Cytological Study of Tuberculosis in Pulmonary and Extrapulmonary Lesions in Correlation with Cartridge Based Nucleic Acid Amplification Test (CBNAAT)
Keywords:
Tuberculosis, polymerase chain reaction amplification, pleural fluid, smear microscopy
Abstract
Introduction: Various methods can be used for the detection of tuberculosis of which microscopy, culture and identification of the organism's DNA are known. Newly introduced Nucleic acid amplification test (NAAT) if used in combination with other tests provide improved diagnostic yield. Aims and Objectives: To diagnose tuberculosis bacilli in various cytological samples and sputum samples. To evaluate the diagnostic efficacy of combined approach of conventional smear study and and CBNAAT. Material and Methods: A Total of 50 cytology samples received in Pathology Department were studied over a period of 6 months. These included sputum (20), lymph node(22),body fluids(8).For these samples routine staining and ziehl neelsen are done and the remaining sample is sent for CBNAAT.Results are compared among AFB,CBNAAT for these samples. Sensitivity and specificity of microscopy and CBNAAT tests were calculated. Results: Out of 50 cases 31 cases were positive for smear study and 29 cases were positive for CBNAAT. Conclusion: Cytological examination of TB in association with CBNAAT is more confirmatory, sensitive and specific tool for the early diagnosis of MTB in variety of clinical samples.References
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[2]. Singh KG, Tandon S, Nagdeote S.T, Sharma K, Kumar A. Role of CBNAAT in diagnosing Mycobacterial tuberculosis and rifampicin resistance in tubercular peripheral lymphadenopathy. 2017; 5(03)
[3]. World Health Organization: Xpert MTB/RIF implementation manual: technical and operational ‘how-to’: practical considerations. GPS Publishing; 2014.
[4]. Christopher A. French. Respiratory tract. In:Edmund S.Cibas,BarbaraS.Ducatman(Eds). Cytology Diagnostic Principles and clinical correlates. 3rd ed. Philadelphia: Sanders Elsevier;2009. P65-98.
[5]. Qadri SM, Akhtar M, Ali MA. Sensitivity of fine-needle aspiration biopsy in the detection of mycobacterial infections. Diagn Cytopathol. 1991;7:142-146.
[6]. Das DK, Bhambhani S, Pant JN, et al.: Superficial and deep-seated tuberculosis lesions: Fine-needle aspiration cytology diagnosis of 547 cases. Diagn Cytopathol. 1992;8:211-215.
[7]. Jon H. R, Hannah R. K. Lung. In: Humphrey, Peter A. D, Louis P. P, John D(Eds). Washington Manual of Surgical Pathology. 1sted. Lippincott Williams & Wilkins;2008.
[8]. Helb, D, et al. Rapid Detection of Mycobacterium Tuberculosis and Rifampin Resistance by Use of On-Demand, Near-Patient Technology. Journal of Clinical Microbiology. 2010;48: 229–237.
[9]. Alexander J. M, Danny A. M, Arlene H. S. Infectious diseases. In: Vinay K, Abdul K. A, John C. A. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Philadelphia: Sanders Elsevier;2009. P65-98.
[10]. Jeffrey L. M. In: Juan R, Lauren V. A. Rosai and Ackerman’s Surgical pathology.10th ed. Philadelphia: Sanders Elsevier;2011. P370-443.
[11]. Sunil K K, Uma P, Bhagyalakshmi A, Nammi V, Divya Y. Role of CB-NAAT in diagnosing extra pulmonary tuberculosis in correlation with FNA in a tertiary care center. International Journal of Research in Medical Sciences. 2018 Dec;6(12):4039-4045.
[12].Promod K. M, Ankush R, Netrapal S, Gopal K. K. Diagnosis of extrapulmonary tuberculosis by PCR. FEMS Immunology & Medical Microbiology.2012; 66:20–36.
[13]. Stephen D L, Alimuddin I Z. The diagnosis of extrapulmonary tuberculosis using the Xpert® MTB/RIF assay. Europe PMC Funders Group Author Manuscript. 2012 June; 10(6): 631–635.
[14].Massoud H, Mohammad R, Rana A. Is PCR assay reliable for diagnosis of extrapulmonary tuberculosis. African Journal of Microbiology Research. 2009;3:877-881.
[15].Lenaerts A, Barry CE, Dartois V. Heterogeneity in tuberculosis pathology, microenvironments and therapeutic responses. Immunological Reviews. 2015;264(1):288-307.
[16].Suzana S, Ninan MM, Gowri M, Venkatesh K, Rupali P, Michael JS.Xpert MTB/Rif for the diagnosis of extrapulmonary tuberculosis-an experience from a tertiary care centre in South India. Trop Med Int Health. 2016 Mar;21(3):385-92.
[17]. Centers for Disease Control and Prevention (CDC). Updated guidelines for the use of nucleic acid amplification tests in the diagnosis of tuberculosis. MMWR Morb Mortal Wkly Rep. 2009;58:7-10.
[18]. Joint Committee for the Revision of Korean Guidelines for Tuberculosis, Korea Centers for Disease Control, and Prevention. Korean guidelines for tuberculosis. 2nd ed. Seoul and Cheongwon: Joint Committee for the Revision of Korean Guidelines for Tuberculosis, Korea Centers for Disease Control and Prevention; 2014.
[19]. International standards for tuberculosis care. Wkly Epidemiol Rec. 2006;81:43-7.
[20]. Achkar JM, Sherpa T, Cohen HW, Holzman RS. Differences in clinical presentation among persons with pulmonary tuberculosis: a comparison of documented and undocumented foreign-born versus US-born persons. Clin Infect Dis 2008;47:1277-83.
[21]. Dewan PK, Grinsdale J, Kawamura LM. Low sensitivity of a whole-blood interferon-gamma release assay for the detection of active tuberculosis. Clin Infect Dis 2007;44:69-73.
[22]. Louis J. elm Xpert MTB/RIF for Rapid Diagnosis of Tuberculous Lymphadenitis from Fine-Needle-Aspiration Biopsy Specimens. Journal of clinical microbiology, 2011;49:3967–3970.
[23]. Zuber A. Antimicrobial drug resistance. Indian Academy of Clinical Medicine 2003; 4(4)
Published
2020-03-12
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