TO STUDY THE USEFULNESS OF CBNAAT (CARTRIDGE BASED NUCLEAR ACID AMPLIFICATION TEST) IN BAL (BRONCHOALVEOLAR LAVAGE) SAMPLES IN THE DIAGNOSIS OF SMEAR-NEGATIVE/NON SPUTUM PRODUCING PATIENTS WITH SUSPECTED TUBERCULOSIS
Journal of Evolution of Medical and Dental Sciences
BACKGROUND Sputum smear negative pulmonary tuberculosis remains a significant burden with a definite role in disease transmission too. They sometimes pose a diagnostic challenge to the treating physician. CBNAAT, a newly endorsed WHO technique, which not only detects the tubercle bacilli but also tells about the resistance to rifampicin, may have a role in sputum smear negative patients if bronchoalveolar lavage fluid is made available. MATERIAL AND METHODS Clinico-radiologically suspected
... ally suspected patients of pulmonary tuberculosis who were either sputum negative or not bringing out adequate sputum sample were included in the study. Included patients who do not have contraindications to bronchoscopy were subjected to the procedure and lavage fluid was obtained. Smear and CBNAAT examination of the fluid were done. The data recorded was then analysed statistically. RESULT In our study out of total 72 cases, 56.9% were male while 43.1% population were of female. Majority of patients belonged to Urban (86.1%) as compared to rural area (13.9%). The most common lesions detected by chest imaging were consolidation (33.3%) followed by fibrocavitary (11.1%). Otherwise not specified opacities constituted about 27.8%. Out of 37 bacteriologically confirmed cases 3 were positive in BAL smear microscopy, while 34 were positive by CBNAAT. Out of 34 CBNAAT positive samples, 3 were resistant to Rifampicin. CONCLUSION CBNAAT done on broncho-alveolar lavage fluid obtained via bronchoscopy can be an important adjunct to bacteriological confirmation of suspected cases who were otherwise sputum negative or not bringing adequate sputum sample. Moreover resistance to rifampicin can be detected prior to the treatment.