Background: Tuberculosis is an infectious disease still remains to be a foremost public health risk worldwide. Even though there is an availability of many highly sensitive diagnostic tools, early case detection plays a significant role in control of the disease which relies specially on the detection of acid-fast bacilli in clinical samples which is low sensitive. Earlier decontamination of sputum sample may improve the detection of mycobacterium.Methods: A prospective study was conducted with a total of (N=464) clinically suspected TB patient sputum samples which were collected and processed directly for AFB. From which AFB +ve samples were excluded. The direct AFB -ve (N=279) samples were processed using concentration methods (NALC, Bleach). After concentration, smears were examined under oil immersion for acid fast bacilli by ZN staining.Results: Out of 464 sputum samples, 185 direct ZN stain +ve were excluded. Among the ZN-ve (N=279) samples, n=44 (15.7%) were positive using bleach method. The positivity has improved to n=48 (17.2%) using NALC-NaOH.Conclusions: Bleach method of sputum decontamination is comparable to standard NALC-NaOH method. Therefore, we conclude that the identification of AFB using bleach concentration method can be used in resource limited health care setups especially in laboratories where mycobacterial culture is not performed which might help us in early diagnosis of tuberculosis.
Objectives: The purpose of the current study is to create awareness among the clinicians on the role of fungal etiological agents in suspected tuberculosis (TB) cases. This would help in preventing unnecessary use of anti-tubercular drugs and in decreasing drug-resistant TB cases. Methods: Prospective study was performed in the clinical microbiology laboratory of Annapoorana Medical College and Hospital, Salem, Tamil Nadu, from January 2013 to February 2017 subsequently getting approval from the institutional ethics committee. 464 sputum samples were collected from both inpatients and outpatients of numerous departments. Signs and symptoms of clinically suspected TB patients were noted for all cases. Statistical Analysis: Categorical variables were summarized by percentages (%). The Fishers exact test (2 × 2) analysis was done. Results: A total of 119 fungal isolates were isolated from the culture. The highest number of fungal isolates were of Candida species (n=61) (30.5%) followed by Cryptococcus neoformans n=38 (19%) and Histoplasma capsulatum n=20 (10%). Amongst the used anti-fungals, Fluconazole was the most effective drug for all the isolated fungi followed by Itraconazole, Amphotericin B, Voriconazole, and Nystatin. Conclusion: Our study findings indicate the significance of considering fungal infections as a prospect however treating disseminated granulomatous infections, even in immune-competent cases, particularly if the reaction to the TB therapy is insufficient.
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