Comparison Studies of GENXPERT versus MGIT Culture of Bronchial Lavage in Sputum Smear Negative Suspected Pulmonary Tuberculosis

Abstract

Introduction: Xpert MTB/RIF (Cepheid, USA) is an automated real-time PCR system that simultaneously detects TB and resistance to rifampicin. The test has excellent accuracy when performed on sputum and is endorsed by the World Health Organisation (WHO) and the USA Federal Drug Administration. Aims: To measure the diagnostic yield of bronchoalveolar lavage gene Xpert and compare it with traditional mycobacterial cultures in smear-negative and sputum-scarce pulmonary tuberculosis. Methods: A prospective observational study at a tertiary care hospital in India was conducted. A total of 200 patients who were 18 years or older under evaluation for clinico-radiological features of PTB with a history of a cough >2 weeks and a chest X-ray with pulmonary parenchymal involvement were recruited after ensuring two consecutive sputum negative smears or inability to produce adequate sputum. A volume of one ml of BAL sample was used to detect mycobacterium tuberculosis by the G4 version of Xpert ® MTB/RIF (Cepheid, USA) and by traditional mycobacterial cultures. cartridges without initial decontamination or centrifugation. Sensitivity, specificity and predictive values were calculated with 95% class intervals (CIs). McNemar's test was used for comparison of sensitivities. Result: The results showed that the AFB smear test had 76.83% (95% CI: 66.20-85.44) sensitivity, 100.0% (95% CI: 96.92-100.0) specificity with 100.% PPV and 86.13% (95%CI: 80.72-90.21) NPV compared to culture report.

To Compare the Diagnostic Sensitivity of ZN (Ziehl-Neelsen) Staining, CBNAAT (Cartridge Based Nucleic Acid Amplification Test) and Mycobacterium Culture of BAL (Bronchoalveolar Lavage) Fluid among Sputum Smear Negative or Non- Sputum Producing Patients wi

“…In the present study, out of 76 patients, 25 (32.9%) and 51 (67.1%) were females and males respectively. Similar dominance of males was shown by study done by Abhay Uppe et al, [13] in their study. There were 121 (60.5%) males and 79 (39.5%) females in study done by Abhay Uppe et al [13] Sanjay Avashia et al1 in their study revealed that 56.9% were male and 43.1% were female.…”

“…Similar dominance of males was shown by study done by Abhay Uppe et al, [13] in their study. There were 121 (60.5%) males and 79 (39.5%) females in study done by Abhay Uppe et al [13] Sanjay Avashia et al1 in their study revealed that 56.9% were male and 43.1% were female. Mushtaq Ahmad et al, [14] in his study found that males constituted 85.3% of patients.…”

Role of cartridge based nucleic acid amplification test in bronchoscopy guided bronchial wash specimens in sputum smear negative PTB patients attending government general hospital, Kakinada

“…The study performed in 100 patients with a high pretest probability for pulmonary Tuberculosis. Present study having 62% males comparable to Uppe et al, 6 study 9 study in which males 42.7 and females 41.6. In general TB incidence is more common in extremes of age group that is adolescents and elderly group.…”

“…The sensitivity of bronchial specimens ZN stain and CBNAAT are 48.86% and 78.89% respectively in Hazarika et al, 9 study. In Uppe et al, 6 study, the sensitivity of bronchial specimen ZN stain and CBNAAT are 76.83% and 84.15% respectively. In Khalil et al, 9 study, the sensitivity for BAL ZN stain and CBNAAT are 39.53% and 91.86% respectively.…”