Comparison of conventional methods with gene xpert mtb/rif assay for rapid detection of mycobacterium tuberculosis and rifampicin resistance in extra-pulmonary samples

Avashia, Sanjay; Bansal, Deepak; Ahuja, Kunal; Agrawal, Vijay P

doi:10.17511/ijmrr.2016.i02.010

Cited by 11 publications

(11 citation statements)

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“…In a study conducted by Bankar et al GeneXpert MTB/RIF assay displayed 18.42% of positive cases in the detection extrapulmonary tuberculosis as compared to the culture and ZN smear microscopy [39] . In a study performed by Ghariani [40] 77% of cases were positively detected for tuberculosis among the lymph node samples [40] . In Nidhi Gupta et al study out of 143 FNAC samples, GeneXpert Mtuberculosis/RIF assay revealed 60.1% as positive for tuberculous lymphadenitis [41] .…”

Section: Discussionmentioning

confidence: 96%

GeneXpert assay – A cutting-edge tool for rapid tissue diagnosis of tuberculous lymphadenitis

Raja

Sreeramulu

Dave

et al. 2020

Journal of Clinical Tuberculosis and Other Mycobacterial Diseas

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Background The most prevalent clinical entity of extra pulmonary tuberculosis is tuberculous lymphadenitis. However, it resembles other granulomatous conditions pathologically and obtaining tissue for microbiological diagnosis is also difficult. Thus it is a challenging task for diagnosis and early initiation of management. Fine needle aspiration cytology and biopsy are the diagnostic methods generally used to obtain the lymph node samples for histopathological and microbiological diagnosis. Mycobacterium culture on Lowenstein-Jensen medium remains the gold standard for definitive diagnosis, but its major limitations is a prolonged turn-around time of 2–4 weeks. The GeneXpert Mtuberculosis/RIF assay is a novel molecular diagnostic method for rapid diagnosis of tuberculosis and rifampicin resistance in clinical specimens. Methods This was a cross sectional analytical study conducted on 67 cases of suspected tubercular lymphadenitis at R.L Jalappa Hospital and Research Centre, Tamaka, Kolar. The study was carried out between December 2017 to June 2019. The samples were collected using excision biopsy and subjected to GeneXpert Mtuberculosis/RIF assay and histopathology. Further, sensitivity, specificity, positive predictive value and negative predictive value was measured and compared with histopathology. Results The average age of the patients was 37.04 ± 19.27 and majority was males. The lymph nodes were predominantly present in cervical region. Histopathology analysis reveals 46 positive cases of tuberculosis Lymphadenitis and GeneXpert Mtuberculosis/RIF assay detects 42 cases of tuberculosis Lymphadenitis. In the present study, GeneXpert Mtuberculosis/RIF assay had a sensitivity of 82.60% and specificity of 85% when compared to histopathology. Further the PPV and NPV was found to be 92.68% and 68% respectively. GeneXpert Mtuberculosis/RIF showed 2 cases of rifampicin resistance out of 67 cases. In this study, the GeneXpert Mtuberculosis/RIF showed the results in 0.79 days. Conclusion The present study showed that GeneXpert Mtuberculosis/RIF is a simple and reliable technique for diagnosing tuberculosis Lymphadenitis with high specificity and sensitivity as compared histopathology. Further, the methods elicit rapid diagnosis and also detected rifampicin resistance. It is thus a reliable and useful diagnostic modality in rapid detection of the causative agent and initiation of appropriate category anti-tubercular therapy when necessary.

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Section: Discussionmentioning

confidence: 96%

GeneXpert assay – A cutting-edge tool for rapid tissue diagnosis of tuberculous lymphadenitis

Raja

Sreeramulu

Dave

et al. 2020

Journal of Clinical Tuberculosis and Other Mycobacterial Diseas

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“…Most of the cases of tuberculous lymphadenitis are paucibacillary and Acid-fast bacilli has low sensitivity, as its detection limit is >10 4 bacilli/slide, or 10 4 bacilli per ml (11) and Culture requires a long time of 5-8 weeks to give results, reliance on culture, the gold standard and mainstay of diagnosis often leads to delay, compromising patients care and outcomes. (12) Diagnosis is therefore made on the classical histological changes of chronic granulomatous inflammation suggestive of tuberculosis. (13) Histology remains the most appropriate method till date, but is time-consuming to undertake and establishing a diagnosis of TB with high specificity remains difficult, as it suffers low sensitivity for paucibacillary samples.…”

Section: B a C K G R O U N Dmentioning

confidence: 99%

Study of CBNAAT and Anti-MPT64 Detection in Cytological and Histopathological Material for Early Diagnosis of TB Lymphadenitis

