scholarly journals Comparison of fluorescent stain and CBNAAT in sputum sample for the diagnosis of pulmonary tuberculosis

Author(s):  
Dr Manish Kumar Gupta ◽  
Dr Anil Meena
2017 ◽  
Vol 13 (1) ◽  
pp. 16-22
Author(s):  
Ashok Thapa ◽  
P Gurung ◽  
G R Ghimire

Introduction: Tuberculosis (TB) is one of the most deadly and common major infectious diseases in developing countries. Rapid and accurate diagnosis of tuberculosis is indispensable to adequately manage the disease and control its transmission. The objective of this study was to evaluate Gene Xpert MTB/RIF Assay for detection of M. tuberculosis in sputum of patients suspected of pulmonary tuberculosis and its comparison with traditional conventional methods.Methodology: A total of 138 patients sputum samples were collected and processed. Gene Xpert MTB/ RIF Assay, culture method and smear microscopy were performed under standard guideline inside biosafety cabinet class II. Data were reported, structured and analyzed using SPSS version 16.00. Study was carried out from June to November 2014.Results: Assay detected M. tuberculosis in 37 (26.81%) samples out of total 138. Of these 37, 10 and 3 were resistance and indeterminate to rifampicin respectively. Culture, Ziehl-Neelsen staining and Auramine staining were positive in 43 (31.16%), 18 (13.04%) and 24 (17.39%) samples respectively. Sensitivity, specificity, Positive predictive value and Negative predictive value of Assay were 76.74%, 95.79%, 89.19% and 90.09% respectively with reference to gold standard culture method.Conclusions: Assay was found rapid in direct detec tion of Mycobacterium tuberculosis in sputum sample and was also found more sensitive than both Ziehl-Neelsen staining and Auramine staining and especially showed good promise in diagnosis of smear negative specimens.SAARC J TUBER LUNG DIS HIV/AIDS, 2016; XIII(1), page: 16-22


2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Konjit Getachew ◽  
Tamrat Abebe ◽  
Abebaw Kebede ◽  
Adane Mihret ◽  
Getachew Melkamu

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.


Author(s):  
Abhijit Ninghot ◽  
Kanchan Mohod ◽  
Mohd. Sameer Khan ◽  
Azmat Kamal Ansari ◽  
Satish Kumar

Introduction: Pulmonary tuberculosis is major public health problem in developing countries like India.Millions of people have died from tuberculosis. Many times it is difficult to get sputum sample from the patients. Some tests lack specificity, some other lack sensitivity. Hence, there is need of precise and faster diagnosis for patients attending hospitals. In this study, we compared the detection potential of biochemical and immunological markers(ADA, LDH and Mycobacterium tuberculosis H37Ra ES-31 & EST-6 antigens & antibodies based ELISAs) in pulmonary tuberculosis. Methods: 50 pulmonary tuberculosis cases confirmed by sputum examinationfor acid fast bacilli (AFB) and 50 age and sex matched control subjects were included in this study.ADA & LDH were estimated by using commercial kits. Tubercular antigens and antibodies were detected by ELISA method. Results: SerumADA detected pulmonary tuberculosis with sensitivityand specificityof 94%. Sensitivity and specificity of serum LDH in detecting pulmonary tuberculosis was found to be 94% and 36% respectively.Serumtubercular antigens detected pulmonary tuberculosis with sensitivity and specificity of 88%. Sensitivity and specificity of serum tubercular antibodies in detecting pulmonary tuberculosis was found to be 80% and 90% respectively. Conclusion: Adenosine deaminase has better detection potential over other markers in pulmonary tuberculosis. Keywords: Adenosine deaminase, Lactate dehydrogenase, Tuberculosis antigen-antibody


2021 ◽  
Vol 8 (4) ◽  
pp. 302-307
Author(s):  
Hetvi Chawda ◽  
Chandani Surani ◽  
Sanjeev Kumar ◽  
Meghana Chauhan ◽  
Ashok Kumar Ramanuj ◽  
...  

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.


