Rapid Detection of Mycobacterium tuberculosis in Sputum Samples by Cepheid Xpert Assay: A Clinical Study

Arora, Divya; Jindal, N; Bansal, Renu; Arora, Shilpa

doi:10.7860/jcdr/2015/11352.5935

Cited by 15 publications

(12 citation statements)

References 12 publications

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“…Sethi et al reported HIV-TB co-infection in 20.1% cases [8] and in the study of Arora et al, 2.5% were HIV positive. [9] According to WHO reports on MDR, MDR-TB in India continues to be reported in between 2.5-2.8% and 14-17% amongst new TB and retreated patients, respectively. [10][11][12][13] In present study, the cases with Rifampicin resistance were 165 (13.91%) among Old and New TB cases (1186).…”

Section: R E S U L T Smentioning

confidence: 99%

A Three-Year Experience with GeneXpert MTB/RIF Assay in Tuberculosis Control Programme (RNTCP)- A Clinical Study

Nemagouda¹

2019

jemds

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BACKGROUND MDR-TB caused an estimated 600,000 new TB cases and 240,000 deaths in 2016 and MDR-TB accounts for 4.1% of all new TB cases and 19% of previously treated cases worldwide. Globally, most MDR-TB cases occur in South America, Southern Africa, India, China, and the former Soviet Union. Rapid detection of drug resistance of M. tuberculosis and MDR-TB strains ensures effective treatment of TB patients and limits further development of resistance to additional drugs. The GeneXpert test is a molecular test for TB which diagnoses TB by detecting the presence of TB bacteria, as well as testing for resistance to the drug Rifampicin. In India, where this test is starting to be widely used, it is known as the CBNAAT. The full name of the CBNAAT test is the Cartridge Based Nucleic Acid Amplification Test. The objective of the study is to assess the performance of GeneXpert MTB/RIF as an initial diagnostic tool for the diagnosis of Mycobacterium tuberculosis and Rifampicin Resistance. METHODS The RNTCP programme is being strictly followed and carried out in Shri B.M. Patil Medical college Hospital, BLDE University Vijayapur Karnataka. Samples of patients with symptoms suggestive of tuberculosis including, suspected new TB cases, old TB cases and on treatment TB cases, were received from all the Primary Healthcare Canters, and all other Healthcare Centres including two Medical College Hospitals of Vijayapur district. Samples collected under this programme were analysed by GeneXpert Test at District TB Hospital CBNAAT center Vijayapur, Karnataka. A retrospective study was conducted from 1 January 2016 to 31 December 2018. The samples were subjected to GeneXpert MTB/ RIF manufactured by Cepheid, France for the detection of M. tuberculosis and then rifampicin resistance in them. Data analysis was done using SPSS Version 22.0.0.0. RESULTS In this study a total of 4978 patients' samples was processed for CBNAAT test. Out of these cases, MTB was detected in 1186 (23.82%), Rifampicin Resistance (RR) was detected in 165 (13.91%) cases. Among these 165 MTB-RR cases, the MTB detection level was, 50 (30.30%) High, 65 (39.39%) Medium, 26 (15.79%) Low, 16 (9.69%) Very Low & 8 (4.84%) Intermediate. Out of 4978 cases 427 (8.58%) were HIV positive, among these HIV positive cases MTB was detected in 51 (12%) & RR detected in 13 (25.50%) cases. CONCLUSIONS The implementation of the GeneXpert MTB/RIF assay in programmatic management of TB & MDR-TB in RNTCP has dramatically improved the rapid diagnosis of tuberculosis & drug resistance, especially in People Living with HIV/AIDS (PLWHA).

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Section: R E S U L T Smentioning

confidence: 99%

A Three-Year Experience with GeneXpert MTB/RIF Assay in Tuberculosis Control Programme (RNTCP)- A Clinical Study

Nemagouda¹

2019

jemds

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“…As evident from Table 1 A study done by Arora et al, found rifampicin resistance of 15.7% in PLHIV which was higher than this study. 10 Another study done by Dewan et al, done in Delhi found rifampicin resistance of 10. 11 This high resistance to rifampicin compared to our study may be due to higher prevalence of MDR TB in north India and also referral from multiple states.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic yield of cartridge based nucleic acid amplification test in Mycobacterium tuberculosis in a tertiary care medical college and hospital of Southern Odisha, India

