽  
pp. 4761
Author(s):  
Mayank Kapur ◽  
Atul Luhadia ◽  
Shanti Kumar Luhadia
Keyword(s):  
Early Diagnosis ◽  
Pulmonary Tuberculosis ◽  
Hypertonic Saline ◽  
Invasive Procedure ◽  
Induced Sputum ◽  
Sputum Smear ◽  
Sputum Induction ◽  
Pulmonary Tb ◽  
Smear Negative

Background: Pulmonary Tuberculosis is one of the common infections in the world, especially in developing countries like India and is a leading cause of morbidity and mortality worldwide. Therefore, early diagnosis and microbiological confirmation of pulmonary TB is important. This study was done to assess the role of induced sputum with hypertonic saline in suspected pulmonary TB patients who produce no or inadequate sputum or who are sputum for AFB smear negative.Methods: 100 patients with clinical and radiological evidence of pulmonary TB with no or inadequate sputum or who are smear negative with spontaneous sputum were included in the study. Sputum was induced with 5ml of 3% hypertonic saline delivered through nebulizer and then was sent for Ziehl Neelsen staining examination.Results: 96 patients could produce adequate sputum after sputum induction. In 47 patients, sputum for AFB smear was found positive after induction.Conclusions: Sputum induction is a safe, cheap and non-invasive procedure and offers an alternative or additional approach in the diagnosis of sputum smear-negative suspected pulmonary tuberculosis patients and would enhance sensitivity for the diagnosis of tuberculosis. 

scholarly journals Diagnostic Accuracy of Ziehl-Neelsen Smear Microscopy in Comparison with GeneXpert in Pulmonary Tuberculosis: A Multi-Center Study in Kandahar Province, Afghanistan

2021 ◽  
pp. 1-7
Author(s):  
Mujeeb Ahmad ◽  
Muhammad Haroon Stanikzai ◽  
Najeeb Rahimy ◽  
Abdul Wahed Wasiq ◽  
Hadia Sayam
Keyword(s):  
Pulmonary Tuberculosis ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Disease Transmission ◽  
Predictive Value ◽  
Smear Microscopy ◽  
Cross Sectional ◽  
Pulmonary Tb ◽  
Kappa Value

Background: Tuberculosis (TB) is a major global health problem. The early and accurate diagnosis is crucial for disease management and to control disease transmission and the emergence of drug resistance TB. Objectives: This study was carried out to determine the diagnostic accuracy of Ziehl Neelsen (ZN) smear microscopy in comparison with GeneXpert MTB/RIF in pulmonary tuberculosis in Kandahar province, Afghanistan. Methods: This was a facility-based cross-sectional study. We scrutinized TB registers of three health facilities to include patients who had their sputum tested by both ZN smear microscopy and GeneXpert MTB/RIF. We extracted 734 patients’ data registered during January 2019 - June 2020 in a structured form. Kappa value was analyzed using SPSS version 19 software at 95% Confidence Interval (CI). We calculated sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of ZN smear microscopy against GeneXpert MTB/RIF. Results: In comparison with GeneXpert as a reference test, ZN smear microscopy has 67.7% (95% CI:63.44%-70.74%) sensitivity and 100% (95% CI:98.74%-100.00%) specificity. The positive predictive value (PPV) and negative predictive value (NPV) were 100% and 99.89% (95% CI:99.88%-99.90%), respectively. The agreement between ZN smear microscopy and GeneXpert MTB/RIF results was moderate (70.4%) and the Kappa value was 0.45 (95% CI:0.38-0.59). Conclusion: This study has found high specificity but moderate sensitivity for the diagnosis of pulmonary TB using sputum ZN smear microscopy test. Hence, GeneXpert MTB/RIF test is more accurate and reliable for the diagnosis of pulmonary TB.

scholarly journals Comparison of Led Fluorescent Microscopy and the Gene Xpert MTB/RIF Assay in Diagnosis of Pulmonary and Extrapulmonary Tuberculosis

2019 ◽  
Vol 6 ◽  
pp. 127-132
Author(s):  
Sanam Thapa Magar ◽  
Gokarna Ghimire ◽  
Pradeep Kumar Shah
Keyword(s):  
Pulmonary Tuberculosis ◽  
Extrapulmonary Tuberculosis ◽  
Fluorescent Microscopy ◽  
Cross Sectional Study ◽  
Smear Microscopy ◽  
Cross Sectional ◽  
Female Ratio ◽  
Standard Guideline ◽  
National Tuberculosis ◽  
Male To Female

