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

Mathur, Rajendra Babu; Shukla, Uma Shankar; Bindal, Hemant Kumar

doi:10.18203/2320-6012.ijrms20195000

Cited by 4 publications

(1 citation statement)

References 6 publications

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“…Male patients made up 74% of those with MTB positivity. Our results are in line with those of recent studies in India that found that 76%, 75%, 70.5%, 71%, and 72% of TB patients were males, as reported [29][30][31][32] . According to the WHO study from 2021, adult males, who made up 56% of all TB cases in 2019, have the highest prevalence of the disease [6].…”

Section: Discussionsupporting

confidence: 93%

Clinico-microbiological profile and treatment outcomes in patients with isoniazid monoresistant tuberculosis in South India

Madeneni

Muthuraj

et al. 2023

Preprint

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Isoniazid (INH) is an important first-line medication for the treatment of tuberculosis. The impact that tuberculosis drug resistance has on treatment outcomes is a topic that is receiving a lot of attention these days because of the rising incidence of INH-resistant cases. Study involves a single group of patients who have been diagnosed with Isoniazid monoresistant tuberculosis. Treatment history and demographic data of the patients were obtained after informed consent. The mutation patterns of isoniazid were observed after multiplex PCR and Line Probe Assay (LPA). A total of 101 patient (M,F) records at the IRL, Puducherry were analyzed. The predominant gene responsible for TB was KATG (67.3%). The KATG Mut1 was a prime mutation observed in the present study population (58.41%). Study showed positive association with males (74%), occupation as coolie (88%), diabetes as comorbidity (33%), pulmonary tuberculosis as the TB site (98.01%), history of previous ATT intake in 43 patients (42.6%), katG mutation (67.3%), katG Mut 1 was the prime mutation (58.4%). The cure rate was high in INH high concentration resistance patients which was statistically significant (p=0.0167). INH monoresistance mutations seen in 64.3% of the patients with katG, compared to inhA (34.65%). Similar to katG mutations, inhA mutations also have MUT1 as their most frequent gene pattern. There is a significant association between males, diabetes, smoking and alcohol addictions were associated with high risk of developing high dose INH monoresistance (katG). High prevalence of recurrent tuberculosis was seen in high dose INH monoresistance tuberculosis. Patients who are microbiologically confirmed pulmonary tuberculosis and diabetes with rifampicin sensitive status needs to be checked for LPA for isoniazid sensitivity status to prevent treatment failure and relapse. It is crucial to understand the gene pattern in each of these patients since these mutations are closely associated to high or low-degree resistance to INH.

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Section: Discussionsupporting

confidence: 93%

Clinico-microbiological profile and treatment outcomes in patients with isoniazid monoresistant tuberculosis in South India

Madeneni

Muthuraj

et al. 2023

Preprint

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Combination method for the diagnosis of Tuberculous lymphadenitis in high burden settings

Shetty

Vyas²

2022

Surg Exp Pathol

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Background India reports the highest number of extrapulmonary tuberculosis (EPTB) cases globally, most of which are lymph node TB (LNTB). In high tuberculosis (TB) burden countries rapid diagnosis is very important. Fine needle aspirate cytology (FNAC) diagnosis can be made with features of caseous necrosis with/without epithelioid granulomas. However, bacteriological confirmation is essential. This study was performed to evaluate the performance of the diagnostic tests available namely FNAC, GeneXpert (GX) and Ziehl Neelsen stain (ZN) stain at resource restricted settings, for LNTB. Methods FNAC samples from affected lymph nodes were collected from 100 consenting patients with clinically suspected LNTB. FNA material was analyzed by cytomorphology, ZN and GX. If no Mycobacterium tuberculosis (MTB) was detected, repeat aspirate was cultured on Lowenstein Jensen medium. Descriptive statistical analysis was performed. Results Out of 100 cases, 73% showed cytological features consistent with TB. The most common cytomorphological pattern was epithelioid cell granulomas with caseous necrosis (59%). Caseous necrosis only pattern was seen in 14%. MTB was detected in 34% by ZN and 60% by GX. Overall, the combination of FNAC, ZN, GX detected 85% of LNTB. Conclusions A combination of FNAC, ZN and GX is a practical tool that can improve and quicken the diagnosis of LNTB in resource restricted high-burden settings.

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Evaluating Diagnostic Performance of Extrapulmonary Tuberculosis Using Cartridge-Based Nucleic Acid Amplification Test Assay: A Retrospective Cross-Sectional Study at a Tertiary Health Care Setup in India

Kashyap,

Sarkar,

LNU

et al. 2024

EMJ

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Background: Extrapulmonary tuberculosis (EPTB) diagnosis is difficult due to its subclinical or nonspecific clinical symptoms, paucibacillary nature, and difficulties in obtaining qualified pathological specimens for Mycobacterium tuberculosis detection. Given the paucibacillary nature of EPTB, and drug resistance as high as 19%, rapid diagnostic methods like Xpert MTB/RIF (Cepheid, Sunnyvale, California, USA) can make a significant clinical impact. In this study, the authors aim to determine the positivity rate of Mycobacterium tuberculosis in EPTB samples by Xpert MTB/RIF or cartridge-based nucleic acid amplification test (CBNAAT) in a tertiary healthcare setup. Materials and methods: This was a retrospective cross-sectional study where presumptive extrapulmonary cases of any age were considered for inclusion. A total of 688 suspected extrapulmonary samples were analysed by CBNAAT over a period of 7 months. Result: A total of 25% (170/688) of the cases were reported to be positive, while the combined rate of Error, Invalid, and No result was 8.5% (59/688). Rifampicin resistance was seen in 14 isolates, while four isolates showed indeterminate results. Conclusion: Varied clinical presentations and the paucibacillary nature of the extrapulmonary samples often lead to the failure of diagnosis by conventional diagnostic tests (smear microscopy and culture). Hence, molecular diagnostic techniques play a crucial role in rapid diagnosis. The present study thus highlights the impact of CBNAAT in the definite diagnosis of extrapulmonary tuberculosis in a tertiary healthcare centre.

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

Cited by 4 publications

References 6 publications

Clinico-microbiological profile and treatment outcomes in patients with isoniazid monoresistant tuberculosis in South India

Clinico-microbiological profile and treatment outcomes in patients with isoniazid monoresistant tuberculosis in South India

Combination method for the diagnosis of Tuberculous lymphadenitis in high burden settings

Evaluating Diagnostic Performance of Extrapulmonary Tuberculosis Using Cartridge-Based Nucleic Acid Amplification Test Assay: A Retrospective Cross-Sectional Study at a Tertiary Health Care Setup in India

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