Assessment of tubercle bacilli in various organs by staining and polymerase chain reaction technique

Background: Early diagnosis of tuberculosis (TB) by different clinical methods plays a major role in control of TB in early stages. The present study was done with the aim to assess and compare the efficiency of staining techniques and polymerase chain reaction (PCR) for detection of tubercle bacilli in various organs.Methods: The study included data 14,472 patients of both prospective (during March 2008 to 2009) and retrospective cases (past one year of the study period). For prospective cases the cytological material for the study was collected by fine needle aspiration cytology (FNAC). For retrospective cases of past one year were retrieved from the records. TB suspected cases were evaluated by Ziel-Nelson (ZN), Auramine-Rhodamine (A-R) staining techniques and by PCR.Results: Total 284 cases were diagnosed with TB in various organs. In them, epithelioid granuloma was seen 227 cases (79.92%) and Langhans giant cells were seen in 18 cases (6.34%). AFB positivity on ZN staining was observed in 161 cases (56.69%) and 9 cases (3.16%) showed positivity for tubercle bacilli on A-R staining. PCR was done in 20 prospective cases and total percentage of positivity by PCR was seen in 18 cases (90%).Conclusions: The total percentage positivity for detection of tubercule bacilli by PCR assay was found to be more (90%) with high sensitivity and specificity compared to ZN (56.6%) and AR staining techniques (3.16%).

A Clinical Study of I.V.P. and Tubercle Bacilli in Urine of the Patients with Pulmonary Tuberculosis / 대한비뇨기과학회지

Sixty-nine pulmonary tuberculosis patients with no clinical evidence of genito-urinary tuberculosis were studied of I.V.P. and tubercle bacilli in their urine and the following results were obtained: Of 69 patients studied, 3 cases (4.34%) were found having positive tubercle bacilli in their urine of which two were found in the thirty-two moderately advanced cases and one was found in twenty-one far-advanced of their pulmonary tuberculosis. One of three was treated irregularly with anti-tuberculous triple therapy during about seven months and two were not treated Of 69 patients studied, 3 cases (4.34%) were found having positive intravenous pyelographic examination, of which two cases were group 1 of Lattimer's classification and one was group 3. Two of these were found in moderately advanced pulmonary tuberculosis and one was far-advanced.

A Clinical Study on Examination of Tubercle Bacilli in Renal Tuberculosis / 대한비뇨기과학회지

Comparative studies were performed between discovery of tubercle bacilli from prenephrectomy bladder urine and other clinical tests as performed on all 19 patients with renal tuberculosis who had been admitted to the Department of Urology at Seoul National University Hospital for the period of April 1958 hrough February 1959. The results in this study were summarized as follows: 1. Modes of antituberculosis medications prior to admission on these patients were as follow: SM only, 4 cases; combined use of SM and PAS, a cases; SM, PAS and INHcombined, 1 cases; unknown, 4 cases, and not used in 3 cases. 2. Durations of antituberculosis medications were as follow: Less one month, 4 cases, less than 6 months, 7 cases; over 6 months, 1 case; unknown, 4 cases, and not used in 3 cases. 3. Positivity rate for microscopic examination was 79% on prenephrectomy bladder urine and when two cases who also developed prostatic tuberculosis were excluded the positivity rate was 76% 4. Discovery of tubercle bacilli was not easy even on urine specimen which showed much protein and many white blood cells. 5. Cases which did not reveal tubercle bacilli on microscopic examination from caseous material of tuberculous renal cavity again showed microscopical negativity from prenephrectomy bladder urine. 6. The presence of the severe lesion of bladder wall was not related with ease with which tubercle bacilli being found from prenephrectomy bladder uriue. 7. Adverse effect was to be foundfrom antituberculosis medication as to the tubercle bacilli on prenephrectomy urine. Cases who had used antituberculosis drugs for less than one month showed high positivity rate equal to the cases who never did. 8. It was deemed unnecessary to stop using antituberculosis medication of less than two months' duration in order to discover tubercle bacilli on prenephrectomy bladder urine. 9.Inability to discover tubercle bacilli on prenephrectomy bladder urine was not wholly due to the previous use of antituberculosis drugs and to raise the positivity rate repeated examination would be indicated.