Manoranjan¹,

Samal²,

Rekha³

et al. 2019

Int J Res Med Sci

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Background: Tuberculosis is the ninth leading cause of death worldwide. India contributes to about one fifth of global TB burden. It is very important to diagnose early and treat tuberculosis to cut down transmission of tuberculosis.Methods: Author conducted a retrospective study in Department of Pulmonary Medicine SLN Medical College, Koraput, Odisha to analyze the utility and yield of CBNAAT. Study period was from April 2018 to March 2019. Inclusion criteria was all patients whose samples were subjected to CBNAAT were included in our study. Sputum samples from pulmonary tuberculosis patients, and extra pulmonary samples (pleural fluid, ascitic fluid, CSF, synovial fluid and gastric lavage etc. were included in our study population. Exclusion criteria was patients who were under anti tubercular therapy for pulmonary, extra pulmonary and MDR TB were excluded from this study. Data were collected from Pulmonary Medicine Department, ART center, DOTS center and CBNAAT center. Total number of samples tested for CBNAAT, different sample collection sites, age and sex distribution of patients, HIV status of all patients, result of smear microscopy for AFB and CBNAAT and Rifampicin resistance status were analyzed.The detail statistical analysis was done in tabulation form.Results: A total of 2621 samples were tested in CBNAAT during the study period. Mean age of the study population was 38.03 years. 1881 tested were negative and 740 samples were positive for CBNAAT. Of these 2621 samples, 2526 were pulmonary samples (sputum, pleural fluid samples) and 95 were extra pulmonary samples. Author found rifampicin resistance rate of 0.54% (4/740)) in pulmonary tuberculosis cases. There was no rifampicin resistance detected in extra pulmonary samples. CBNAAT could identify 536 cases (23.2%) that were smear negative. Author found TB- HIV co-infection rate of 6.22%.Conclusions: CBNAAT is an important diagnostic modality especially in sputum negative patients for early diagnosis and treatment. In our study it detected Mycobacterium tuberculosis in 23.2% of patients with negative smear for microscopy. Rifampicin resistance rate detected was very low compared to other studies.

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“…3 Revised National TB Control Programme (RNTCP) also currently recommends use of CBNAAT to diagnose pulmonary TB, pediatric TB, extrapulmonary TB and rifampicin resistant and Multi Drug Resistant Tuberculosis in high risk populations like HIV positive as recommended by WHO under 2013 policy recommendations. 4 The CBNAAT assay consists of a closed system that is based on real-time polymerase chain reaction (PCR) which requires minimal technical expertise in the diagnosis of TB and rifampicin resistance within two hours. 5 It has been validated and optimized for sputum samples to diagnose HIV associated TB and multidrugresistant TB also.…”

Section: Introductionmentioning

confidence: 99%

Cartridge based nucleic acid amplification test negative in highly suspected case of tuberculosis: a case report

Moradiya¹,

Muley²,

Kumar³

et al. 2020

Int J Res Med Sci

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Diagnosis of pulmonary tuberculosis is challenging till today. Smear microscopy is the easiest, commonest and widely employed tool for confirmatory diagnosis of pulmonary tuberculosis, but it has low sensitivity and specificity. Sputum culture can increase the diagnostic yield by 20-40%, but it takes long duration of 2-8 weeks to give result. The role of newly introduced cartridge based nucleic acid amplification test (CBNAAT) in the revised national TB control program (RNTCP) is highly promising with a higher yield of bacteriological diagnosis in sputum negative pulmonary tuberculosis patients with detection of rifampicin resistance rapidly. However, it also has some limitations which may result in false negative results. Case of a 50- year-old-male was reported who was initially managed for community-acquired pneumonia in view of negative sputum and CBNAAT but was later confirmed to have TB but by then he had developed cavities in lung and had transmitted the infection to his son.

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Rapid Detection of Mycobacterium tuberculosis in Sputum Samples by Cepheid Xpert Assay: A Clinical Study

Cited by 15 publications

References 12 publications

A Three-Year Experience with GeneXpert MTB/RIF Assay in Tuberculosis Control Programme (RNTCP)- A Clinical Study

A Three-Year Experience with GeneXpert MTB/RIF Assay in Tuberculosis Control Programme (RNTCP)- A Clinical Study

Diagnostic yield of cartridge based nucleic acid amplification test in Mycobacterium tuberculosis in a tertiary care medical college and hospital of Southern Odisha, India

Cartridge based nucleic acid amplification test negative in highly suspected case of tuberculosis: a case report

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