Cytological Study of Tuberculosis in Pulmonary and Extrapulmonary Lesions in Correlation with Cartridge Based Nucleic Acid Amplification Test (CBNAAT)

Dronadula, Gayathri; Apuroopa, Murari

doi:10.21276/apalm.2682

APALM

2020

DOI: 10.21276/apalm.2682

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Cytological Study of Tuberculosis in Pulmonary and Extrapulmonary Lesions in Correlation with Cartridge Based Nucleic Acid Amplification Test (CBNAAT)

Gayathri Dronadula

Murari Apuroopa

Abstract: Introduction: Various methods can be used for the detection of tuberculosis of which microscopy,culture and identification of the organism's DNA are known. Newly introduced Nucleic acid amplification test (NAAT) if used in combination with other tests provide improved diagnostic yield.Aims and Objectives: Todiagnose tuberculosis bacilli in various cytological samples and sputum samples. To evaluate the diagnostic efficacy of combined approach of conventional smear study and and CBNAAT. Material and Methods:A T… Show more

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Cited by 3 publications

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A Study of the Diagnostic Utility of Cartridge Based Nucleic Acid Amplification Test of Various Body Fluids Other Than Sputum in Different Forms of Tuberculosis

Radhika

Srinivasan

2020

PIJR

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Introduction: Diagnosis of TB is difficult in specimens having low number of bacilli. In recent times, CBNAAT is used due to its rapidity, sensitivity and specificity The heterogeneous clinical presentations, pauci-bacillary nature and difficulty in obtaining specimens (often requiring invasive procedures) make the diagnosis of TB, a challenging task and hence the requirement for a rapid, simplified and cost effective diagnostic tool arises. Objectives: To determine the sensitivity, specificity, positive predictive value and negative predictive value of CBNAAT for diagnosis of Tuberculosis from specimens other than sputum. Methodology: Study Design-Longitudinal prospective study, Duration of Study-1 year study period, Study Setting -RNTCP Cell in the Department of Respiratory Medicine, MMCHRI, Sample Size-60, Study Population-Sputum Negative Presumptive Pulmonary and Extra pulmonary Tuberculosis Patients, Sample Collection- BAL, Pleural Fluid, Pus Aspirate, CSF, Lymph Node aspirate, Ascitic Fluid, Gastric Aspirate, Synovial Fluid. Results: In our study Majority of study population were in the age group of Less than 30(30%). About 25% were in the age group of more than 61 years. Nearly 12% were in the age group of 41-50 years. About 15% were in the age group of 31-40 years. Nearly 18% were in the age group of 51-60 years. In our study 63% were males and 37% were females. In our study 40% are smokers and 60% are nonsmokers. In our study 27% are diabetics and 73% are non-diabetics. In our study 3.4% had HIV and 96.6% are HIV negative. 10% of study population had previously taken ATT and 90% had not taken ATT. About 25% tested positive for CBNAAT test and 75% tested negative for the test. Conclusion: The diagnosis of Tuberculosis remains challenging since the number of M.tb bacilli present in tissue at the site of disease is often low and clinical specimen from deep seated organs may be difficult to obtain. CBNAAT provides an edge over other methods by reducing the time required for diagnosis and precision in detection of M.tb bacilli not only in sputum samples but also in extra-pulmonary specimens.

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A Study of the Diagnostic Utility of Cartridge Based Nucleic Acid Amplification Test of Various Body Fluids Other Than Sputum in Different Forms of Tuberculosis

Radhika

Srinivasan

2020

PIJR

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Combined modalities for the rapid diagnosis of patients with suspected tuberculous lymphadenitis: A cross-sectional study

