The Validity of Mycobacterium Tuberculosis Antigens Cocktail: Esat-6, CFP-10 and Mpt64 in Sputum and Cerebrospinal Fluid for Pulmonary Tuberculosis and Tuberculous Meningitis Diagnosis

Abstract

Objective: To determine the validity of tuberculosis (TB) antigen cocktail (ESAT-6, CFP-10 and MPT64) for pulmonary tuberculosis and TB meningitis diagnosis.Methods: This is a descriptive observational study design. The study was conducted at the Clinical Pathology Laboratory of Dr. Hasan Sadikin General Hospital during September 2012 until March 2013 for the pulmonary tuberculosis study and from January 2014 to May 2014 for the TB meningitis study. The TB antigen cocktail rapid immunochromatography (ICT) test was conduncted on all samples. The sputum and cerebrospinal fluid (CSF) were cultured as gold standards.Results: There were 149 pulmonary and 41 TB meningitis subjects. The sensitivity of rapid ICT TB antigen cocktail for diagnosing pulmonary tuberculosis was 95.7% with a specificity of 87.2%. Of 41 TB meningitis subjects, based on Marais criteria, there were 6 (16%) subjects with a definite TB meningitis, 26 (63%) subjects with probable TB meningitis, and 9 (21%) subjects with possible TB meningitis. The sensitivity and specificity of TB antigen cocktail rapid ICT for TB meningitis diagnosis were 83.3% and 68.5%, respectively. Conclusions:In this study, rapid ICT TB antigen cocktail (ESAT-6, CFP-10 and MPT64) from sputum sample has good validity for diagnosing a pulmonary tuberculosis. Cerebrospinal fluid sample has moderate validity to diagnose TB meningitis.

Role of Risk Factors in the Incidence of Multidrug-Resistant Tuberculosis

“…The MDR-TB patients are likely to continue with the TB treatment, then move to the second line, until a screening for MDR-TB suspects is conducted. 19,20 Nevertheless, Garcia Vázquez et al 18 stated that the risk of MDR-TB to occur by the factor of the number of previous TB treatments alone is minimum.…”