Comparative Study between Fluorescent Microscopy, Mycobacterial Growth Indicator Tube (MGIT) and Gene Xpert for the Detection of Mycobacterium Tuberculosis from Clinical Suspects of Smear Negative Pulmonary Tuberculosis and Extra Pulmonary Tuberculosis Patients

Kayalvili, K K (2015) Comparative Study between Fluorescent Microscopy, Mycobacterial Growth Indicator Tube (MGIT) and Gene Xpert for the Detection of Mycobacterium Tuberculosis from Clinical Suspects of Smear Negative Pulmonary Tuberculosis and Extra Pulmonary Tuberculosis Patients. Masters thesis, Stanley Medical College, Chennai.

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Abstract

BACK GROUND AND OBJECTIVES: Mycobacterium tuberculosis remains one of the most significant causes of death from an infectious agent. The rapid diagnosis of tuberculosis and detection of anti tubercular drug resistance are essential for early disease management. We determined the performance of the Fluorescent Microscopy, MGIT, Gene Xpert MTB/RIF assay for rapid diagnosis of tuberculosis in smear positive and smear-negative pulmonary and extra pulmonary specimens obtained from clinical and radiological suspects of tuberculosis patients. A total 100 patients, among them specimens such as sputum and BAL fluid were collected from 49 patients, and pleural fluid, ascitic fluid, Pus, Lymph Node aspirates were collected from 51 patients. METHODS: Specimens were digested and decontaminated with standard NaoH-NALC method for MGIT culture. RESULTS: Overall ,Modified Ziehl- Neelsen detected 3,Fluorescent Microscopy detected 5, MGIT detected 17 and Gene Xpert detected 26.In smear negative pulmonary specimens MGIT detected 8 strains whereas Gene Xpert 10. Among the Extra pulmonary specimens ZN detected 3, Fluorescent Microscopy 5, MGIT detected 9, and Gene Xpert 16. There was 100 % agreement between Fluorescent microscopy, in relation to MGIT culture and Gene Xpert. There was 90% agreement between MGIT & Gene X pert with respect to Mycobacterium tuberculosis complex identification. All 10 MTBC strains were sensitive to streptomycin, Isoniazide, Rifampicin and Ethambutol, which is also sensitive for Rifampicin by Gene Xpert. There was no discrepancy in the sensitivity results. Gene Xpert detected 1 MTBC Rifampicin Resistant strain which was not picked up by MGIT. Among the 7 Atypical mycobacterias all were resistant to Streptomycin, Isoniazide, and Ethambutol, except one strain which was sensitive to Rifampicin by MGIT. CONCLUSION: The results of this study indicated that the implementation of Gene Xpert MTB/RIF assay could dramatically improve the rapid diagnosis of tuberculosis particularly in smear negative pulmonary & extra pulmonary specimens such as pus, lymph node aspirates and wound discharges. Gene X pert negative specimens can be processed in MGIT to recover Atypical Mycobacteria.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Fluorescent Microscopy ; MGIT ; Gene Xpert. NALC- N ; acetyl-Lcysteine.
Subjects: MEDICAL > Microbiology
Depositing User: Punitha K
Date Deposited: 23 May 2018 03:01
Last Modified: 27 May 2018 05:27
URI: http://repository-tnmgrmu.ac.in/id/eprint/8029

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