Sayed,

Sane

2024

Lung India

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Background: In settings with high burden of extrapulmonary tuberculosis, the use of various diagnostic modalities can result in superior and quick diagnosis leading to prompt initiation of treatment. Objective: This study assessed the diagnostic performance of the fine-needle aspiration cytology (FNAC), Ziehl–Neelsen (ZN) stain, fluorescence microscopy (FM) and cartridge-based nucleic acid amplification test (CBNAAT) in patients with suspected tuberculous lymphadenitis (TBLN). Methods: This cross-sectional studyodes, who underwent FNAC. The FNAC samples were subjected to cytomorphological examinati involved 255 patients clinically suspected of TBLN with palpable lymph non, ZN stain, FM and CBNAAT. The diagnostic performance of each modality was compared with CBNAAT, and combined performance was determined. The diagnostic performance of CBNAAT was determined by comparing it with composite reference standard. Results: Of 255 patients, 148 (58.04%) showed features of TBLN on FNAC. The presence of epithelioid cell granulomas with caseous necrosis (67.57%) was the predominant cytomorphological pattern. On ZN stain, FM and CBNAAT, 31 (20.95%), 63 (42.57%) and 100 (67.57%) patients were found to be positive for TBLN, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of CBNAAT was 58.59%, 91.83%, 92% and 58.06%, respectively. Finally, the combination of ZN stain, FM and CBNAAT led to the detection of 88.51% patients with TBLN. Conclusion: Combined use of ZN stain, FM and CBNAAT leads to superior and swift diagnosis of patients with clinically suspected TBLN.

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Diagnosis of Extrapulmonary Tuberculosis by Cartridge-Based Nucleic Acid Amplification Test (CBNAAT) and Detection of Rifampicin Resistance on Fine-Needle Aspiration Samples

Phukan

Adhikary

Das

et al. 2022

Medical Journal of Babylon

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Background: Extrapulmonary tuberculosis (EPTB) is still a major health problem in developing countries. Diagnosis of EPTB is difficult due to paucity of acid-fast bacilli in clinical specimens. Objectives: To study the diagnostic role of cartridge-based nucleic acid amplification test (CBNAAT) and rifampicin resistance in EPTB on fine-needle aspiration samples. Materials and Methods: It is a prospective study comprising 79 patients of clinically suspected EPTB cases for 1 year duration. All patients underwent fine-needle aspiration cytology (FNAC) with Ziehl–Neelsen (ZN) staining followed by CBNAAT for confirmation of tuberculosis (TB) and to detect rifampicin resistance. Data have been collected and analyzed regarding sensitivity, specificity, positive predictive value, and negative predictive value of FNAC in comparison with CBNAAT. Results: Out of 79 patients, 47 (59.49%) patients were male and cervical lymph node was the most common site of aspiration (42, 52.16%). Granuloma with necrosis (38, 48.10%) followed by necrosis only (14, 17.72%) were the common findings on FNAC. Out of 79 suspected EPTB patients, CBNAAT confirmed 62 patients as having TB. Specificity of FNAC with ZN staining was 100.0%; however, sensitivity was low (43.55%) compared to CBNAAT. Only three cases were detected as rifampicin resistant. Conclusion: Compared to FNAC, CBNAAT has very good sensitivity and specificity in the diagnosis of EPTB. It has also as added advantage of detecting rifampicin resistance at the same time. CBNAAT should be used for diagnosis of EPTB wherever the facility is available.

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Cytological Study of Tuberculosis in Pulmonary and Extrapulmonary Lesions in Correlation with Cartridge Based Nucleic Acid Amplification Test (CBNAAT)

Cited by 3 publications

References 7 publications

A Study of the Diagnostic Utility of Cartridge Based Nucleic Acid Amplification Test of Various Body Fluids Other Than Sputum in Different Forms of Tuberculosis

A Study of the Diagnostic Utility of Cartridge Based Nucleic Acid Amplification Test of Various Body Fluids Other Than Sputum in Different Forms of Tuberculosis

Combined modalities for the rapid diagnosis of patients with suspected tuberculous lymphadenitis: A cross-sectional study

Diagnosis of Extrapulmonary Tuberculosis by Cartridge-Based Nucleic Acid Amplification Test (CBNAAT) and Detection of Rifampicin Resistance on Fine-Needle Aspiration Samples

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