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ORIGINAL ARTICLE
Year : 2013  |  Volume : 27  |  Issue : 3  |  Page : 203-207

Detection of Mycobacterium tuberculosis by three methods and their correlation to chest X-ray findings and CD4 T-lymphocyte counts in human immunodeficiency virus-pulmonary tuberculosis coinfection


1 Department of Microbiology, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India
2 Department of Microbiology, Regional Institute of Medical Sciences, Imphal, Manipur, India

Correspondence Address:
Supriya Laifangbam
Brain and Spinal Cord Centre, Regional Institute of Medical Sciences Road, Imphal - 795 004, Manipur
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-4958.127394

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Aims: 1) To compare three microbiological methods of detection of Mycobacterium tuberculosis 2) To find their correlation with (a) chest x-ray (CXR) findings and (b) absolute CD4 counts. Materials and Methods: 147 human immunodeficiency virus (HIV)-pulmonary tuberculosis (PTB) suspects were enrolled. Sputum from 108 of them were subjected to light microscopy of Ziehl-Neelsen (ZN) stained smear, fluorescence microscopy of Auramine-O (AO)-stained smear, and culture on Lowenstein-Jensen media for detection of M. tuberculosis. The results were analyzed statistically and compared with CXRs and CD4 counts. Results: Of 147 eligible patients, 108 were studied and 78 were diagnosed as HIV-PTB coinfection. Positivity rates for ZN, AO, and culture were 39 (36.1%), 80 (74.1%), and 78 (72.2%), respectively. Sensitivity and specificity for ZN were 48.7% and 96.6%, respectively, whereas those for AO were 100% and 93.3%, respectively. Additional yield of AO over ZN was 42 (38.8%). AO was able to detect all the culture positives. The difference in case-yields between ZN and AO has been found to be highly significant at P value 0.05 and χ2 test = 3.84. The sensitiveness of these methods of detection was higher for patients showing active disease on CXR and those with CD4 count > 200 cells/μL. Conclusion: Fluorescence microscopy is recommended in HIV-PTB coinfection to enhance case detection and management.


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