scholarly journals Prevalence of Extrapulmonary Tuberculosis in Newly Registered HIV Patients

2020 ◽  
Vol 07 (04) ◽  
pp. 7-10
Author(s):  
Kuldeep Kumar ◽  
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
Nucleic Acid Amplification ◽  
Rifampicin Resistance ◽  
Diagnostic Challenge ◽  
Hiv Patients ◽  
Case Record ◽  
Extra Pulmonary Tuberculosis ◽  
Time Period ◽  
Immunodeficiency Virus ◽  
High Positive Predictive Value

Introduction: Human Immunodeficiency Virus infection and Tuberculosis are among the ten leading causes of death worldwide. In advanced AIDS, M. tuberculosis frequently causes disseminated Extra-Pulmonary Tuberculosis (EPTB). EPTB being paucibacillary infection poses a diagnostic challenge. The emergence of Cartridge Based Nucleic Acid Amplification Test (CBNAAT) has marked an important development in the field of rapid molecular diagnostics of tuberculosis. Aims and Objective: The purpose of this study was to determine the prevalence of EPTB in newly registered HIV patients visiting ART clinic and to find the prevalence of Rifampicin resistance using CBNAAT. Materials and Method: 213 newly registered HIV patients were included in the study recruited over 10 months time period and followed up for six months from recruitment. Case record of each patient with detailed history, clinical examination and necessary blood, radiological and specimen sampling done to investigate for tuberculosis was maintained. The data obtained were analyzed using SPSS 20.0 software. Result: The prevalence of EPTB in newly registered HIV patients was found to be 14.5%, with abdomen being the most common site for EPTB. Rifampicin resistance was seen in 3.2% cases. Conclusion: The result of this study showed that the prevalence of EPTB was higher compared to PTB in HIV patients. CBNAAT sensitivity for different samples were variable. This study showed maximum sensitivity of CBNAAT for lymph node aspirate (100%) and minimum for CSF (0%). Overall the sensitivity of CBNAAT was low, yet it is a very useful investigation for detection of EPTB with high positive predictive value.

scholarly journals Utility of cartridge based nucleic acid amplification test in the diagnosis of extra pulmonary tuberculosis

2019 ◽  
Vol 6 (6) ◽  
pp. 1801
Author(s):  
Mahesh Chand Bairwa ◽  
Mahendra Kumar Banera ◽  
Chandan Mal Fatehpuria
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Nucleic Acid ◽  
Pulmonary Tuberculosis ◽  
Pleural Fluid ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
World Health ◽  
Rifampicin Resistance ◽  
Extra Pulmonary Tuberculosis ◽  
Extra Pulmonary

Background: Tuberculosis is one of the top 10 cause of death globally. Extra-pulmonary tuberculosis is an important clinical problem. Extra-pulmonary tuberculosis range from 30%-53% in India. Diagnosis of extra-pulmonary tuberculosis is still challenging despite many investigations. World Health Organization recommends Gene-Xpert Mycobacterium Tuberculosis/Rifampicin (Cartridge Based Nucleic Acid Amplification Test-CBNAAT) over conventional tests for diagnosis of extra-pulmonary tuberculosis which permits rapid tuberculosis diagnosis through detection of the genetic sequence of DNA of mycobacterium tuberculosis and simultaneous identification of a majority of the mutations that confirm Rifampicin resistance which is highly predictive of multi-drug resistant tuberculosis.Methods: Study was carried out over a period of one year.  Patients with suggestive of extra-pulmonary tuberculosis were included in study. Diagnosis of extra-pulmonary tuberculosis carried out by clinical, radiological, biochemical analysis, cytological, bacteriological confirmation. Based on mycobacterium tuberculosis result, the study population were divided into ‘Mycobacterium Tuberculosis detected’ and ‘Mycobacterium Tuberculosis not detected’ groups. Mycobacterium Tuberculosis detected group was further divided into ‘Rifampicin resistant’ and ‘Rifampicin sensitive’.Results:  Total 220 patients were included. Among extra-pulmonary tuberculosis, there were 83.64% were pleural fluid. 65.91% patients where be <45 years of age. Mostly patients were from rural areas and illiterate. Diabetes Mellitus found as the most common co-morbidities. CB-NAAT was able to detect mycobacterium tuberculosis in 35% (77) extra-pulmonary samples, out of which 6 were rifampicin resistant. Out of 184 samples of pleural fluid, 53 were rifampicin sensitive and 4 were found rifampicin resistant.Conclusions: CB-NAAT has to be endorsed in every health care centres as the test gives rapid result and also detection of rifampicin resistance which is the major concern for every clinician.

