Improved Diagnosis of Pulmonary Tuberculosis using Bleach (Sodium hypochlorite) Concentration Technique at Tertiary Care Hospital

Introduction: In the Revised National Tuberculosis Control Program (RNTCP), microscopic examination of sputum for acid-fast bacilli (AFB) is currently the backbone for the diagnosis of pulmonary tuberculosis. Studies have shown liquefaction and concentration of sputum by 5% sodium hypochlorite is useful in providing increased sensitivity and safety for the handling of specimens. Objective: To assess the utility of the 5% Sodium hypochlorite concentration method in increasing the sensitivity of smear microscopy for detection of AFB for diagnosis of pulmonary tuberculosis. Methods: The study included a total of 1000 sputum samples from 500 patients with suspected pulmonary tuberculosis. Direct smears were prepared from the sputum samples as per RNTCP guidelines. The remaining sputum was used for bleach concentration and smears prepared from the concentrated material. Both smears were stained by Ziehl-Neelsen staining and screened for acid-fast bacilli and graded according to the RNTCP guidelines. Results: A total of 158 samples (15.8%) from 89 patients were positive by a routine direct method whereas by concentration method 236 samples (23.6%) from 143 patients were found positive diagnosing additional 54 patients. The gain in sputum smear positivity of 7.8% over the routine method is highly significant (p=0.0000, χ2= 270) with a 10.8% increase in case detection. Conclusions: Improvement in the sensitivity of smears microscopy will be useful in case detection of tuberculosis especially in resource-poor countries. The increased positivity of microscopy by bleach method indicates that would prove useful if included in the RNTCP to improve case detection. Keywords: Concentration; smear positivity; sodium hypochlorite; tuberculosis.

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Comparison between ziehl-neelsen staining and fluorescent staining of sputum samples to detect acid fast bacilli in suspected case of pulmonary tuberculosis at tertiary care hospital, Amreli, Gujarat

Indian Journal of Microbiology Research ◽

10.18231/j.ijmr.2021.061 ◽

2021 ◽

Vol 8 (4) ◽

pp. 302-307

Author(s):

Hetvi Chawda ◽

Chandani Surani ◽

Sanjeev Kumar ◽

Meghana Chauhan ◽

Ashok Kumar Ramanuj ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Tertiary Care ◽

Early Morning ◽

Causative Organism ◽

Sputum Smear ◽

Suspected Case ◽

Care Hospital ◽

Fluorescent Staining ◽

Acid Fast Bacilli ◽

Fluorescent Stain

In India, Tuberculosis (TB) is one of the major community health problems.Pulmonary tuberculosis (PTB) is a respiratory disease. Causative organism for this is acid fast bacilli known as . It is the most ordinary disease affecting the lower socio-economic class in developing countries. Microbiological diagnosis is the heart for the effective treatment of pulmonary TB (PTB). The look forrapid and efficient method has resulted in several staining techniques. Objective of the study was to compare the results of ZN stain (RNTCP) with fluorescent stain by use of microscopy. The study was carried out in Microbiology Department, SMCGH, Amreli. 350 sputum samples (Spot and early morning sample) collected from 175 suspected case of the pulmonary tuberculosis. All 350 samples were processed by ZN stain and Fluorescent stain to detect acid fast bacilli. By use of microscope, the results of the stained smears were given according to RNTCP guideline.Out of 350 sputum smears, 52 (14.85%) and 61 (17.4%) were positive by ZN and FM staining respectively. Males are predominantly affected than females. Majority of the patients were in age above 50 years. Early morning samples were more reliable than spot samples for detection of acid fast bacilli for ZN stain, but not for fluorescent stain.Fluorescent staining with LED microscopy was more efficient than ZN staining for detection of acid fast bacilli from sputum smear.

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Concordance of two sputum smear microscopy for diagnosis of presumptive pulmonary tuberculosis in a tertiary care hospital

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20173152 ◽

2017 ◽

Vol 4 (8) ◽

pp. 2686

Author(s):

Star Pala ◽

Kyrshan G. Lynrah

Keyword(s):

Pulmonary Tuberculosis ◽

Tertiary Care Hospital ◽

Sputum Sample ◽

Tertiary Care ◽

Positive Sample ◽

Sputum Smear ◽

Smear Microscopy ◽

Care Hospital ◽

Sputum Smear Microscopy ◽

Tuberculosis Case

Background: Under revised National tuberculosis control program two sputum samples are to be collected for diagnosis of presumptive pulmonary tuberculosis case. The objective of this study is to find the concordance of both sputum smear microscopy samples at a tertiary care hospital. Methods: Hospital based record was collected from designated microscopy center laboratory register. The data collected were from January 2015 to November 2016. Results: A total of 2117 paired of sputum sample were collected for the year 2015-16 in one of the DMC of a tertiary care hospital. A total of 183 patient (at least one sputum sample) were positive (8.64%) and 1934 were both negative. Among the positive sample concordance for both spot and morning samples were 89% (163/183) and discordance where spot sample positive and morning sample negative was 4.91% (9/183) and where spot sample negative and morning sample positive was 6.01% (11/183). Overall discordance between spot and morning samples were only 0.94% (20/2117). Conclusions: There is a good concordance of two sputum samples. Discordance of two sputum samples were <1% in a tertiary care hospital. One sample may be sufficient for operational purpose for diagnosis of pulmonary Tb. But to have a robust recommendation a RCT will be required to see the extent of discordance by ruling out bias in sputum smear examination.

