GeneXpert positivity and evaluation of rifampicin resistance among endometrial biopsy specimens for the diagnosis of Genital Tuberculosis

Abstract

Objective: The aim of this study was to find out the GeneXpert positivity among endometrial biopsy specimens for diagnosis of genital tuberculosis. Materials and Methods: A retrospective study was conducted from January 2019 to June 2019 on all women clinically and radiologically diagnosed with infertility, dyspareunia, menstrual irregularities and pelvic inflammatory disease. Endometrial biopsies were taken from all cases and subjected to GeneXpert test for detection of Mycobacterium tuberculosis. Result: Total number of suspected cases was 62 with age ranging from 19 years to 65 years. Majority of suspected cases were from the age group 21-30 years (54.8%). Five out of 62 (8%) cases tested positive for Mycobacterium tuberculosis by GeneXpert which were all sensitive to Rifampicin. Among these 5 cases, 2 were reported as medium positive and 3 as very low positive based on cycle threshold value. Conclusion: GeneXpert on endometrial biopsy may prove to be a reliable diagnostic modality for genital tuberculosis as well as multidrug resistance tuberculosis in females leading to timely management of the disease.

Diagnosis of urogenital tuberculosis by multiplex-nested PCR targeting mpt64 (Rv1980c) and IS6110: comparison with multiplex PCR and GeneXpert® MTB/RIF

“…In addition, we obtained results of RIF resistance by Xpert, wherein three of six cases positive for Mtb identification were also positive for RIF resistance. Xpert results of this study are well in consensus with the previous reports on urine/EB specimens of male/female UGTB cases, wherein sensitivities were in the range of 8-41Á3% but a high specificity (100%) was attained, against CRS/culture (Chen et al 2019; Kashyap et al 2020;Tiwari et al 2020). The present findings and the previous reports suggest that Xpert can be employed as an excellent rule-in test for UGTB diagnosis but not as a good rule-out test.…”

A retrospective analysis of drug resistance in M. tuberculosis and role of CBNAAT, LPA and culture in diagnosis

“…In addition, the low positivity samples showed higher Rif indeterminate results thus further obscuring use of Xpert MTB/RIF ULTRA in these samples. This is similar to lowpositivity percentage obtained by Kashyap et al in GUN; and high-positivity percentage obtained by Agarwala et al in-liver abscess; and low-positivity percentage, in pleural fluid, and high-positivity percentage in lymph nodes and abscess by Chaudhary et al [6][7][8] False positive and false negative calls by Xpert MTB/ RIF have been reported by authors earlier. This study showed that percentage drug resistance for Rif, streptomycin was similar to resistance % published by Lohiya et al which had included a total of 90 nonduplicate studies published till 2018 for their review.…”