scholarly journals Cartridge based nucleic acid amplification test: a sensitive diagnostic tool for tuberculosis on fine needle aspirates samples

2020 ◽  
Vol 7 (4) ◽  
pp. 1511
Author(s):  
Suwarna B. Patil ◽  
Shweta M. Dhage ◽  
Pradeep S. Umap ◽  
S. V. Ghorpade ◽  
Shyamkant Patharwat
Keyword(s):  
Nucleic Acid ◽  
Correct Diagnosis ◽  
Extrapulmonary Tuberculosis ◽  
Needle Aspiration ◽  
Epithelioid Cell ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Cross Sectional ◽  
Fine Needle ◽  
Fine Needle Aspirates

Background: The extrapulmonary tuberculosis (EPTB) is challenging to diagnose due to its pauci-bacillary nature. According to recent research, WHO recommends cartridge based nucleic acid amplification test (CBNAAT) to be used as initial diagnostic test in suspected cases of extrapulmonary tuberculosis. Aim of the present study is to assess the role of CBNAAT in comparison with cytomorphological features upon fine needle aspiration cytology (FNAC) and Ziehl-Neelson (ZN) stain in clinically suspected cases of EPTB.Methods: Present pilot study is descriptive cross-sectional study of 439 cases of clinically suspected EPTB over a period of 12 months (January 2019 to December 2019). After procedure of fine needle aspirates, smears were stained with routine H&E, papanicolaou stain and ZN stain. In the same setting, aspirate was also sent for CBNAAT. Results were obtained after detailed study.Results: Out of 439 cases, presumptive tuberculosis was diagnosed in 192 cases showing either epithelioid cell granulomas or caseous necrosis or both upon morphology, while overall 94 cases were positive on ZN stain and 146 cases were CBNAAT positive with the sensitivity of 84.04% and specificity of 80.57%.Conclusions: FNAC is the cheapest and simplest method to diagnose extrapulmonary tuberculosis, however those smears where tuberculosis cannot be diagnosed on FNAC like suppurative lesions, reactive lymphadenitis and low cellularity, CBNAAT plays a key role for the correct diagnosis thereby significantly reducing the morbidity and mortality. 

scholarly journals A Retrospective Cross-Sectional Study of the Utility of Cartridge-Based Nucleic Acid Amplification Test in Diagnosis of Pulmonary and Extrapulmonary Tuberculosis in People Living with HIV in Second Highest HIV Prevalent State in India

2021 ◽  
Author(s):  
Tade Bagbi ◽  
Ningthoukhongjam Reema ◽  
S. Bhagyabati Devi ◽  
Thangjam Gautam Singh ◽  
Mohammad Jaleel ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Cross Sectional Study ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Rifampicin Resistance ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Smear Negative

Abstract Introduction Tuberculosis (TB) in people living with human immunodeficiency virus (PLHIV) is difficult to diagnose due to fewer organisms in sputum and extrapulmonary samples. Sputum culture takes 4 to 8 weeks for growth of the mycobacteria. Delayed treatment for TB in PLHIV leads to increased mortality. This study evaluated cartridge-based nucleic acid amplification test (CBNAAT) as a diagnostic tool for diagnosis of pulmonary TB (PTB) and extrapulmonary TB (EPTB) in PLHIV in the second most HIV prevalent state in India and for comparing its efficacy between Ziehl–Neelsen (ZN) staining sputum smear–positive and sputum smear–negative TB. Methods This cross-sectional study was conducted in RIMS, Imphal, with 167 PLHIV patients, age 15 years or older, having signs and symptoms of TB. Appropriate samples for sputum microscopy and CBNAAT were sent. Conclusion The overall sensitivity of sputum smear for acid-fast bacillus (AFB) was found to be 30.71% and that of CBNAAT was 38.57%. Sensitivity of CBNAAT for sputum smear–positive and sputum smear–negative TB was 100 and 11.3%, respectively. Sensitivity of ZN smear for AFB of EPTB sample was 48.1% and that of CBNAAT was 59.25%. In both PTB and EPTB, CBNAAT showed an increase in diagnosis of microbiologically confirmed PTB cases by 7.8 and 11.1%, respectively, over and above the cases diagnosed by ZN smear microscopy. Rifampicin resistance was detected in five patients. We conclude that CBNAAT is a rapid test with better sensitivity in diagnosis of PTB and EPTB in PLHIV, compared with ZN smear microscopy. It detects rifampicin resistance for multidrug-resistant TB and helps in early treatment intervention.

