Abstract

RECOVERY OF MYCOBACTERIUM IN BRONCHOALVEOLAR LAVAGE SAMPLES FOR RAPID DIAGNOSIS OF TUBERCULOSIS IN PATIENTS WHO ARE UNABLE TO EXPECTORATE SPUTUM

H. Vashistha, Z. Nowshad, J. Kakroo, J. Khosa, A. Syed, Z. Jabeen, M. Ahamad*, D. Shrivastava, M. Hanif, N. Shah, A. Mathur

ABSTRACT

Aims-1. To check the recovery of M. tuberculosis in Broncheoalveolar lavage samples in patients who are unable to expectorate sputum. 2. To determine the Drug Susceptibility and/or Resistance pattern through LJ DST. Methods & Results- We assessed whether acid-fast bacilli (AFB) investigation in bronchial lavage (BAL) contributes to diagnosis in patients with smear negative and radiologically suggestive of pulmonary tuberculosis. 225 patients were recruited for this multi-centric study, 100 cases were excluded as they were negative for MTB. The remaining 125 patients were evaluated. All patients were unable to expectorate sputum and their Broncho alveolar lavages were negative for AFB. LJ Culture and DST were performed for the detection of Mycobacterium tuberculosis in all patients. Bronchial lavage smear were positive in 10.4% (13 patients). BAL culture positivity was 55.5% (125 patients). BAL culture was positive even in 13 cases that had bronchial lavage smear negativity. Conclusion- We suggest that in cases who do not produce sputum and whose bronchial lavage smears are negative; BAL culture and DST should be performed for rapid diagnosis of pulmonary tuberculosis. Significance and Impact of study- This is an attempt to record the presence of active TB and also to confirm the drug resistance pattern in patients who are unable to expectorate sputum.

Keywords: Recovery, Brocheo alveolar lavage, Diagnosis, Drug resistance, Tuberculosis.