Isolation of Mycobacterium Tuberculosis in Body Fluids and Comparison of Conventional Methods with Polymerase Chain Reaction in a Tertiary Care Hospital Chennai.

Jayamani, N (2011) Isolation of Mycobacterium Tuberculosis in Body Fluids and Comparison of Conventional Methods with Polymerase Chain Reaction in a Tertiary Care Hospital Chennai. Masters thesis, Stanley Medical College, Chennai.


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INTRODUCTION : Tuberculosis has co-existed with humanity since the days before recorded history and evidence of tuberculosis has been found in the skeletal remains of mummies. Hippocrates not only described the disease but also named it ‘phthisis’ which means to mart or waste away. Tuberculosis remains a major global public health problem. Roughly a third of the world's population has been infected with M. tuberculosis, and new infections occur at a rate of one per second. However, not all infections with M. tuberculosis cause TB disease and many infections are asymptomatic. As per WHO 2009 report, in 2008, there were an estimated 8.9-9.9 million incident cases of Tuberculosis, 9.6-13.3 million prevalent cases of Tuberculosis 1.1-1.7 million deaths from Tuberculosis. India had the largest total incidence, with an estimated 2.0 million new cases. India has the most number of cases of tuberculosis and accounts for about one-fifth of the global TB burden and 2/3th of the South –East Asian countries burden. Nearly 40% of the Indian population is affected with tuberculosis bacillus. Each year, 1.9 million cases of TB are detected, amongst which 0.8 million are smear positive new cases (infectious cases). Daily, nearly 1000 people die due to TB (2 deaths/ 3 minutes). As per WHO estimate, there were nearly 322,000 TB deaths in 2006 in India which accounted for 26% of all the preventable adult deaths. AIMS AND OBJECTIVES : Study of prevalence of extra pulmonary tuberculosis in a Tertiary Care Hospital, Chennai Comparison of smear by Ziehl-Neelsen and Auramine Phenol Fluorescence Staining Isolation of Mycobacterium in Extra Pulmonary specimens by employing conventional bacteriological methods. Comparison of culture by Kirchner’s and Lowenstein-Jensen Medium Identification of Mycobacteria by employing standard phenotypic methods. Performing drug susceptibility on the isolates identified as Mycobacterium tuberculosis. Comparison of conventional methods with molecular method IS 6110 based Polymerase Chain Reaction. CONCLUSION A high index of suspicion is necessary to diagnose of Extra Pulmonary Tuberculosis. Delay in diagnosis leads to sequelae in severe forms of Tuberculosis. More than one diagnostic procedure is often needed for confirmation of the diagnosis, as Extra Pulmonary Specimens were paucibacillary in nature. Staining is a rapid method for detection of Mycobacterium Tuberculosis but always it should be confirmed with culture in Lowenstein-Jensen medium which is the Gold standard conventional method. Bacteriological and molecular methods aid in correct diagnosis of Extra Pulmonary Tuberculosis. Drug susceptibility on culture positives will detect Multi Drug Resistant tuberculosis. Mycobacteria grow slowly and replicate every 18-20 hours, so growth in culture requires days or weeks. Culture is laborious and time consuming. The Rapid detection of bacilli with IS6110 based PCR assay is needed in management and prevention of complication.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Isolation ; Mycobacterium Tuberculosis ; Body Fluids ; Comparison ; Conventional Methods ; Polymerase Chain Reaction ; Tertiary Care Hospital ; Chennai.
Subjects: MEDICAL > Microbiology
Depositing User: Subramani R
Date Deposited: 24 Jul 2017 06:59
Last Modified: 24 Jul 2017 06:59

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