Epithelioid Cell Clusters With an Extensive Lymphoid Background

2007 ◽  
Vol 131 (3) ◽  
pp. 424-433
Author(s):  
Matthew A. Zarka
Keyword(s):  
Salivary Gland ◽  
Fine Needle Aspiration ◽  
Correct Diagnosis ◽  
Diagnostic Category ◽  
Needle Aspiration ◽  
Epithelioid Cell ◽  
Common Pattern ◽  
Fine Needle ◽  
Cell Clusters ◽  
Architectural Pattern

Abstract Context.—Fine-needle aspiration of salivary gland lesions can be particularly challenging for pathologists. There are numerous neoplasms that occur in this area and several cytologic variations of each specific lesion. Objective.—To present and discuss a practical pattern recognition approach to fine-needle aspiration diagnosis, which includes categorizing lesions that share a certain overall cytologic architectural pattern, followed by identifying unique cellular characteristics that are specific to a certain lesion. An extensive discussion of one cytologic common pattern of salivary gland lesions, “epithelioid cell clusters with an extensive lymphoid background,” is presented. The pathologic entities that fall under this architectural pattern group are discussed, with an emphasis on neoplasms. Data Sources.—Published literature and personal experience. Conclusions.—A practical cytologic architectural pattern method can aid the pathologist in rendering a correct diagnosis when evaluating salivary gland lesions. One common pattern in salivary gland cytopathology is epithelioid cell clusters with an extensive lymphoid background. This pattern is often associated with Warthin tumor; however, other benign and malignant entities fall under this diagnostic group. Unique cytologic features separate these lesions into their respective diagnostic category.

Changing Clinicoradiologic Spectrum of Intracranial Neurotuberculosis in Children: A Cross-sectional Study

2020 ◽  
Vol 35 (13) ◽  
pp. 879-888
Author(s):  
Sumiti Banga ◽  
Chandrika Azad ◽  
Rekha Gupta ◽  
Nishit Sawal ◽  
Vidushi Mahajan ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Gastric Aspirate ◽  
Sectional Study ◽  
Tubercular Meningitis ◽  
Cross Sectional

Background: Neurotuberculosis is among the most severe type of tuberculosis with high mortality and morbidity in all age groups. Various sociodemographic and disease-/treatment-related factors have emerged over the years that can affect clinical and radiologic features of neurotuberculosis. Objective: To investigate various clinical and neuroradiologic presentations of neurotuberculosis. Methodology: This cross-sectional study was done in a tertiary care center of northern India. The patients between the ages of 3 months and 18 years with newly diagnosed neurotuberculosis were enrolled after taking informed consent. Results: A total of 78 patients (37% males) were enrolled. Fifty-six patients (72%) had tubercular meningitis (TBM) and 22 (28%) isolated tuberculomas. Very high percentage of patients in both the groups was BCG vaccinated. In the tubercular meningitis group, fever (68%), headache (59%), and vomiting (54%) were the most common complaints whereas in the tuberculoma group, seizures (95.5%) were the main complaint and systemic symptoms were rare. In tubercular meningitis patients, cerebrospinal fluid–based studies showed cartridge-based nucleic acid amplification test (Xpert MTB/RIF) positivity for Mycobacterium tuberculosis in 17.6% cases, whereas on gastric aspirate and sputum examination, acid-fast bacilli were seen in 30.7% and cartridge-based nucleic acid amplification test was positive in 19% patients. On neuroimaging, hydrocephalus was seen in 44.6% of tubercular meningitis patients, infarcts in 32%, and basal exudates in 12% patients only; coexistent tuberculomas were seen in 53%. Conclusion: Compared with the available literature, the present study showed a smaller percentage of children <5 years of age, stage III tubercular meningitis cases, and typical neuroradiologic findings like hydrocephalus and basal exudates and more tuberculomas associated with tubercular meningitis.