Sumayya¹,

Kharidehal²,

S³

et al. 2019

jemds

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BACKGROUND Tuberculosis is primarily a pulmonary disease, but it can affect almost any organ system, with lymph node involvement being the most common form of extrapulmonary tuberculosis and tuberculous pleuritis being the 2 nd most frequent extrapulmonary manifestation. Immune-compromising diseases such as HIV, have resulted in increase in the incidence of tuberculous lymphadenitis. METHODS This study is a prospective study, which included 80 patients, in the age group of 15-60 years, done over a period of 18 months from November 2016 to April 2018 in Upgraded Department of Pathology, Osmania General Hospital, Hyderabad, a tertiary referral centre for the state of Telangana and various districts of neighbouring states. In the present study, patients who presented with cervical lymphadenopathy as the manifestation of extrapulmonary tuberculosis were included. Cervical lymphadenopathy is the most common presentation of EPTB. Pus from the suspected lymph nodes was aspirated for cytological examination, ZN staining and GeneXpert analysis. Biopsy from the suspected lymph node was obtained and the material processed for CBNAAT, histopathology, Ziehl Neelsen staining and IHC. RESULTS CBNAAT was positive in 70 (87.5%) cases on cytological aspirates with 24 (30%) cases showing rifampicin resistance and on biopsy, 64/80 (80%) cases were positive on CBNAAT with rifampicin resistance in 25 (31.25%) cases. IHC with anti-MPT64 antibody was positive in 72 (90%) cases with sensitivity, specificity, positive and negative predictive value of 100%, 97%, 98% and 100% respectively and p value of <0.0001. CONCLUSIONS Present study provides the insight for the feasibility of using CBNAAT and IHC as diagnostic techniques for better management of EPTB patients and be useful in settings where culture or higher molecular facilities are not available.

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“…MTB detected (%) Pl fluid LNTB Ascitic fluid Rif resistance (%) Pravin et al [9] 10.1 -9.3 19.2 Avashia S et al [11] 23.3 54.2 20 5.4 Ahmed naeem sajed et al [4] 15.8 -6.3 -Uria GA et al [5] 32 -27.8 -Hillemann D et al [6] 2.9 --4 Shukla et al [15] 20 [5] from India the positivity rate with GeneXpert assay was 24.6% for CSF, 32% for pleural fluid and 27.8% for ascitic fluid. Hillemann et al [6] found 3 positive Gene Xpert results out of 113 pleural fluid samples (2.9%) all of which were negative on mycobacterial culture.…”

Section: Table-1: Comparative Analysis Of Different Studiesmentioning

confidence: 99%

“…Avashia S et al [11] examined 300 various extra-pulmonary samples from suspected extrapulmonary tuberculosis and out of it MTB was detected in 111 samples and 105 samples were rifampicin sensitive and 6 samples were rifampicin resistant (5.40%). Hillman D et al [12] tested 29 strains, all were found to be susceptible to Rifampicin.…”

Section: Table-1: Comparative Analysis Of Different Studiesmentioning

confidence: 99%

Prevalence of positivity of CBNAAT(cartridge based nucleic acid amplification test) in extra-pulmonary tuberculosis.

2018

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Original Research Article Introduction: Tuberculosis (TB) remains a key challenge in the face of global public health and inadequate diagnostic assays have hampered our chances to tackle this disease effectively. The Gene X-pert MTB/RIF assay marks an important development in the field of rapid molecular TB diagnostics. This study was done to see the prevalence of gene Xpert MTB/RIF assay and drug resistant tuberculosis in extrapulmonary tuberculosis. Material and methods: The 300 samples of extra-pulmonary tuberculosis constituting pleural fluid, pus, CSF, lymph tissue, peritoneal fluid diagnosed on the basis of clinico radiological and/or histopathological findings were sent for gene Xpert MTB/RIF. Results: Maximum number of patients in our study are tubercular pleural effusion (67.7%) followed by tubercular lymphadenitis, empyema, Cerebrospinal fluid, ascitic fluid and pericardial fluid. Mtb had been detected in pleural effusion (13.8%), lymphadenitis (60.3%), empyema (44.4%) and ascitic fluid (11.1%). 16.7% cases were diagnosed as multi drug resistant-extrapulmonary tuberculosis (MDR-EPTB). Conclusion: Gene Xpert assays a more sensitive technique as compared to conventional methods. The Gene X-pert MTB/RIF assay marks an important development in the field of rapid molecular TB diagnostics.

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Comparison of conventional methods with gene xpert mtb/rif assay for rapid detection of mycobacterium tuberculosis and rifampicin resistance in extra-pulmonary samples

Cited by 11 publications

References 13 publications

GeneXpert assay – A cutting-edge tool for rapid tissue diagnosis of tuberculous lymphadenitis

GeneXpert assay – A cutting-edge tool for rapid tissue diagnosis of tuberculous lymphadenitis

Study of CBNAAT and Anti-MPT64 Detection in Cytological and Histopathological Material for Early Diagnosis of TB Lymphadenitis

Prevalence of positivity of CBNAAT(cartridge based nucleic acid amplification test) in extra-pulmonary tuberculosis.

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