Comparison of GeneXpert MTB/RIF Assay in Broncho Alveolar Lavage and Gastric Lavage Samples

Ravi Mahat,Nausheen Saifullah,Madiha Tawfik,Nadeem Rizvi,Ashok Kumar

doi:10.4236/aid.2016.63014

Abstract

Objective: To compare the yield from Gastric lavage (GL) and Broncho alveolar lavage (BAL) samples in adult patients suspected case of Tuberculosis but not producing sputum. Methodology: 80 adults with suspected case of tuberculosis but not producing sputum were recruited. 72 patients were then subjected to one gastric lavage followed by Broncho-alveolar lavage in the same morning. The collected samples were subjected to GeneXpert MTB/RIF assay. Result: Of the 72 patients samples, the mean age was 38.6 years. 41 (56.9%) were male and 31 (43.1%) were female. History of TB contact was present in 25 (34.7%) patients. 37 (51.4%) patients had GeneXpert MTB/RIF positive on BAL and/or GL samples. The GeneXpert MTB/RIF of BAL fluid was positive on 35 (48.6%), which was not significantly greater than that for specimens from GL, which was 28 (38.9%) (p > 0.05). In 26 (36.1%) cases, GeneXpert MTB/RIF was positive in both BAL and GL samples. Conclusion: This study showed the yield of GeneXpert MTB/RIF in GL was comparable to BAL to detect Mycobacterium tuberculosis complex. Patients who can’t produce sputum, GL can be a good alternative to BAL to detect Mycobacterium tuberculosis complex in resource poor areas and patients who do not tolerate Bronchoscopy.

Highlights

Tuberculosis (TB) is one of the most common communicable diseases affecting all age groups in low-incomeHow to cite this paper: Mahat, R., Rizvi, N., Saifullah, N., Tawfik, M. and Kumar, A. (2016) Comparison of GeneXpert MTB/RIF Assay in Broncho Alveolar Lavage and Gastric Lavage Samples
Total 80 cases of suspected pulmonary tuberculosis not producing sputum were recruited for the study. 5 patients declined to undergo bronchoscopy, one refused Gastric lavage (GL) later on and two patients did not tolerate bronchoscopy
In Broncho alveolar lavage (BAL) fluid sample, MTB complex was detected by GeneXpert MTB/RIF in 35 (48.6%) patients and negative in 37(51.4%)

Summary

Introduction

Tuberculosis (TB) is one of the most common communicable diseases affecting all age groups in low-incomeHow to cite this paper: Mahat, R., Rizvi, N., Saifullah, N., Tawfik, M. and Kumar, A. (2016) Comparison of GeneXpert MTB/RIF Assay in Broncho Alveolar Lavage and Gastric Lavage Samples. TB is preventable and treatable in most cases, according to the WHO Global Report 2014, approximately 9.0 million people developed TB in 2013 amongst which 1.5 million died from it [1]. It ranks as the second leading cause of death from an infectious disease worldwide, after the human immunodeficiency virus (HIV). Diagnosis of pulmonary TB in individuals is through clinical presentation, sputum test and bacteriological confirmation in laboratories These diagnostic tests range from traditional smear microscopy, culture to newer rapid tests like GeneXpert MTB/RIF and line probe assay

Methods

Results

Conclusion