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.

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 Role of CB-NAAT in diagnosing extra pulmonary tuberculosis in correlation with FNA in a tertiary care center

2018 ◽  
Vol 6 (12) ◽  
pp. 4039 ◽  
Author(s):  
Sunil Kumar Komanapalli ◽  
Uma Prasad ◽  
Bhagyalakshmi Atla ◽  
Vasundhara Nammi ◽  
Divya Yendluri
Keyword(s):  
Pulmonary Tuberculosis ◽  
Light Emitting Diode ◽  
Care Center ◽  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
Nucleic Acid Amplification ◽  
Extra Pulmonary Tuberculosis ◽  
Granulomatous Lymphadenitis ◽  
Extra Pulmonary

Background: The diagnosis of extra-pulmonary tuberculosis (EPTB) is challenging due to the pauci-bacillary nature of disease. Recently, WHO recommends GeneXpert/CBNAAT to be used as the initial diagnostic test in patients suspected extra-pulmonary tuberculosis (EPTB). The study was done to assess the role of Cartridge Based Nucleic Acid Amplification Test (CB-NAAT) in the diagnosis of EPTB. Aims and objectives was to study the role of FNAC, CBNAAT and Fluorescent LED in diagnosing extra-pulmonary tuberculosis (EPTB).Methods: This is a descriptive observational study carried out over a period of 12 months (April 2017 to March 2018) at department of Pathology, Andhra Medical College. All presumptive cases of extrapulmonary tuberculosis and purulent aspirates from the various sites between the age group of <10yrs to 60 years of age were included in the study. FNA was done and material sent to CBNAAT and fluorescent LED (Light-emitting Diode) microscopy in all the cases and results tabulated.Results: The total number of cases with presumptive extra pulmonary Tb were 289. Majority of the aspirates are from lymph nodal and cervical swellings 94.1% (272/289). CBNAAT has detected 6.5 % of cases (19/289) which were not detected by FNA and 9.3% of cases (27/289) LED negative cases. Resistant to rifampicin was identified in 2.1% (3/142 cases) of CBNAAT positive cases.Conclusions: FNA still remains the cheapest test to diagnose TB. In cases with Granulomatous lymphadenitis and purulent aspirates CBNAAT has an important role in diagnosing EPTB. In addition it offered rapid detection of rifampicin-resistant M. tuberculosis strains which is an added advantage.

scholarly journals Lymphogranuloma venereum – the first Hungarian cases

2015 ◽  
Vol 156 (1) ◽  
pp. 36-40
Author(s):  
András Bánvölgyi ◽  
Eszter Balla ◽  
Péter Bognár ◽  
Béla Tóth ◽  
Eszter Ostorházi ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Western Europe ◽  
Lymphogranuloma Venereum ◽  
Nucleic Acid Amplification ◽  
Diagnostic Challenge ◽  
Transmitted Infection ◽  
Rectal Pain ◽  
Urethral Discharge ◽  
Immunodeficiency Virus ◽  
Sex With Men

Lymphogranuloma venereum is a sexually transmitted infection caused by the Chlamydia trachomatis serovars L1–3. It has been found to be endemic in tropical countries. In the last decades several cases have been reported in Western Europe, particularly in men who have sex with men population infected with human immunodeficiency virus. The authors present three cases of lymphogranuloma venereum infections, observed at their department in 2013 and 2014. The three human immunodeficiency virus infected patients who belonged to men who have sex with men population had casual sexual contacts in Western Europe. The symptoms included urethral discharge, discomfort and inguinal lymphadenomegaly in two patients, and rectal pain, discharge and perianal ulceration in one patient. The diagnosis was confirmed by nucleic acid amplification test performed in samples obtained from urethral discharge and exudate of perianal ulcer; lymphogranuloma venereum 2b serovars were demonstrated in two patients and serovar 2 in one patient. Doxycyclin (daily dose of two times 100 mg for 21 days) resolved the symptoms in all cases. The authors conclude that lymphogranuloma venereum is a diagnostic challenge in Hungary, too. It is important to be aware of the altered clinical features of this disease to prevent complications and spreading. Orv. Hetil., 2015, 156(1), 36–40.

