Comparative study of the smear microscopy, with conventional  culture in clinically suspected cases of pulmonary and extra  pulmonary tuberculosis

Paramjit Singh; Sapna Chauhan; Mapary Lakshmikantha; Swati Tiwari; Sachin Sharma

doi:10.18203/2320-6012.ijrms20150602

Authors

Paramjit Singh Department of Microbiology, Muzaffarnagar Medical College and Hospital, Muzaffarnagar, UP
Sapna Chauhan Department of Microbiology, Muzaffarnagar Medical College and Hospital, Muzaffarnagar, UP
Mapary Lakshmikantha Department of Microbiology, Muzaffarnagar Medical College and Hospital, Muzaffarnagar, UP
Swati Tiwari Department of Microbiology, Muzaffarnagar Medical College and Hospital, Muzaffarnagar, UP
Sachin Sharma Department of Microbiology, Muzaffarnagar Medical College and Hospital, Muzaffarnagar, UP

DOI:

https://doi.org/10.18203/2320-6012.ijrms20150602

Keywords:

Tuberculosis, Conventional culture, ZN staining, Pulmonary, Extra pulmonary

Abstract

Background: Tuberculosis is a significant cause of morbidity and mortality in the Indian subcontinent. A major challenge to clinical microbiology is the detection of Mycobacterium tuberculosis as accurately as possible.

Objective: Tthe most important tool in the diagnosis of tuberculosis is direct microscopic examination of appropriately stained specimens for acid- fast bacilli and the gold standard for diagnosing tuberculosis is MTB convention culture on L-J media So, the present study was undertaken to compare smear microscopy by Z – N staining with conventional culture on L-J media, in cases of clinically suspected Pulmonary Tuberculosis and Extra Pulmonary Tuberculosis.

Methods: 279 samples were processed within 24 hours of receipt. Samples from non-sterile sites were subjected to decontamination by the modified Petroff’s method. Sterile samples were directly processed as per conventional methods. Smear microscopy was done by Z- N staining and culture was done on L- J media. A control organism in the form of M. tuberculosis H37Rv was also tested with each batch of clinical isolates.

Result: Results of smear microscopy and conventional culture of pulmonary and extra pulmonary specimens were compared. 22 and 14 more cases were detected by culture as compared to smear in case of pulmonary and extra pulmonary specimens respectively.

Conclusion: From this study we can state that direct microscopic examination of appropriately stained Pulmonary and Extra Pulmonary specimens for acid fast Bacilli is an important tool in the diagnosis of tuberculosis. The Technique is simple, inexpensive and fast .However many Paucibacillary cases may be missed on smear microscopy. Thus specimens from all suspected cases of Pulmonary and Extrapulmonary Tuberculosis should be subjected to conventional culture on LJ media. This is the Gold Standard for Diagnosing Tuberculosis.

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References

Haas DW. Mycobacterium Tuberculosis. In: Mandell GL, Bennett JE and Dolin R, editors. Mandell Douglas and Bennett’s Principles and practice of infectious Diseases. 5th edition. New York. Churchill Livingstone, 2000; 2576-2607.

The World Health Report 2014: Office of Publications, World Health Organization, Geneva. 2014; 13-14.

Khatri GR. DOTS Progress in India: 1995-2002. Tuberculosis 2003;83:30-4.

Walker D. Economic Analysis Of Tuberculosis Diagnostic Tests in Disease Control: How it can be modeled and what additional information is needed? Int J Tuberc Lung Dis 2001;5(12):1099-108.

Catanzaro A, Davidson BL, Fujiwara et al. Rapid Diagnostic Tests for Tuberculosis: what is the appropriate use? Am J Respir Crit Care Med 1997; 155:1804-1814.

Barnes PF. Rapid Diagnostics Tests for Tuberculosis: Progress but no Gold Standard. Am J Respir Crit Care Med 1997; 155:1497-1498.

Koneman EW, Allen SD, Janda WM, Schreckenberger PC, Winn WC. Color Atlas and Textbook of Diagnostic Microbiology 5th edn. Philadelphia: Lippincott – Raven Publishers; 1997: 893-952.

Behr MA, Warren SA, Salamon Het al. Transition of Mycobacterium tuberculosis from patients smear negative for acid-fast bacilli. Lancet. 1999;353:444-9.

American Thoracic Society and Centers for Disease Control and Prevention. Diagnostic Standards and Classification of Tuberculosis in Adults & Children. Am J Resp Crit Care Med. 2000;161:1376-95.

Somoskovi A, Mester J, Hale YM, Parsons LM, Salfinger M. Laboratory Diagnosis of Nontuberculous Mycobacteria. Clin Chest Med 2003;23:585-97.

Kent PT, Kubica GP. Public Health Mycobacteriology: A guide for the level III laboratory. Atlanta: Department of Health and Human Services. 1985.

Perkins MD. New Diagnostic Tools for Tuberculosis. Int J Tuberc lung Dis. 2000;4(12):S182-S188.

Muzaffar R, Batool S, Aziz F, Naqvi A, Rizvi A. Evaluation of the FAST Plaque TB assay for direct detection of Mycobacterium Tuberculosis in sputum specimens. Int J Tuberc Lung Dis. 2002;6(7):635-40.

Albert H, Heydenrych A, Brookes R, et al. Performance of a Rapid Phage Based-Test, FASTPlaqueTBTM , to diagnose Tuberculosis from sputum specimens in South Africa. Int J Tuberc Lung Dis. 2002;6:529-37.

Shenai S, Rodrigues C, Mehta AP. Evaluation of a New Phage Amplification Technology for Rapid Diagnosis of Tuberculosis. Indian J Med Microbiol. 2002;20(4):194-9.

Cohn ML, Waggoner RF, McClatchy JK. The 7H11 medium for the cultivation of Mycobacteria. Am Rev Resp Di.s 1968;98:295-6.