USE OF CARTRIDGE BASED NUCLEIC ACID AMPLIFICATION TEST FOR RAPID DETECTION OF MYCOBACTERIUM TUBERCULOSIS IN PULMONARY AND EXTRAPULMONARY TUBERCULOSIS
DOI:
https://doi.org/10.22159/ijpps.2021v13i2.40055Keywords:
Tuberculosis, CBNAAT, Rifampicin resistanceAbstract
Objective: Tuberculosis is an airborne infection caused by Mycobacterium tuberculosis. Timely diagnosis and treatment are important to prevent the spread of infection. Cartridge-based nucleic acid amplification test (CBNAAT) provides a valuable tool in the early detection of TB. This study is undertaken to evaluate the utility of CBNAAT for the detection of MTB. Comparison of cartridge-based nucleic acid amplification testing with ZN staining.
Methods: This prospective observational study was carried out in the Department of Microbiology, BLDEDU’s Shri B. M. Patil Medical College, Hospital and RC and Dr. Karigoudar Diagnostic Laboratory, Vijayapur. A total of 129 samples from patients with the presumptive diagnosis of TB based on history, clinical presentation, and radiological findings were included in the study. All samples were subjected to ZN staining, and Cartridge-based nucleic acid amplification test and data were analyzed.
Results: The present study showed ZN smear positivity of 7.75% and CBNAAT positivity of 19.38%. CBNAAT sensitivity and specificity were 90% and 86.55, respectively, compared with ZN staining with a significant P value of <0.001.
Conclusion: CBNAAT helps diagnose TB and detect rifampicin resistance within 2-3 h with high sensitivity and specificity. Rifampicin resistance detection is of great concern, which otherwise leads to treatment failure and on time spread of multidrug resistance TB, leading to increased morbidity and mortality.
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References
Tuberculosis. WHO global tuberculosis report; 2019. Available from: https://www.who.int/news-room/fact-sheets/detail/ tuberculosis. [Last accessed on 10 Sep 2020].
Arora D, Jindal N, Bansal R, Arora S. Rapid detection of mycobacterium tuberculosis in sputum samples by cepheid xpert assay: a clinical study. J Clin Diagn Res 2015;9:3-5.
Sachdeva K, Shrivastava T. CBNAAT: a boon for early diagnosis of tuberculosis-head and neck. Indian J Otolaryngol Head Neck Surg 2018;70:572-7.
Jain T, Raja JD, Dutta R, Sivaprakasam P, Jayashri D, Gomathy P, et al. Is tuberculosis a familial communicable disease? High time to strengthen contact screening. Asian J Pharm Clin Res 2018;11:7-8.
Scott LE, Beylis N, Nicol M, Nkuna G, Molapo S, Berrie L, et al. Diagnostic accuracy of Xpert MTB/RIF for extrapulmonary tuberculosis specimens: establishing a laboratory testing algorithm for South Africa. J Clin Microbiol 2014;52:1818-23.
Sulochana S, Subhashini V, Chitra S. Pulmonary tuberculosis-a prospective analysis of hematological changes. Asian J Pharm Clin Res 2018;11:169-72.
Munir MK, Rehman S, Aasim M, Iqbal R, Saeed S. Comparison of ziehl neelsen microscopy with genexpert for detection of mycobacterium tuberculosis. IOSR J Dental Med Sci 2015;14:56-60.
Mukherjee S, Biswas D, Begum S. Evaluation of cartridge-based nucleic acid amplification test in the diagnosis of pulmonary tuberculosis. J Evolution Med Dent Sci 2017;6:5281-6.
Mostaza JL, Garcia N, Fernandez S, Bahamonde A, Fuentes MI, Palomo MJ. Analysis and predictor of delay in suspicion and treatment among hospitalized patients with pulmonary tuberculosis. An Med Interna 2007;24:478-83.
Ramirez HL, Garcia Clemente MM, Alvarez Alvarez C. Impact of the xpert MTB/RIF molecular test on the late diagnosis of pulmonary tuberculosis. Int Union Against Tuberculosis Lung Disease 2014;18:435-7.
Bajrami R, Mulliqi G, Kurti A, Lila G, Raka L. Comparison of GeneXpert MTB/RIF and conventional methods for the diagnosis of tuberculosis in Kosovo. J Infect Dev Ctries 2016;10:418–22.
Kandi S, Reddy V, Nagaraja SB. Diagnosis of pulmonary and extra pulmonary tuberculosis: How best is CBNAAT when compared to conventional methods of TB detection? Pulm Res Respir Med Open J 2017;4:38-41.
Panayotis I, Papaventsis D, Karabela S. Cepheid GeneXpert MTB/RIF assay for mycobacterium tuberculosis detection and rifampin resistance identification in patients with substantial clinical indications of tuberculosis and smear-negative microscopy results. J Clin Microbiol 2011;49:3068-70.
Armand S, Vanhuls P, Delcroix G, Courcol R, Lemaître N. Comparison of the Xpert MTB/RIF test with an IS6110-TaqMan real-time PCR assay for direct detection of Mycobacterium tuberculosis in respiratory and nonrespiratory specimens. J Clin Microbiol 2011;49:1772–6.
Steingart KR, Schiller I, Horne DJ, Pai M, Boehme CC, Dendukuri N. Xpert® MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults. Cochrane Database Syst Rev 2014. DOI:10.1002/14651858.CD009593.pub3
Theron G, Pooran A, Peter J. Do adjunct tuberculosis tests, when combined with Xpert MTB/RIF, improve accuracy and the cost of diagnosis in resource-poor settings? Eur Respir J 2012;40:161-8.
Shashidhar M, Sandhya Sm, Suresh Kt, Pankaj P, Suhasini B. A critical insight into shikimate kinase pathway. Int J Curr Pharm Res 2015;7:111-3.
Boyles TH, Hughes J, Cox V, Burton R, Meintjes G, Mendelson M. False-positive Xpert(®) MTB/RIF assays in previously treated patients: need for caution in interpreting results. Int J Tuberc Lung Dis 2014;18:876-8.
Basavaraj VP, Rajani R. CBNAAT: a novel tool for rapid detection of MTB and rifampicin resistance. Int J Curr Microbiol Appl Sci 2016;5:383-8.
Road map for rolling out Xpert MTB/RIF for rapid diagnosis of TB and MDR-TB. WHO 2010. Available from: http://www.who.int/tb/laboratory/roadmap_xpert_mtb-rif.pdf. [Last accessed on 10 Sep 2020].
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