Objectives: The objective of this study was to evaluate Gene Xpert MTB/RIF Assay and anid fast staining (AFB) for rapid detection of Mycobacterium tuberculosis in specimen of patients suspected of pulmonary tuberculosis (PTB) and extra pulmonary tuberculosis (EPTB). Methods: A comparative cross-sectional study of 400 samples (PTB-365 and EPTB-35) of patients visiting National Tuberculosis Centre (NTC) was conducted from July 2018 to December 2018. Gene Xpert MTB/ RIF Assay, smear microscopy were performed under standard guideline inside biosafety cabinet class II. The result obtained from both the tests were analyzed using SPSS 20.0 software and Excel 2019. Results: Of the total samples, 18% (72/400) and 39% (156/400) were positive by AFB smear microscopy and Xpert MTB/RIF assay respectively. Prevalence of MTB positive was highest in the age group 35-44 years, 33 cases (17.74%) were detected in total, with a male to female ratio of 2.3:1. Pleural fluid, pus, and CSF fluid also yielded positive results with the Gene Xpert MTB/RIF assay accounting 1.28%, 0.64% and 1.28% of MTB positive case respectively. Rifampicin resistance was observed in 1.28% of the cases. Conclusion: The key findings of this study suggest that Gene Xpert test should be implemented as primary diagnostic test for PTB and EPTB.

scholarly journals Performance of LED Fluorescence Microscopy for the Diagnosis of Pulmonary Tuberculosis in HIV Positive Individuals in Addis Ababa, Ethiopia

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Konjit Getachew ◽  
Tamrat Abebe ◽  
Abebaw Kebede ◽  
Adane Mihret ◽  
Getachew Melkamu
Keyword(s):  
Pulmonary Tuberculosis ◽  
Predictive Value ◽  
Addis Ababa ◽  
Sputum Sample ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Smear Microscopy ◽  
Lower Sensitivity ◽  
Cross Sectional ◽  
Sensitivity Specificity

Background. Despite its lower sensitivity, smear microscopy remains the main diagnostic method for pulmonary tuberculosis (PTB) in resource-limited countries as TB culturing methods like LJ (Lowenstein-Jensen) are expensive to use as a routine base. This study aimed to evaluate the performance of LED-FM for the diagnosis of PTB in HIV positive individuals.Methods. Cross-sectional study was conducted in Zewditu Memorial Hospital and Teklehaimanot Health Center HIV/ART clinics in Addis Ababa, Ethiopia. Each sample was stained with ZN and Auramine O staining and examined with bright-field microscope and LED-FM microscope, respectively. LJ culture was used as a reference.Results. Out of 178 study participants, twenty-four (13.5%) patients were confirmed as positive for MTB with LJ culture. The yield of ZN microscopy and LED-FM in direct and concentrated sample was 3.9%, 8.4%, 6.2%, and 8.4%, respectively. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of direct ZN microscopy were 29.2%, 100%, 100%, and 90.1%, respectively, and of LED-FM microscopy in direct sputum sample were 62.5%, 100%, 100%, and 94.5%, respectively.Conclusion. LED-FM has better sensitivity for the diagnosis of PTB in HIV positive individuals as compared to conventional ZN microscopy. LED-FM can be used as an alternative to conventional ZN microscopy.

scholarly journals Diagnostic challenges and Gene-Xpert utility in detecting Mycobacterium tuberculosis among suspected cases of Pulmonary tuberculosis

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251858
Author(s):  
Shaila Kabir ◽  
M. Tanveer Hossain Parash ◽  
Nor Amalina Emran ◽  
A. B. M. Tofazzal Hossain ◽  
Sadia Choudhury Shimmi
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Predictive Value ◽  
Demographic Data ◽  
Nucleic Acid Amplification ◽  
Age Group ◽  
Cross Sectional ◽  
Care Clinic ◽  
Pulmonary Tb ◽  
Smear Negative