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Case-Detection Rate of Direct Sputum Smear Microscopy for Diagnosis of Pulmonary Tuberculosis in Abia State, Nigeria

African Journal of Clinical and Experimental Microbiology ◽

10.4314/ajcem.v15i2.9 ◽

2014 ◽

Vol 15 (2) ◽

pp. 109

Author(s):

EO Ekundayo ◽

SD Abbey ◽

O Okorie

Keyword(s):

Pulmonary Tuberculosis ◽

Detection Rate ◽

Sputum Smear ◽

Smear Microscopy ◽

Case Detection ◽

Sputum Smear Microscopy ◽

Case Detection Rate

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THE IMPORTANCE OF CHEST-X-RAY (TIMIKA SCORE) TO PREDICT THE CLINICO-BACTERIOLOGICAL PROFILE OF PULMONARY TUBERCULOSIS PATIENTS

10.36106/ijar/8602284 ◽

2021 ◽

pp. 55-58

Author(s):

Surinder Pal Singh ◽

Harjinder Singh ◽

Komal Deep Kaur ◽

Kailash Meena ◽

Ashish Shukla ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Tertiary Care ◽

Clinical Signs ◽

Sputum Smear ◽

Karnofsky Performance Score ◽

Care Hospital ◽

Duration Of Symptoms ◽

Cavitary Lesion ◽

X Ray ◽

Chest X Ray

Introduction: Chest x-ray (CXR) is the primary modality for diagnosis and severity assessment and monitoring the ATT response in pulmonary tuberculosis (PTB). The aim of our study was to determine the correlation between the radiographic involvement of disease on CXR based on Timika CXR score with the clinically and bacteriological specications at diagnosis and initiation of ATT in sputum smear-positive PTB patients. Material And Method: A cross-sectional study was conducted in the Department of Pulmonary Medicine, a tertiary care hospital, Punjab, from January to June 2020. Seventy new sputum smear-positive cases of PTB were included. At the time of diagnosis, the patient's baseline test, clinical signs and symptoms were evaluated using TB scores I, II, Karnofsky performance score (KPS), and body mass index (BMI). Two chest physicians, according to the Timika CXR score, evaluated the CXR of each patient Independently. Result: Cavitary lesion on CXR resulted in a signicantly higher Timika score associated with higher Mycobacterial load in sputum grading compared to non-cavitary disease. 55.17% of patients with CXR score ≥71 had statistically signicant higher baseline sputum grading compared to 9.76% of patients with CXR ≤ 71. Higher Timika CXR score ≥ 71 was signicantly associated with a longer mean duration of symptoms, lower BMI, higher TB score, lower KPS at baseline, higher ESR, low hemoglobin, low serum albumin. Discussion: The study shows that Timika CXR score signicantly correlates with radiographic involvement and extent of disease severity on CXR with the clinically and bacteriological prole of PTB patients, which a pulmonologist can use in a medical practice. A Higher CXR Timika score is associated with the patient's poor clinical condition and the severity of the disease. Cavitary lesion on CXR associated with higher sputum smear grading. It is observed that the Timika CXR score can be used to identify the PTB patients at risk of treatment failure for their more aggressive management.

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DIAGNOSTIC PERFORMANCE OF ZIEHL-NEELSEN & CBNAAT TECHNIQUES IN PULMONARY TUBERCULOSIS, A RETROSPECTIVE ANALYSIS AT TERTIARY CARE HOSPITAL IN JHALAWAR, RAJASTHAN.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i1.1633 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Shilpi Hora ◽

Neeraj Raman ◽

Mukesh Kumar ◽

Needa Saneef

Keyword(s):