2019 ◽  
pp. 1-3
Author(s):  
B.V. Ramana* ◽  
A. Srikar ◽  
P. Prakash ◽  
Abhijit Chaudhury

Introduction: Tuberculosis is one of the oldest diseases with high morbidity and mortality. India accounts for one- fourth of the global TB burden (2.7million cases). Material and methods: A total 1056 patients were included in this study. All patients were requested to give two sputum samples, spot sputum sample (at the time of visit) and early morning sputum for mycobacterial testing. All spot samples tested with smear microscopy and Xpert MTB/Rif assay. Rifampicin resistant samples compared with conventional method. Results: Out of 1056 sputum samples GeneXpert MTB Rif assay detected positive 204 (19.3%), not detected 827 (78.31%). There is significant difference founded for positivity in spot samples and early morning sputum samples (P =0.0026). Rifampicins resistant were 8 (3.9%) andshown 100% sensitivity, specificity with Conventional method. Conclusion: For diagnosing tuberculosis and detecting Rifampicin resistance GeneXpert MTB/RIF has been especially recommended.


2018 ◽  
Vol 10 (02) ◽  
pp. 135-139
Author(s):  
T. Jaya Chandra

ABSTRACT BACKGROUND: To evaluate the efficacy of one-sputum sample two-smear approach for the diagnosis of pulmonary tuberculosis (PT). MATERIALS AND METHODS: Data from January 2012 to December 2015 were analyzed to find (1) number of smear positives (SPs) by spot (S) sample with one and two smears; (2) number of SPs by morning (M) sample with one and two smears; and (iii) number of SPs by two samples with two smears, that is, same-day (SS2) and spot morning (SM) approaches. The Chi-square test was used to evaluate the statistical difference in SP cases. RESULTS: With one-sample two-smear approach, the smear positivity (SPT) was 87% and 87.5%, for S and M samples, respectively, for Ziehl–Neelsen (ZN) staining; whereas, SPT was 96% and 97%, respectively, for S and M samples, for fluorescent staining (FS) technique. With two-sample two-smear approach, for ZN staining, SPT was 89% each and for FS technique, SPT was 97% and 99%, respectively, for SS2 and SM approaches. The difference was not statistically significant (P > 0.05) between one- and two-sample approaches in the staining techniques. CONCLUSION: Significant number of SP cases are identified by S sample two-smear approach. Thus, the World Health Organization/Revised National Tuberculosis Control Programme can initiate S sample two-smear approach for the diagnosis of PT.


2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Eva Carolina del Portillo-Mustieles ◽  
Rafael Laniado-Laborín

Background.One of the main strategies for the early detection of pulmonary tuberculosis (PTB) is through the screening of individuals with symptoms compatible with PTB. Although this is programmatic strategy for active case finding, its yield is not well known.Objective.To determine the yield of pulmonary tuberculosis active case finding through the screening of respiratory symptomatic (RS) patients at a general hospital.Methods.RS patients were defined as subjects complaining of cough and/or sputum for a period of 2 or more weeks. Outpatients and their companions were approached while they waited in the outpatient care areas of the hospital to detect RS. Two samples from different days or 2 samples taken 2 hours apart on the same day were collected.Results.122 RS patients were identified. Fifty-seven patients (46.7%) had at least one sputum sample analyzed. Three patients presented a positive smear and 2 were culture positive; neither had upper airway symptoms. None of the patients with productive cough and upper airway symptoms had a positive smear (). Only 19 (33.3%) returned to the laboratory to retrieve their results.Conclusion.Current strategy to screen RS patients based only on clinical data has a low compliance. Specific strategies to increase compliance (removal of barriers, incentives, etc.) should be implemented.


2015 ◽  
Vol 57 (6) ◽  
pp. 496 ◽  
Author(s):  
Claudia Ortiz-Rico ◽  
Cristina Aldaz ◽  
Héctor Javier Sánchez-Pérez ◽  
Miguel Martín Mateo ◽  
Natalia Romero-Sandoval

Objective. To estimate rates of cases of respiratory symptomatic subjects and the incidence rate of pulmonary tuberculosis in two border areas of Ecuador, and contrast them with official figures. Materials and methods. Cross-sectional survey in the southeastern (SEBA), and the Andean southern Ecuadorian border areas (ASBA), which were conducted, respectively, in 1 598 and 2 419 persons aged over 15 years recruited over periods of three weeks. In identified respiratory symptomatic cases, a sputum sample was taken for smear testing. The results (odds ratios and their respective 95% confidence intervals), were compared with local and national official figures using maximum likelihood contrasts. Results. The rates of respiratory symptomatic subjects (7.7% and 5.9% in the SEBA, and ASBA, respectively) and of pulmonary tuberculosis (cumulative incidence rates of 125 and 140 per 100 000 inhabitants, in the same order) were significantly greater than the official figures (of 0.98 and 0.99% for respiratory symptomatic subjects in the SEBA and ASBA, respectively; and of 38.23 per 100 000 inhabitants for pulmonary tuberculosis in Ecuador as a whole) (p<0.001). Conclusion. It is necessary to reinforce both active case finding for respiratory symptomatic subject cases, and epidemiological surveillance of pulmonary tuberculosis in Ecuadorian border regions. 


