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Year : 2022  |  Volume : 17  |  Issue : 3  |  Page : 557-562

Cartridge-based nucleic acid amplification test: An early tool for the diagnosis of sputum smear-negative pulmonary tuberculosis

1 Department of Respiratory Medicine, DMIMS and JNMC Sawangi, Wardha, Maharashtra, India
2 Department of Respiratory Medicine, BYL and Nair Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Dr. Pankaj Wagh
Department of Respiratory Medicine, DMIMS and JNMC Sawangi, Wardha, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jdmimsu.jdmimsu_62_22

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Introduction: Tuberculosis (TB) of the lung is an infectious disease caused by Mycobacterium tuberculosis, which is an aerobic, acid-fast, Gram-positive bacillus. India has the world's highest number of TB cases, accounting for one-fourth of all TB cases. For efficient treatment of pulmonary TB, microbiological diagnosis is the mainstay. Acid-fast bacillus (AFB) smear-negative patients could account for 31% of new cases. After multiple negative induced-sputum smear tests, we conducted this study to observe whether cartridge-based nucleic acid amplification test (CBNAAT) provides an additional and early diagnostic yield for undiagnosed cases of pulmonary TB. Objectives and Goals: The purpose of this study was to observe if CBNAAT could be used to diagnose pulmonary TB early in patients who had TB clinically and radiologically but negative for sputum direct smear. Materials and Methods: At our institute, 82 patients were involved in an observational study for assessing the utility of CBNAAT in the early confirmation of TB in individuals who had an X-ray chest that is indicative of PTB, but a negative sputum smear for AFB. Our hospital's department of respiratory medicine was the site of the current clinical study. Results: The patients were mostly between the ages of 31 and 40 years, with a male majority. Cough was the most common symptom in 72 (88%) patients. In 30 patients, the sputum CBNAAT test was positive (36.5%). All 82 instances were given a bronchoalveolar lavage (BAL). In 46 (56%) patients, BAL CBNAAT was positive. In 12 (15%) cases, bronchial brushings tested positive for AFB on smear examination. Caseating epithelioid granuloma was seen in 4 (14%) patients after a transbronchial lung biopsy. Conclusion: In individuals with strong indication of pulmonary TB, sputum CBNAAT and BAL CBNAAT provide a higher bacteriological confirmation of diagnosis.

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