SMEET KALITA
Vydehi Institute Of Medical Sciences & Research Centre, India
Biography:
Smeet Jyoti Kalita currently working as a Medical Superintendent at Dr. B. R. Ambedkar Hospital, Guwahati, Assam, India, he is an Indian Medical Microbiologist & Researcher. He did his Medical Graduation from Sikkim Manipal University, Sikkim, India followed by his Post Graduation in Medical Microbiology from the prestigious Rajiv Gandhi University of Health Sciences, Bangalore, Karnataka, India. He also holds a MBA degree in Healthcare Management & a fellowship in Diabetes.
He has presented an Oral Presentation on TB & Gene X-pert in the MICROCON, 2017 at Bellary, Karnataka and conducted a study for the same at Vydehi Institute of Medical Sciences, Bangalore, Karnataka on Tuberculosis & its diagnosis.
Abstract:
INTRODUCTION:
Tuberculosis is a transmissible infection caused by mycobacterium tuberculosis (mtb) & is still one of the biggest challenges for developing countries.
India bears the highest tb burden in the world. India accounts for 2.2 million cases of tb annually of the 9 million cases reported globally.
Emergence of drug resistance is a major hurdle in tb control. The common reasons for the development of drug resistance include incorrect prescription, irregular supply of drugs, non compliance of treatment, and lack of follow up. Multidrug resistant tb (mdr-tb) is more difficult to treat. The rate of mdr tb in india is 2.1%.
There are a number of tests available for the diagnosis of tuberculosis but conventional microscopy has low sensitivity. Culture, although the gold standard, takes longer time for positivity. Nucleic acid amplification techniques due to its rapidity & sensitivity help in early diagnosis and management of tuberculosis and thereby curtails the transmission of the disease.
RESULTS:
In our study, 66(70.21%) were males & 28(29.79%) were females.
Out of total 94 samples, 58 samples were bal fluid (61.70%), sputum sample of 26 (27.66%), followed by others like pleural fluid, etc of 12(12.77%) in number.
of the 94 mtb suspected samples, 25 samples came out to be mtb positive by gene expert; 8 were positive by conventional zn staining microscopy, 9 were positive with fluorescent microscopy (auramine staining) and 10 showed afb culture positivity (growth in lj media).
The sensitivity of zn staining against afb culture was 77.8%
The sensitivity of gene xpert versus afb culture was 90%, specificity was 81%, ppv was 36% and npv was 98%.
Two patient samples showed atypical mycobacteria in afb culture.
CONCLUSION:
Gene expert & afb smear microscopy share almost same specificity but sensitivity of gene expert is much higher than afb smear microscopy in respiratory samples. Although culture is considered as a gold standard method but it takes days to come positive & simultaneous detection of rifampicin resistance is not possible with it. On the other side, gene expert can be a useful diagnostic method in patients of suspected pulmonary tuberculosis either afb smear negative or positive due to its rapidity & simultaneous detection of rifampicin resistance especially benificial in patient with mdr & hiv associated tuberculosis. Cost effectiveness of gene expert in developing countries like India with high prevalence of tuberculosis need to be done.