Pulmonary Tuberculosis ◽

Tertiary Care Hospital ◽

Point Of Care ◽

Tertiary Care ◽

Nucleic Acid Amplification ◽

Smear Microscopy ◽

Care Hospital ◽

Age Group ◽

Hands On ◽

High Incidence

Introduction: Tuberculosis (TB) remains a leading cause of death among infectious diseases worldwide. The advent of the CBNAAT was a revolution in the diagnosis of tuberculosis, especially with high incidence and resource poor regions. It can be used close to the point of care by operators with minimal technical expertise, enabling diagnosis of TB and rifampicin Resistance (RIF) concurrently using unprocessed clinical specimens, in less than 2h. Aim: To evaluate the diagnostic performances of Ziehl-Neelsen & CBNAAT techniques in detection of Pulmonary Tuberculosis. Materials and Methods: We retrospectively reviewed the 2414 sputum samples of suspected pulmonary TB. Sputum samples were subjected for ZN staining and CBNAAT.RIF resistance was detected by CBNAAT. Results: Out of 2414 samples, 751 sputum samples were positive by smear microscopy. 1127 Samples were confirmed positive by CBNAAT examination. Majority of cases, 43.57% were in 21-40 yrs age group.24.40% were females and 75.59% were males. Sensitivity of CBNAAT was 100% for sputum positive cases and sensitivity was 22.6% for sputum negative cases. Overall RIF resistance was detected in 49 (4.4%) cases in present study. Conclusion: CBNAAT provide sensitive detection of tuberculosis and rifampicin resistance directly from untreated sputum in less than 2 hours with minimal hands-on time. Keywords: Cartridge-based nucleic acid amplification tests (CBNAAT), Rifampicin(RIF)

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Magnetic Nanoparticle-Based Biosensing Assay Quantitatively Enhances Acid-Fast Bacilli Count in Paucibacillary Pulmonary Tuberculosis

Biosensors ◽

10.3390/bios8040128 ◽

2018 ◽

Vol 8 (4) ◽

pp. 128 ◽

Cited By ~ 3

Author(s):

Cristina Gordillo-Marroquín ◽

Anaximandro Gómez-Velasco ◽

Héctor Sánchez-Pérez ◽

Kasey Pryg ◽

John Shinners ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Magnetic Nanoparticle ◽

Sputum Sample ◽

Sputum Smear ◽

Smear Microscopy ◽

Tb Control ◽

Control Programs ◽

Acid Fast Bacilli ◽

Functionalized Magnetic Nanoparticles ◽

Colorimetric Biosensing

A new method using a magnetic nanoparticle-based colorimetric biosensing assay (NCBA) was compared with sputum smear microscopy (SSM) for the detection of pulmonary tuberculosis (PTB) in sputum samples. Studies were made to compare the NCBA against SSM using sputum samples collected from PTB patients prior to receiving treatment. Experiments were also conducted to determine the appropriate concentration of glycan-functionalized magnetic nanoparticles (GMNP) used in the NCBA and to evaluate the optimal digestion/decontamination solution to increase the extraction, concentration and detection of acid-fast bacilli (AFB). The optimized NCBA consisted of a 1:1 mixture of 0.4% NaOH and 4% N-acetyl-L-cysteine (NALC) to homogenize the sputum sample. Additionally, 10 mg/mL of GMNP was added to isolate and concentrate the AFB. All TB positive sputum samples were identified with an increased AFB count of 47% compared to SSM, demonstrating GMNP’s ability to extract and concentrate AFB. Results showed that NCBA increased AFB count compared to SSM, improving the grade from “1+” (in SSM) to “2+”. Extending the finding to paucibacillary cases, there is the likelihood of a “scant” grade to become “1+”. The assay uses a simple magnet and only costs $0.10/test. NCBA has great potential application in TB control programs.

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Cavities Herald Persistent Sputum Positivity

10.21203/rs.3.rs-324393/v1 ◽

2021 ◽

Author(s):

Nadia Jawad ◽

Nausheen Saifullah ◽

Naseem Ahmed ◽

Saira Jafri

Keyword(s):

Pulmonary Tuberculosis ◽

Medical Center ◽

Tertiary Care ◽

National Policy ◽

Cross Sectional Study ◽

Tuberculosis Patient ◽

Sputum Smear ◽

Care Hospital ◽

Cross Sectional ◽

Directly Observed Treatment

Abstract Aim: To determine the factors associated with persistent sputum positivity at the end of two months of treatment in patients presenting with (drug-susceptible) pulmonary tuberculosis at a tertiary care hospital in Karachi.Setting: A cross-sectional study was conducted at the Department of Chest Medicine (Ward 12), Jinnah Postgraduate Medical Center (JPMC), Karachi over six months.Methods:A sample of 73 consenting, newly diagnosed, smear positive drug-susceptible pulmonary tuberculosis patients was studied. Demographic (age, gender, height, weight and duration of tuberculosis, body mass index (BMI), socioeconomic, occupational, marital, educational and residential statuses) and clinical factors (chest X-ray extent and cavities, initial smear results, diabetic and smoking statuses) which may be associated with sputum non-conversion were entered in a proforma. Patients were followed up at two months of treatment with a sputum smear. Data analysis was done on SPSS-20.0.Results:Rate of sputum positivity after two months of treatment was 17.8%. None of the factors was associated with persistence of sputum positivity except for the presence of chest radiograph (CXR) cavities; which made it 5.5 times more likely that the patient would remain smear-positive at two months (p=0.035).Conclusion:The finding of CXR cavities makes it highly likely that a pulmonary tuberculosis patient may remain infectious or have an unfavourable outcome despite taking treatment for 2 months. Clinicians and national policy-makers should thus bear in mind the implications this can have with regard to disease control and pay particular attention in terms of stringent monitoring and Directly Observed Treatment Short-course (DOTS) provision.

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