Effectiveness of CBNAAT in the diagnosis of extrapulmonary tuberculosis

Kasat, Shivprasad; Deshmukh, Ashish; Jadhav, Sunil; Deshmukh, Hafiz

doi:10.18203/2320-6012.ijrms20184884

Cited by 15 publications

(12 citation statements)

References 7 publications

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“…In our study, there were 144 (29.5%) CBNAAT positive specimens that had shown negative results for Acid-fast bacilli (70% Sensitivity and 96.1% Negative predictive value). The findings were similar to the study done in Maharashtra which had shown that (8/25) 32% samples had been missed for TB diagnosis by AFB smear which was positive for CBNAAT [27].…”

Section: Resultssupporting

confidence: 89%

Evaluation of Rifampicin-resistant Tuberculosis in Pediatric Patients by GeneXpert MTB/RIF

William¹,

Rai²,

Kaur³

2021

Journal of Microbiology and Infectious Diseases

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Objectives: India has the largest burden of MDR-TB worldwide, with an annual incidence of 1,30 000 patients. Multidrug-resistant tuberculosis (MDR-TB) carries a poor prognosis, a high mortality rate, and treatment success rates as low as 65%. The mortality in India is estimated to be about 480,000 per year. The aim of the study was to evaluate Rifampicin-resistant Tuberculosis and its distribution by GeneXpert in a tertiary care hospital. Methods: A total of 2864 samples were processed from the patients attending outpatient departments and indoor wards as per the pediatrician's request. Acid-fast bacilli (AFB) smear microscopy was done on all samples by Acid-fast staining for early diagnosis followed by GeneXpert MTB/RIF (CBNAAT) testing. Specimens were transported and stored at 2-8 °C prior to processing for CBNAAT. Results were read and reported within 2 hours.Results: A total of 2864 samples were tested for TB using CBNAAT (including 645 [22.5%] extra-pulmonary and 2219 [77.5%] pulmonary samples). The test results were positive in a total of 346 (12%) samples by CBNAAT. The positivity is highest in the age group >10 years and in sputum samples (37.28%) followed by pus samples (23.26%) in pulmonary and extrapulmonary distribution. Out ZN staining was positive in 244 (8.5%) specimens. There were 102 (29.5%) CBNAAT positive specimens which showed negative results for Acid-fast bacilli (70.52% Sensitivity). Among 346 TB-positive patients, 10.46% samples were pulmonary and 17.67% were extrapulmonary. It was observed that in positive CBNAAT patients, the prevalence of Rifampicin resistance was 12.72% i.e. 44 samples which include 31(13.36%) and 13(11.40%) pulmonary and extra-pulmonary samples respectively. Among the Rifampicin resistant samples, there were 29.55% samples that were extrapulmonary. Conclusion:GeneXpert MTB/RIF is a very rapid diagnostic assay that provides information regarding the mutation pattern of RIF resistance in MTB isolates.

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Section: Resultssupporting

confidence: 89%

Evaluation of Rifampicin-resistant Tuberculosis in Pediatric Patients by GeneXpert MTB/RIF

William¹,

Rai²,

Kaur³

2021

Journal of Microbiology and Infectious Diseases

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“…AFB smear hasn't proved to be much useful in diagnosing EPTB. 3 For several decades smear microscopy and conventional culture techniques have been the mainstay of diagnostic testing for pulmonary tuberculosis. While smear microscopy has poor sensitivity and issues related to quality control, conventional solid culture techniques have the limitation of long turnaround time of several weeks.…”

Section: Introductionmentioning

confidence: 99%

Role of cartridge-based nucleic acid amplification test to diagnose tuberculosis at tertiary care teaching hospital in Rajasthan, India