1970 ◽  
Vol 8 (2) ◽  
pp. 28-30
Author(s):  
J Kishan ◽  
P Kaur ◽  
A Mahajan ◽  
M Monika ◽  
K Navneet ◽  
...  

Introduction: Under the Revised National Tuberculosis Control Programme of India, three sputum samples are examined and 2 samples positivity criteria are used for labeling the patient as sputum positive pulmonary tuberculosis. Recent studies advocate use of two samples (one spot & one morning) for diagnosis of Tuberculosis. The objective was to compare three versus two sputum smears and to study the relevance of third sputum sample for microscopy in the current practice under Revised National Tuberculosis and Control Programme. Methodology: A study of the laboratory register of the designated microscopic centre for the calendar year 2008 was undertaken. In all 9028 suspects were examined. An analysis of contribution of various sputum samples, S1 (fi rst spot sample), M (early morning) & S2 (second spot) towards diagnosis of Pulmonary Tuberculosis was undertaken. Results: Sputum smear examination results of all the patients examined during 2008 were analyzed. Twelve hundred and eighty eight patients (99.3%) were labeled as smear positive tuberculosis when three sputum samples positivity criteria was considered. By applying two samples and any smear positivity criteria 1296 (99.9%) patients were labeled as sputum smear positive. Among 1296 smears, S1 was positive in 1088 (83.8%) and M in 1293 (99.6%) patients. Early morning sample positivity yield was found higher. Conclusion: Considering 2 samples for examination with at least one morning specimen and one sample positivity criteria, the work load on laboratory can be reduced by 1/3rd without affecting case detection rate. DOI: http://dx.doi.org/10.3126/saarctb.v8i2.5898 SAARCTB 2011; 8(2): 28-30


2020 ◽  
Vol 9 (3) ◽  
pp. 190-194
Author(s):  
Naureen Saeed ◽  
Fatima-tuz-zuhra ◽  
Nadeem Ikram ◽  
Farhana Shaukat ◽  
Fareeha Sardar

Background: Pakistan faces an immense burden of pulmonary tuberculosis (TB) due to large number of cases and limited resources. Despite the recent advancement in the diagnostic techniques for pulmonary TB, smear microscopy is still a useful technique for the diagnosis of this disease. This study was conducted in order to compare the diagnostic value of Auramine stain with the conventional Ziehl-Neelsen (ZN) stain on the sputum smear for the diagnosis of pulmonary TB, keeping GeneXpert MTB/RIF as the gold standard. Method: This cross-sectional study was conducted on 356 suspected patients of pulmonary TB referred to the Pathology laboratory from TB ward and OPD of District Head Quarter (DHQ) teaching hospital Rawalpindi, Pakistan. Sputum specimen were collected and two smears were prepared from each sputum sample on which Auramine phenol and Ziehl-Neelsen staining were carried out as per WHO recommendations. All these samples were further tested using Gene Xpert MTB/RIF technique. The sensitivity, specificity, Positive predictive value (PPV) and Negative predictive values (NPV) of ZN and Auramine stain were calculated and compared with GeneXpert MTB/RIF technique. Results: Out of the total 356 samples, 64(18%) were positive and 291(82%) were negative by GeneXpert which was taken as the gold standard. On comparison with GeneXpert, percentage of true positive was greater in case of Auramine than ZN stained samples (16.29% versus 12.92%), while the percentage of false positive was same for both staining techniques (0.28%). There were lesser false negative cases observed in samples stained by Auramine as compared to the ones stained by ZN (1.68% versus 5.05%). The sensitivity, specificity, positive predictive value and negative predictive values were 97.87%, 94.17%, 71.88 and 99.66%, respectively for the ZN staining and 98.31%, 97.98%, 90.63% and 99.66% respectively, for the Auramine phenol staining. Conclusion: Smear microscopy using Auramine phenol stain is a useful technique for the diagnosis of pulmonary TB. The Auramine phenol staining with fluorescent microscopy is found to be superior to ZN staining because of higher sensitivity and specificity. Keywords: Auramine phenol, Fluorescence microscopy, GeneXpert, Mycobacterium tuberculosis, Ziehl-Neelsen


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