Role of Bronchial Washing Gene Xpert in Sputum-Scarce Cases of Suspected Pulmonary Tuberculosis

Zuberi, Faisal Faiyaz; Hussain, Sagheer; Hameed, Sidra; Zuberi, Bader Faiyaz

doi:10.12669/pjms.35.1.107

Cited by 2 publications

(3 citation statements)

References 17 publications

(20 reference statements)

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“…Важное место при верификации диагноза туберкулеза занимала полимеразная цепная реакция, позволяющая выявлять ДНК МБТ [11]. Так, у пациентов с отсутствием продукции мокроты, при исследовании жидкости БАЛ с помощью молекулярно-генетических методов было подтверждено наличие МБТ в 69,2% случаев [12]. Пациентам с отрицательными результатами бактериоскопических и культуральных методов исследования мокроты при наличии признаков, подозрительных на туберкулез, обусловленный МБТ с МЛУ/ШЛУ, рекомендован тест Xpert MTB/RIF [12][13][14], позволяющий установить наличие МБТ в 57,9% случаев [13].…”

Section: молекулярно-генетические методы диагностикиunclassified

“…Так, у пациентов с отсутствием продукции мокроты, при исследовании жидкости БАЛ с помощью молекулярно-генетических методов было подтверждено наличие МБТ в 69,2% случаев [12]. Пациентам с отрицательными результатами бактериоскопических и культуральных методов исследования мокроты при наличии признаков, подозрительных на туберкулез, обусловленный МБТ с МЛУ/ШЛУ, рекомендован тест Xpert MTB/RIF [12][13][14], позволяющий установить наличие МБТ в 57,9% случаев [13]. При сравнении с тестом Xpert он показал более высокую чувствительность (70,9% против 57,9%, р=0,001) в случаях диагностики легочного туберкулеза при недоказанном бактериовыделении [14].…”

Section: молекулярно-генетические методы диагностикиunclassified

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Diagnosis of bacteriologically unconfirmed pulmonary tuberculosis (literature review)

Tyulkova¹,

Lugovkina²,

Kutuzova³

et al. 2022

Russian Medical Inquiry

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The authors analyzed 31 scientific publications, which highlighted modern methods to the diagnosis of bacteriologically unconfirmed pulmonary tuberculosis (PTB). In the article, such clinical cases are classified into two groups due to the absence of the tuberculosis causative agent. This approach can serve as a justification for choosing optimal and appropriate additional methods and techniques for diagnosing bacteriologically unconfirmed PTB. Given the fact that bacterial excretion is determined by traditional microbiological methods (microscopic and cultural) in sputum, the literature review presents data on additional measures for obtaining biological material for the etiological diagnosis of tuberculosis, using molecular genetic methods for detecting Mycobacterium tuberculosis DNA. Besides, the article shows the diagnostic significance of immunological and serological tests for the tuberculosis diagnosis, as well as modern methods to the X-ray results interpretation, using mathematical methods that evaluate the dynamic X-ray imaging. A special place in the bacteriologically unconfirmed PTB diagnosis is occupied by the description of biopsy material using artificial intelligence. That is, the integration of medicine and information technology achievements allows us having a source of additional information that should help the doctor diagnose tuberculosis in difficult clinical cases. KEYWORDS: tuberculosis, oligobacillar forms of tuberculosis, sputum smear-negative tuberculosis, diagnosis, bacteriologically unconfirmed, diagnostic material, immunological methods, radiation methods, mathematical methods. FOR CITATION: Tyulkova T.E., Lugovkina T.K., Kutuzova D.M., Khabibullina N.F. Diagnosis of bacteriologically unconfirmed pulmonary tuberculosis (literature review). Russian Medical Inquiry. 2022;6(7):387–392 (in Russ.). DOI: 10.32364/2587-6821-2022-6-7-387-392.

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Section: молекулярно-генетические методы диагностикиunclassified

Diagnosis of bacteriologically unconfirmed pulmonary tuberculosis (literature review)

Tyulkova¹,

Lugovkina²,

Kutuzova³

et al. 2022

Russian Medical Inquiry

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“… 4 For diagnosis of PTB in such individuals alternative methods are used including Gastric lavage (GL), Bronchoalveolar Lavage (BAL) and Sputum Induction (SI). 5 However, these substitute methods have merits and demerits of their own. For instance, BAL is an invasive procedure which is not possible in all regions of developing countries due to limited resources and other constraints.…”

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Yield & accuracy of Gastric Lavage in non-expectorating adults with Suspected Pulmonary Tuberculosis

et al. 2023

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Objective: To determine the yield of Gastric lavage (GL) in non-expectorating adults with suspected Pulmonary Tuberculosis (PTB) and accuracy of GL-AFB smear with GL-GeneXpert (GXP) by taking AFB culture as gold standard. Methods: Cross-sectional study on suspected PTB patients was done at Ojha Institute of Chest Diseases during period 16th July 2020 till 15th January 2021. Adult patients of either gender suspected to have PTB and not expectorating were included. GL was performed and sent for AFB smear, GXP and AFB culture. Odds ratio, sensitivity and specificity were calculated. Results: After informed written consent, 206 patients, mean age was 38.17 ±17.30 years were inducted, including 89 (43.2%) males and 117 (56.8%) females. Gene Xpert, AFB smear & AFB culture were positive in 83(40%), 50 (24%) & 72 (35%) respectively in GL samples. Odds of PTB were 3.95 times higher among patients with ≤1 month of duration of symptoms (aOR 3.95, 95% CI 1.82-8.57, p-value 0.001), 6.24 times higher among patients with weight loss (aOR 6.24, 95% CI 3.03-12.84, p-value <0.001), and 4.22 times higher among patients with cavitation (aOR 4.22, 95% CI 1.99-8.93, p-value <0.001). GL-AFB smear showed sensitivity 63.89%, specificity 97.01%, positive predicted value 92%, negative predicted value 83.3%, and overall diagnostic accuracy 85.4%. Whereas GL-GXP showed sensitivity 94.4%, specificity 88.81%, positive predicted value 81.93%, negative predicted value 96.75%, and overall diagnostic accuracy 90.78%. Conclusion: Yield of GL significant to detect PTB in suspected cases who are not expectorating. GL-GXP diagnostic accuracy and sensitivity is higher than GL-AFB smear. doi: https://doi.org/10.12669/pjms.39.5.6972 How to cite this: Ghafoor L, Zuberi FF, Khan GM, Ismail M. Yield & accuracy of Gastric Lavage in non-expectorating adults with Suspected Pulmonary Tuberculosis. Pak J Med Sci. 2023;39(5):---------. doi: https://doi.org/10.12669/pjms.39.5.6972 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Role of Bronchial Washing Gene Xpert in Sputum-Scarce Cases of Suspected Pulmonary Tuberculosis

Cited by 2 publications

References 17 publications

Diagnosis of bacteriologically unconfirmed pulmonary tuberculosis (literature review)

Diagnosis of bacteriologically unconfirmed pulmonary tuberculosis (literature review)

Yield & accuracy of Gastric Lavage in non-expectorating adults with Suspected Pulmonary Tuberculosis

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