ABSTRACT
Objective: To evaluate direct drug susceptibility testing on MGIT 960 system for detection of multidrug resistant tuberculosis from smear positive pulmonary specimens
Study Design: Cross-sectional analytical study
Place and Duration of Study: Microbiology Department, Armed Forces Institute of Pathology, Rawalpindi, from July 2016 to September 2017
Methodology: Smear positive specimens were pretreated according to guidelines and then tested on MGIT 960 TB system for direct drug susceptibility testing [DST] of isoniazid and rifampin. Samples were also processed by gold standard indirect method, which comprises culture and then DST from positive growth by MGIT 960 TB system
Results: Out of 108 specimens, 95 [88%] DST results were reportable. Out of 95 reportable specimens, 17 isolates were resistant to both isoniazid [INH] and rifampin [RIF] by direct DST. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy for INH were 92%, 93%, 82%, 97% and 92.6%, respectively; and 95%, 96%, 86.3%, 98.6% and 95.7%, respectively for RIF. Average time to report DST by indirect method was 23.6 +/-3.9 days, while it was 11.4 +/- 2.7 days for the direct method
Conclusion: Direct susceptibility testing on MGIT 960 system showed very good agreement when compared with indirect method. Time saving is crucial factor in initiation of early effective therapy, especially in drug resistant cases. Further studies on large scale are required for more accurate evaluation of this method
ABSTRACT
Objective: To evaluate the performance of nitrate reductase assay on smear positive pulmonary specimens for detection of multi and extensively drug resistant tuberculosis simultaneously. Study Design: Cross-sectional analytical study. Place and Duration of Study: Microbiology Department, Armed Forces Institute of Pathology, Rawalpindi from June to December 2016
Methodology: Smear positive pulmonary samples were processed both by nitrate reductase method on Lowenstein Jenson medium and also inoculated on gold standard Bactec MGIT 960 TB system. All the specimens were first digested and decontaminated according to standard protocol before inoculation
Results: Out of total 76 samples, three did not give color and, therefore, were excluded from the final data analysis. Among the remaining 73 samples, mycobacterial index was: 28 specimens were having 1+ [1-9 bacilli/100 fields], 26 samples were 2+ [1-9 bacilli/ field], and 19 samples were having 3+ index [>9 bacilli/field]. The respective sensitivity and specificity were 84% and 100% for isoniazid [INH]; 82% and 100% for rifampin [RIF]; 67% and 100% for amikacin [AK]; and both 100% for ofloxacin [OFX]. Overall agreement in case of INH, RIF, AK, and OFX was 94.5%, 97.2%, 98.6% and100%, respectively. Overall average agreement was 97.5%
Conclusion: Nitrate reductase assay is a reliable, low cost and accurate method that can be used for early for diagnosis of multi and extensively drug resistant tuberculosis
ABSTRACT
Infective endocarditis is rarely caused by Burkholderia cepacia
Pseudomonas putida has not been reported to cause infective endocarditis so far. This is the first case of infective endocarditis being reported, that is caused by Pseudomonas putida and Burkholderia cepacia in an immunocompetent host with no predisposing factors. Aortic valve replacement surgery was carried out and antibiotics were given, to which the patient responded well and recovered
Subject(s)
Humans , Male , Adult , Burkholderia cepacia , Pseudomonas putida , Transcatheter Aortic Valve Replacement/statistics & numerical data , Anti-Bacterial Agents/therapeutic useABSTRACT
Objective: To determine the current sensitivity pattern of second line anti-tuberculosis drugs against clinical isolates of Multidrug Resistant Mycobacterium tuberculosis [MDR-TB]. Study Design: A cross-sectional study. Place and Duration of Study: Department of Microbiology, Armed Forces Institute of Pathology [AFIP], Rawalpindi, from November 2011 to April 2013. Methodology: Samples received during the study period were processed on BACTEC MGIT 960 system for Mycobacterium tuberculosis [MTB] culture followed by first line drugs susceptibility testing of culture proven MTB isolates. On the basis of resistance to rifampicin and isoniazid, 100 clinical isolates of MDR-TB were further subjected to susceptibility testing against amikacin [AMK], capreomycin [CAP], ofloxacin [OFL] and ethionamide [ETH] as per st and ard BACTEC MGIT 960 instructions. Results: Out of 100 MDR-TB isolates, 62% were from male patients and 38% from female patients. 97% were sensitive to AMK, 53% to OFL, 87% to CAP; and 87% were sensitive to ETH. Conclusion: The majority of the MDR-TB isolates showed excellent sensitivity against AMK, CAP and ETH. However, sensitivity of MDR-TB isolates against fluoroquinolones like OFL was not encouraging. Key Words: Multidrug resistant tuberculosis. Mycobacteria growth indicator tube. Second line anti-tuberculosis drugs. Amikacin. Capreomycin. Ethionamide
ABSTRACT
To determine the frequency of endometrial tuberculosis in infertility patients. Design: An observational analytical study. Place and Duration of Study: Military Hospital Rawalpindi and Armed Forces Institute of Pathology, Rawalpindi from August 1998 to April 1999. Subjects and Endometrial biopsies were taken from 50 cases of infertility and subjected to culture on BACTEC 460 TB instrument. Tuberculous endometritis was found in 10% [n=5] of cases. It was concluded that endometrial tuberculosis is not an infrequent cause of infertility in our setup