The incidence of pulmonary tuberculosis (PTB) can be reduced by preventing transmission with rapid and precise case detection and early treatment. The Gene-Xpert MTB/RIF assay is a useful tool for detecting Mycobacterium tuberculosis (MTB) with rifampicin resistance within approximately two hours by using a nucleic acid amplification technique. This study was designed to reduce the underdiagnosis of smear-negative pulmonary TB and to assess the clinical and radiological characteristics of PTB patients. This cross-sectional study included 235 participants who went to the Luyang primary health care clinic from September 2016 to June 2017. The demographic data were analyzed to investigate the association of patient gender, age group, and ethnicity by chi-square test. To assess the efficacy of the diagnostic test, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated. The area under the curve for sputum for both AFB and gene-Xpert was analyzed to compare their accuracy in diagnosing TB. In this study, TB was more common in males than in females. The majority (50.71%) of the cases belonged to the 25–44-year-old age group and the Bajau ethnicity (57.74%). Out of 50 pulmonary TB cases (smear-positive with AFB staining), 49 samples were positive according to the Gene-Xpert MTB/RIF assay and was confirmed by MTB culture. However, out of 185 smear-negative presumptive cases, 21 cases were positive by Gene-Xpert MTB/RIF assay in that a sample showed drug resistance, and these results were confirmed by MTB culture, showing resistance to isoniazid. In comparison to sputum for AFB, Gene-Xpert showed more sensitivity and specificity with almost complete accuracy. The additional 21 PTB cases detection from the presumptive cases by GeneXpert had significant impact compared to initial observation by the routine tests which overcame the diagnostic challenges and ambiguities.

scholarly journals Profile of SGOT and SGPT levels in Patients with Pulmonary Tuberculosis

2020 ◽  
Vol 2 (1) ◽  
pp. 18-21
Author(s):  
Siti Chairini ◽  
Widodo Widodo
Keyword(s):  
Liver Injury ◽  
Pulmonary Tuberculosis ◽  
Direct Effect ◽  
Medical Records ◽  
Laboratory Data ◽  
Pulmonary Tb ◽  
Research Results ◽  
Men Elderly ◽  
Injury Research ◽  
Research Type

Liver disfunction is characterized by increased levels of SGOT and SGPT. The mechanism of liver disfunction by anti-tuberculosis drug (ATD) is not yet clearly known, but several research mention the occurrence of hepatotoxicity which caused by direct effect or through the complex production of drug enzyme which have consequences in cell disfunction as well as membrane disfunction. Hepatotoxicity due to ATD does not occur in each patient, but it could cause liver injury. research objective to find out the description of examination of SGOT and SGPT levels in patients of pulmonary tuberculosis. The research type was descriptive using medical records data and laboratory data of RSUP patients of pulmonary TB in January-March 2020. Research results : the normal SGOT levels in men 6-33 U/L as much as 63,33%, and SGOT normal 50-66 U/L as much as 2,35%. The normal SGOT levels in women 10-25 U/L as much as 25,88%, and SGOT normal in women 15-63 U/L as much as 8,24%. The normal SGPT levels in men 3-43 U/L as much as 62,35%, and SGPT normal 55-65 U/L as much as 3,53%. The normal SGPT levels in women 7-29 U/L as much as 34,12%. Hepatotoxicity based on SGOT levels as many as 9 people (10,59%), namely 2 men (elderly and old man) and 7 women (adolescent, adult, and elderly). Hepatotoxicity based on SGPT levels as many as 3 people (3,53%) in elderly and old man.

scholarly journals Hubungan Pelaksanaan Strategi Directly Observed Treatment Short Course dengan Hasil Pengobatan Tuberkulosis Paru Puskesmas Padang Pasir Kota Padang 2011-2013

2015 ◽  
Vol 4 (1) ◽  
Author(s):  
Nurmadya Nurmadya ◽  
Irvan Medison ◽  
Hafni Bachtiar
Keyword(s):  
Pulmonary Tuberculosis ◽  
Statistical Tests ◽  
Treatment Success ◽  
Study Data ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Pulmonary Tb ◽  
Results Of Treatment ◽  
The World