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.

scholarly journals A Case of False-PositiveMycobacterium tuberculosisCaused byMycobacterium celatum

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Edward Gildeh ◽  
Zaid Abdel-Rahman ◽  
Ruchira Sengupta ◽  
Laura Johnson
Keyword(s):  
High Performance ◽  
Case Reports ◽  
Public Health Intervention ◽  
Signs And Symptoms ◽  
Clinical History ◽  
Nucleic Acid Amplification ◽  
Nontuberculous Mycobacterium ◽  
Diagnostic Challenge ◽  
Reliable Differentiation ◽  
Oligonucleotide Sequence

Mycobacterium celatumis a nontuberculous mycobacterium shown to cause symptoms similar to pulmonaryM. tuberculosis. Certain strains have been shown to cross-react with the probes used to detectM. tuberculosis, making this a diagnostic challenge. We present a 56-year-old gentleman who developed signs and symptoms of lung infection with computed tomography scan of the chest showing right lung apex cavitation. Serial sputum samples were positive for acid-fast bacilli and nucleic acid amplification testing identifiedM. tuberculosisribosomal RNA, resulting in treatment initiation. Further testing with high performance liquid chromatography showed a pattern consistent withM. celatum. This case illustrates the potential forM. celatumto mimicM. tuberculosisin both its clinical history and laboratory testing due to the identical oligonucleotide sequence contained in both. An increasing number of case reports suggest that early reliable differentiation could reduce unnecessary treatment and public health intervention associated with misdiagnosed tuberculosis.

scholarly journals Tuberculosis in Otorhinolaryngology: Clinical Presentation and Diagnostic Challenges

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Rajiv C. Michael ◽  
Joy S. Michael
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Clinical Presentation ◽  
Extrapulmonary Tuberculosis ◽  
Common Type ◽  
The Body ◽  
Diagnostic Challenge ◽  
Cervical Adenitis ◽  
Important Form

Tuberculosis affects all tissues of the body, although some more commonly than the others. Pulmonary tuberculosis is the most common type of tuberculosis accounting for approximately 80% of the tuberculosis cases. Tuberculosis of the otorhinolaryngeal region is one of the rarer forms of extrapulmonary tuberculosis but still poses a significant clinical and diagnostic challenge. Over three years, only five out of 121 patients suspected to have tuberculosis of the otorhinolaryngeal region (cervical adenitis excluded) hadMycobacterium tuberculosisculture-proven disease. Additional 7 had histology-proven tuberculosis. Only one patient had concomitant sputum-positive pulmonary tuberculosis. We look at the various clinical and laboratory aspects of tuberculosis of the otorhinolaryngeal region that would help to diagnose this uncommon but important form of extrapulmonary tuberculosis.

A STUDY ON THE USE OF MENSTRUAL BLOOD SAMPLING IN THE DETECTION OF FEMALE GENITAL TUBERCULOSIS BY NUCLEIC ACID AMPLIFICATION TECHNIQUE (NAAT)

2021 ◽  
pp. 61-64
Author(s):  
Pallavi Bajpai ◽  
Eema Chaudhary ◽  
Mamta Tyagi ◽  
Sonal Jindal
Keyword(s):  
Nucleic Acid ◽  
Small Sample Size ◽  
Pilot Project ◽  
Small Sample ◽  
Nucleic Acid Amplification ◽  
Rifampicin Resistance ◽  
Menstrual Blood ◽  
Childbearing Age ◽  
Genital Tuberculosis ◽  
Mdr Tb

Objectives:To assess the prevalence of multidrug resistant tuberculosis (MDR-TB) and rifampicin resistance in females of fertile age group suffering from genital tuberculosis using menstrual blood (MB), through nucleic acid amplication technique (NAAT).Methods: A prospective observational study was conducted for a period of 23 months which included 50 women of clinically suspected genital tuberculosis of childbearing age Day 1 or Day 2 MB of all females of child bearing age was taken. The specimen were subjected to AFB testing by ZN staining and NAAT by Truenat for Mycobacterium tuberculosis (MTB) DNA detection and Rifampicin resistance. The data was entered in MS EXCEL spreadsheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. Results: The mean age of study subjects were 26.6 ± 6 years. MB was positive for AFB Stain (ZN Stain) in 50% cases but MTB DNA was detected through Truenat in 1 only out of 50 patients. MDR -TB suspicion on the basis of ATT response was present in 7 out of 50 patients(14%) but none of the patients showed Rifampicin resistance on NAAT technique.Conclusion: We performed this study as a sort of Pilot project, which used Menstrual blood as a sample, since it is the most non-invasive sampling and tried to use new technique of Truenat for MTB detection and drug resistance characterisation. The negative ndings of the study must be interpreted in consideration of limitations such as small sample size, relatively newer technique and sampling method.

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