Mathur¹,

Shukla²,

Bindal³

2019

Int J Res Med Sci

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Background: Tuberculosis is one of the top 10 causes of death worldwide as per the Global TB report 2017, the estimated incidence of TB in India was approximately 28,00,000 cases accounting for about a quarter of the world’s TB cases (10 million). It is of utmost important to diagnose early and treat it to reduce disease transmission. GeneXpert MTB/RIF, an automated cartridge-based molecular technique detects Mycobacterium Tuberculosis and rifampicin resistance within two hours, has been recommended by WHO for rapid diagnosis of TB.Methods: Author conducted a retrospective study in the Department of TB and Chest, of tertiary care center at Jhalawar Medical College (JMC), Jhalawar to evaluate and analyze the role of CBNAAT to diagnose tuberculosis from 1st January 2018 to 31st December 2018. Author included all patients who came to department of TB and Chest of JMC, Jhalawar either new/ relapsed/ defaulters/ referred cases from ART/ ICTC center, Pediatric Department; Gynaecology and Obstetrics Department, peripheral Government Health Care Facilities and Private Hospitals of Jhalawar District catering about 15.5 lac population were subjected to both ZN staining/ Fluorescent microscopy and CBNAAT in the study period.Results: A total of 3078 samples (pulmonary 2739+EP 339) were tested for ZN staining / Fluorescent microscopy and CBNAAT during the study period. Mean age of the study population was 36.5±10.3 years. 1873 tested were negative and 1205 samples were positive for CBNAAT. Of these 1205 positive samples, 1174 were sputum/ BAL samples and 31 were extra pulmonary samples. Authors found rifampicin resistance rate of 6.98% (82/1174) in pulmonary tuberculosis cases, 3 rifampicin resistance cases were detected in extra pulmonary samples. CBNAAT could identify 255 cases (14.01%) that were smear negative. Author found TB-HIV coinfection rate of 18.75%.Conclusions: Author found CBNAAT to be an important diagnostic modality especially in smear negative patients for early diagnosis and treatment. Author could detect Mycobacterium Tuberculosis in 14.01% of patients with negative smear microscopy for AFB. In PLHIV, CBNAAT detected Mycobacterium Tuberculosis in 18.75% (12/64) of patients. Author found rifampicin resistance rate of 6.98% (82/1174) in pulmonary tuberculosis cases.

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“…In a study by Raizada et al, that covered a population of 8.8 million across 18 sub-district level tuberculosis units (TU) in India, Overall 28% TB cases were bacteriologically confirmed, of which 27.6% TB cases were detected on CBNAAT against the smear positivity rate of 12.9%. 14 15 Similarly in a study carried out at Hydrabad India, for pulmonary samples the sensitivity and specificity of CBNAAT samples were 79.2% and 89.5% respectively while that for sputum smear negative were 41.5% and 98.2% respectively. For extra-pulmonary samples ,the sensitivity and specificity of CBNAAT samples were 85.7% and 93.5% respectively while that for smear negative were 60.7% and 100% respectively.…”

Section: Resultsmentioning

confidence: 95%

“…Authors assumed that the specificity of Xpert is high, as every study performed to date and meta-analysis has indicated consistently high specificity of 99%. 15 Therefore, although there is no culture confirmation for comparison, this study was not an evaluation of diagnostic accuracy, which has been comprehensively reported elsewhere in other studies. 13,14 It can be reasonably assumed that the cases studied in our study are genuine, and the rate of false positive diagnosis is unlikely to exceed that of culture.…”

Section: Resultsmentioning

confidence: 99%

Pattern of tuberculosis among tribal population of Central India with special reference to cartridge based nucleic acid amplification test as diagnostic tool: a descriptive study at tertiary care hospital

2019

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Background: Tuberculosis (TB) kills close to half a million Indians every year. Lack of reliable rapid diagnostic techniques for TB hampers timely diagnosis and leads to continued disease transmission, causing significant morbidity and mortality. The potential of newly recommended CBNAAT in TB and MDR-TB detection has been underutilized in our area due to lack of awareness regarding the same. Hence we utilized this rapid, logistically simplified test to study the pattern of tuberculosis among tribal population of Central India.Methods: Descriptive study of suspected TB patients in tertiary care centre from March 2016 to March 2019. Appropriate specimens from suspected TB patients were collected and subjected to CBNAAT and AFB smear to study the pattern of TB and Rifampicin- Resistant(RR) TB in our area.Results: CBNAAT detected overall 27% MTB cases; 27.72 % Pulmonary-TB cases as against smear positivity rate of 20.73% whereas 12.74% Extra-pulmonary-TB (EPTB) cases as against smear positivity rate of 1.59%.Overall 94.91% were RiF Sensitive( RS-TB) and 4.58% were RR-TB. Of the 57 (4.16%) HIV-TB coinfected cases; 96.49% were RS-TB and 5.26% were RR-TB. Co-infected patients have high incidence of EPTB(21.05%) involvement with RR-TB 3.50%. Among EPTB cases; lymph node aspirate and pus provided highest CBNAAT positive cases and almost 90.62% EPTB specimens were RS-TB .Conclusions: Availability of new diagnostic services has increased early identification of TB and RR-TB. Awareness among physicians regarding diagnostic utility of CBNAAT should be further increased as early identification of possible MDR cases is key to reducing community transmission and treatment initiation, particularly in high-burden, resource-limited settings.

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Effectiveness of CBNAAT in the diagnosis of extrapulmonary tuberculosis

Cited by 15 publications

References 7 publications

Evaluation of Rifampicin-resistant Tuberculosis in Pediatric Patients by GeneXpert MTB/RIF

Evaluation of Rifampicin-resistant Tuberculosis in Pediatric Patients by GeneXpert MTB/RIF

Role of cartridge-based nucleic acid amplification test to diagnose tuberculosis at tertiary care teaching hospital in Rajasthan, India

Pattern of tuberculosis among tribal population of Central India with special reference to cartridge based nucleic acid amplification test as diagnostic tool: a descriptive study at tertiary care hospital

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