scholarly journals Prospective evaluation of BDProbeTec strand displacement amplification (SDA) system for diagnosis of tuberculosis in non-respiratory and respiratory samples

2004 ◽  
Vol 53 (12) ◽  
pp. 1215-1219 ◽  
Author(s):  
T D McHugh ◽  
C F Pope ◽  
C L Ling ◽  
S Patel ◽  
O J Billington ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Clinical Diagnosis ◽  
Nucleic Acid Amplification ◽  
Prospective Evaluation ◽  
Strand Displacement ◽  
Strand Displacement Amplification ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
Time To Diagnosis ◽  
Smear Negative

Nucleic acid amplification techniques (NAATs) have been demonstrated to make significant improvements in the diagnosis of tuberculosis (TB), particularly in the time to diagnosis and the diagnosis of smear-negative TB. The BD ProbeTec strand displacement amplification (SDA) system for the diagnosis of pulmonary and non-pulmonary tuberculosis was evaluated. A total of 689 samples were analysed from patients with clinically suspected TB. Compared with culture, the sensitivity and specificity for pulmonary samples were 98 and 89 %, and against final clinical diagnosis 93 and 92 %, respectively. This assay has undergone limited evaluation for non-respiratory samples and so 331 non-respiratory samples were tested, identifying those specimens that were likely to yield a useful result. These were CSF (n = 104), fine needle aspirates (n = 64) and pus (n = 41). Pleural fluid (n = 47) was identified as a poor specimen. A concern in using the SDA assay was that low-positive samples were difficult to interpret; 7.8 % of specimens fell into this category. Indeed, 64 % of the discrepant results, when compared to final clinical diagnosis, could be assigned as low-positive samples. Specimen type did not predict likelihood of a sample being in the low-positive zone. Although the manufacturers do not describe the concept of a low-positive zone, we have found that it aids clinical diagnosis.

scholarly journals USE OF CARTRIDGE BASED NUCLEIC ACID AMPLIFICATION TEST FOR RAPID DETECTION OF MYCOBACTERIUM TUBERCULOSIS IN PULMONARY AND EXTRAPULMONARY TUBERCULOSIS

2021 ◽  
pp. 29-33
Author(s):  
RASHMI M. KARIGOUDAR ◽  
MAHESH H. KARIGOUDAR ◽  
SANJAY M. WAVARE ◽  
LAKSHMI KAKHANDKI ◽  
SMITHA BAGALI
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Nucleic Acid ◽  
Sensitivity And Specificity ◽  
Extrapulmonary Tuberculosis ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Rifampicin Resistance ◽  
P Value ◽  
Presumptive Diagnosis ◽  
College Hospital

Objective: Tuberculosis is an airborne infection caused by Mycobacterium tuberculosis. Timely diagnosis and treatment are important to prevent the spread of infection. Cartridge-based nucleic acid amplification test (CBNAAT) provides a valuable tool in the early detection of TB. This study is undertaken to evaluate the utility of CBNAAT for the detection of MTB. Comparison of cartridge-based nucleic acid amplification testing with ZN staining. Methods: This prospective observational study was carried out in the Department of Microbiology, BLDEDU’s Shri B. M. Patil Medical College, Hospital and RC and Dr. Karigoudar Diagnostic Laboratory, Vijayapur. A total of 129 samples from patients with the presumptive diagnosis of TB based on history, clinical presentation, and radiological findings were included in the study. All samples were subjected to ZN staining, and Cartridge-based nucleic acid amplification test and data were analyzed. Results: The present study showed ZN smear positivity of 7.75% and CBNAAT positivity of 19.38%. CBNAAT sensitivity and specificity were 90% and 86.55, respectively, compared with ZN staining with a significant P value of <0.001. Conclusion: CBNAAT helps diagnose TB and detect rifampicin resistance within 2-3 h with high sensitivity and specificity. Rifampicin resistance detection is of great concern, which otherwise leads to treatment failure and on time spread of multidrug resistance TB, leading to increased morbidity and mortality.

Sign in / Sign up

Export Citation Format

Share Document