Novel Method of Grading the Bacillary Load Using Catridge Based Nucleic Acid Amplification Test in Patients with Pulmonary Tuberculosis

Background: Due to low sensitivity and inability to detect drug resistance, smear microscopy limits its impact on TB control. Culture methods and drug susceptibility testing is complex, time consuming, and takes around 6-8 weeks. A new diagnostic test, cartridge based nucleic acid amplification test (CBNAAT) was developed based on real-time polymerase chain reaction (RT PCR). Objective of this study to compare the results of CBNAAT for diagnosis of pulmonary tuberculosis with LED fluorescent microscopy and sputum culture.Methods: A cross-sectional study was conducted in the department of Chest and TB, CIMS, Bilaspur. Each Sputum sample of presumptive TB patients were tested with CBNAAT, sputum smear microscopy by light emitting diode (LED) fluorescent microscopy (FM) and solid and liquid culture for diagnosis of Tuberculosis. Results of CBNAAT, Fluorescent Microscopy and Culture for detection of Mycobacterium Tuberculosis were compared.Results: The sensitivity and specificity for CBNAAT were 97% and 100% respectively; while that for Fluorescent microscopy were 70% and 100% respectively. The positive and negative predictive value for CBNAAT was 100% and 96% respectively. The positive and negative predictive value for Fluorescent microscopy was 100% and 73% respectively.Conclusion: CBNAAT is having high sensitivity and specificity for diagnosis of pulmonary tuberculosis. It should be routinely used under national health programme to detect a tuberculosis case efficiently.

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To Study the Role of Cartridge-Based Nucleic Acid Amplification Test (CBNAAT) in Early Diagnosis of Extra Pulmonary Tuberculosis

Indian Journal of Otolaryngology and Head & Neck Surgery ◽

10.1007/s12070-021-02673-y ◽

2021 ◽

Author(s):

Aditya Gargava ◽

Shivkumar Raghuwanshi ◽

Priyanka Verma ◽

Santosh Jaiswal

Keyword(s):

Nucleic Acid ◽

Early Diagnosis ◽

Pulmonary Tuberculosis ◽

Nucleic Acid Amplification Test ◽

Nucleic Acid Amplification ◽

Extra Pulmonary Tuberculosis ◽

Extra Pulmonary

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Utility of cartridge based nucleic acid amplification test in the diagnosis of extra pulmonary tuberculosis

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20195231 ◽

2019 ◽

Vol 6 (6) ◽

pp. 1801

Author(s):

Mahesh Chand Bairwa ◽

Mahendra Kumar Banera ◽

Chandan Mal Fatehpuria

Keyword(s):

Mycobacterium Tuberculosis ◽

Nucleic Acid ◽

Pulmonary Tuberculosis ◽

Pleural Fluid ◽

Nucleic Acid Amplification Test ◽

Nucleic Acid Amplification ◽

World Health ◽

Rifampicin Resistance ◽

Extra Pulmonary Tuberculosis ◽

Extra Pulmonary

Background: Tuberculosis is one of the top 10 cause of death globally. Extra-pulmonary tuberculosis is an important clinical problem. Extra-pulmonary tuberculosis range from 30%-53% in India. Diagnosis of extra-pulmonary tuberculosis is still challenging despite many investigations. World Health Organization recommends Gene-Xpert Mycobacterium Tuberculosis/Rifampicin (Cartridge Based Nucleic Acid Amplification Test-CBNAAT) over conventional tests for diagnosis of extra-pulmonary tuberculosis which permits rapid tuberculosis diagnosis through detection of the genetic sequence of DNA of mycobacterium tuberculosis and simultaneous identification of a majority of the mutations that confirm Rifampicin resistance which is highly predictive of multi-drug resistant tuberculosis.Methods: Study was carried out over a period of one year. Patients with suggestive of extra-pulmonary tuberculosis were included in study. Diagnosis of extra-pulmonary tuberculosis carried out by clinical, radiological, biochemical analysis, cytological, bacteriological confirmation. Based on mycobacterium tuberculosis result, the study population were divided into ‘Mycobacterium Tuberculosis detected’ and ‘Mycobacterium Tuberculosis not detected’ groups. Mycobacterium Tuberculosis detected group was further divided into ‘Rifampicin resistant’ and ‘Rifampicin sensitive’.Results: Total 220 patients were included. Among extra-pulmonary tuberculosis, there were 83.64% were pleural fluid. 65.91% patients where be <45 years of age. Mostly patients were from rural areas and illiterate. Diabetes Mellitus found as the most common co-morbidities. CB-NAAT was able to detect mycobacterium tuberculosis in 35% (77) extra-pulmonary samples, out of which 6 were rifampicin resistant. Out of 184 samples of pleural fluid, 53 were rifampicin sensitive and 4 were found rifampicin resistant.Conclusions: CB-NAAT has to be endorsed in every health care centres as the test gives rapid result and also detection of rifampicin resistance which is the major concern for every clinician.

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

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20200502 ◽

2020 ◽

Vol 8 (3) ◽

pp. 1130 ◽

Cited By ~ 1

Author(s):

Kalpesh Moradiya ◽

Arti Muley ◽

Sunil Kumar ◽

Kinjal Patel ◽

Harshal Mahida

Keyword(s):

Nucleic Acid ◽

Pulmonary Tuberculosis ◽

Diagnostic Yield ◽

False Negative ◽

Control Program ◽

Nucleic Acid Amplification Test ◽

Nucleic Acid Amplification ◽

Smear Microscopy ◽

Suspected Case ◽

Bacteriological Diagnosis

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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