AbstrakTuberkulosis (TB) paru masih menjadi masalah utama kesehatan global di dunia. Pada tahun 2011, Indonesia berada di posisi keempat dengan jumlah penderita TB terbanyak di dunia. Dalam upaya penanggulangan TB, Indonesia telah mengadopsi strategi DOTS sejak tahun 1995. Berdasarkan laporan tahunan Dinas Kesehatan Kota Padang tahun 2011, angka keberhasilan pengobatan di Puskesmas Padang Pasir yaitu 71,43% dan angka ini belum mencapai target nasional. Penelitian ini bertujuan untuk mengetahui hubungan pelaksanaan strategi DOTS dengan hasil pengobatan TB paru di Puskesmas Padang Pasir Kota Padang. Jenis Penelitian ini adalah analitik dengan desain cross sectional study. Data dikumpulkan melalui wawancara kepada responden menggunakan kuisioner yang kemudian di analisis melalui uji Chi-Square. Hasil uji statistik Chi-Square menunjukkan adanya hubungan antara pelaksanaan komitmen oleh petugas kesehatan (p-value : 0,000), pelaksanaan pemeriksaan dahak (p-value: 0,005, ketersedian OAT (p-value : 0,002) dengan hasil pengobatan TB paru. Hasil uji statistik pada peranan PMO (p-value : 0,185) dan pencatatan pelaporan penderita TB paru (p-value 0,184) menunjukkan tidak terdapat hubungan dengan hasil pengobatan TB paru.Kata kunci: tuberkulosis paru, DOTS, hasil pengobatanAbstractTuberculosis (TB) remains a major problem pulmonary global health in the world. In 2011, Indonesia was in fourth position with the highest number of TB patients in the world. InTB controlefforts, Indonesia hasadopted theDOTS strategysince 1995.Based on the annual report of Padang City Health Department in 2011, the treatment success rate in Padang Pasir Health Center is 71.43% and this figure has not reached the national target. The study aims to determine the relationship implementation of the DOTS strategy with pulmonary TB treatment success in health centers Padang Padang Pasir.This type of study design was cross-sectional analytic study. Data were collected through interviews with respondents using a questionnaire which was then analyzed by chi-square test. The results of the chi -square statistical tests showed that the implementation of commitments by health workers (p - value: 0.000), the implementation of sputum examination (p - value : 0.005), availability of OAT (p - value : 0.002) have a correlation with the results of treatment of pulmonary tuberculosis . While results statistical tests on the role of the PMO (p - value : 0.185) reporting and recording of pulmonary TB patients (p– value : 0.184) showed there was no correlation with the results of treatment of pulmonary tuberculosis.Keywords: pulmonary tuberculosis, DOTS, treatment success

scholarly journals Dual-Energy Computed Tomography Lung in patients of Pulmonary Tuberculosis

2020 ◽  
Vol 10 ◽  
pp. 39
Author(s):  
Ahmad Umar Khan ◽  
Sachin Khanduri ◽  
Zikra Tarin ◽  
Syed Zain Abbas ◽  
Mushahid Husain ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Tuberculosis ◽  
Imaging Techniques ◽  
Ground Glass Opacity ◽  
Signs And Symptoms ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
High Resolution Computed Tomography ◽  
Cross Sectional ◽  
Pulmonary Tb

Objectives: The objective of this study was to characterize findings of high-resolution computed tomography (HRCT) and dual-energy CT (DECT) (80 keV, 140 keV, and mixed) in pulmonary tuberculosis (TB) patients and to compare and correlate HRCT and DECT findings. Material and Methods: This cross-sectional study was conducted on 67 patients of 18–65 years of age who were suspected cases of pulmonary TB with signs and symptoms of cough, fever, hemoptysis, sputum, night sweats, and weight loss with positive sputum AFB examinations/bronchoalveolar lavage. All the patients subjected to HRCT scan and followed with DECT scan. Comparison of various imaging techniques (DECT 80 keV, DECT 140 keV, and DECT mixed) with HRCT was done for detecting lung findings and data so obtained were subjected to statistical analysis. Results: On comparing the various imaging techniques with HRCT for detecting consolidation, tree in bud pattern, cavitary lesions, ground-glass opacity, bronchiectasis, atelectasis, nodules, granuloma, peribronchial thickening, and fibrosis, the maximum agreement of HRCT was found with DECT 80 keV and minimum agreement was found with DECT 140 keV. Conclusion: The study concluded that DECT 80 keV monochromatic reconstructions among 80 keV, mixed, and 140 keV monochromatic reconstructions in lung parenchyma window settings are a faster and better analytical tool for the assessment of findings of pulmonary TB when compared with HRCT.

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