Studies on Cultivation and Drug-Resistance of Tubercle Bacilli Isolated from Renal Tuberculosis / 대한비뇨기과학회지

Author performed clinical studies at random on 19 patients with renal tuberculosis who were admitted for the period of April 1958 through February 1959 to Department of Urology at Seoul National University Hospital as to tuberculosis bacterial cultures and their resistance tests using pre- and postnephrectomy urine and diseased tissue itself. The results in this study were summarized as follows: 1. All except one case had received antituberculosis medication for not more than 6 months. 2. To all cases beginning at the time of admission preoperation medications consisting of SM 1.0 gm, PAS 12gm, and INH 300mg, and these regimen were given throughout study. 3. The culture positivity rates were 79% in prenephrectomy bladder urine. 90% in caseous material from diseased renal cavity and 44% in postnephrectomy bladder urine. The lower were the culture positivity rate in prenephrectomy bladder urine, the longer the preceding period of antituberculosis drugs given. Culture positivity rate of caseous material from diseased renal cavity, however, was persistently high irrespective of the length of the antituberculosis medication and the culture positivity rate of postnephrectomy bladder urine appeared to be dependent more on the presence or absence of the remaining renal tuberculosis rather than on the period of antituberculosis medication. 5. From the repeated culture of prenephrectomy bladder urine over short period of time, in the same individual results were rather inconstant and this seemed to be independent upon the use of antituberculosis drugs. 6. Cultural studies on urine and diseased renal tissue yielded the same results whether it was checked on the day of specimen collection or after less than 7 day's refrigerated storage. 7. While doing cultural studies from prenephrectomy bladder urine on patients who received antituberculosis drugs one case was found to need more than two months to grow and this trend seemed to be more so in cases of cultures from diseased renal tissues. 8. Resistance was shown as to SM in 9 cases out of 10 cases on whom prenephrectomy bladder urines were checked, in 5 out of 6 cases on whom tuberculosis culturers were done from diseased renal caseous tissues and in 2 cases out of each group possessed resistance to PAS as well. 9. Resistance to SM was to be easily acquired and afterward the degree of resistance seemed to increase rapidly from the use of SM of short duration. 10. Cases with positive microscopic finding and negative cultures were seen only in prenephrectomy bladder urine and this fact was thought not to be specifically related to the antituberculosis treatment. 11. Cases with negative microscopic finding and positive cultures were seen in patient who received only long antituberculosis treatment and these were characterized by small number of colonies. 12. The appearance of resistant strain was found not to be specifically related with the status of microscopical finding on prenephrectomy bladder urine nor with cultural studies on the same specimen.

A Clinical Study of Tubercle Bacilli in Urine of the Patients with Pulmonary Tuberculosis / 대한비뇨기과학회지

One hundred and twenty-six patients with pulmonary tuberculosis having no clinical evidence of genito-urinary tuberculosis were studied for tubercle bacilli in their urine and the following results were obtained 0f 126 patients studied, 5 cases (4.0%) were found having positive tubercle bacilli in urine. of which three were found in the moderately advanced cases of pulmonary tuberculosis and two in the far-advanced. While, in the treated group of 56 with anti-tuberculous drugs for pulmonary tuberculosis, three cases were positive for tubercle bacilli in urine, of which two were found in the moderately advanced and one in the far-advanced of pulmonary tuberculosis, two cases were also positive in the non-treated group of 70, of which one was found in the moderately advanced and another in the far-advanced of pulmonary tuberculosis. Two instances of positive tubercle bacilli in urine were found in the group of treatment for less than 6 months and only one in patients having treatment for more than 6 months.