Role of Culture Free Rapid ImmunoAssay (ELISA) and Genexpert (MTB/RIF) Technology in the Diagnosis of Tuberculosis

Authors

  • Shahida Hussain Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore. Pakistan.
  • Sikander Sultan Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore. Pakistan.
  • Saba Riaz Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore. Pakistan.
  • Hajra Hussain Deparment of Gynae & Obs, District Headquarter Hospital, Gilgit Baltistan, Pakistan.
  • Chetan lal Department of Microbiology, Federal Postgraduate Medical Institute, Shaikh Zayed Hospital, Lahore, Pakistan.

DOI:

https://doi.org/10.47489/szmc.v38i1.416

Keywords:

GeneXpert (MTB/RIF), Mycobacterium Tuberculosis, IgG, IgM

Abstract

Introduction: Prolonged laboratory processes are major hurdles in the early diagnosis of tuberculosis. Prompt management of this disease is utmost necessary to control its spread. For this purpose, use of rapid and reliable laboratory testing methods for the diagnosis of Mycobacterium tuberculosis are crucial alongwith timely infection management and preventing its transmission to the close contact population.

Aims and Objective: The aim of this study was to establish a diagnostic-connection between culture free cost effective rapid immuno-assay (IgG and IgM) and GeneXpert (MTB/RIF) technology for the detection of Mycobacterium tuberculosis within the shortest possible turnaround time.

Place and Duration of Study: This cross-sectional study was carried out at Institute of Microbiology and Molecular Genetic, University of the Punjab, Pakistan in collaboration with the Department of Pulmonology and TB Outpatient Department (OPD) at Jinnah Hospital, Lahore over the time of one year (2019-2020).

Material and Methods: To achieve the aim, a total of 180 (pulmonary and extra-pulmonary) samples along with blood samples were collected from clinical suspects of Tuberculosis. All collected samples were subjected to AFB microscopy, GeneXpert (MTB/RIF) assay and Enzyme-linked Immunosorbent Assay (ELISA) for IgG and IgM. The diagnostic sensitivity and specificity of both methods were determined by using the solid culture as the gold standard.Study data collected through questionnaire was entered and analyzed using Statistical Package for Social Sciences (SPSS version 20).p value of ? 0.05 was considered significant.

Results: The overall sensitivity and specificity of GeneXpert (MTB/RIF) assay were 98.2 % and 82.4% respectively, whereas, for IgG (ELISA) antibodies, it was 50.0% and 76.4% and for IgM (ELISA) antibodies 50.4% and 97.1% respectively.

Conclusion: It was concluded that with fully automated GeneXpert (MTB/RIF) technology, maximum sensitivity and specificity can be achieved for diagnosis of tuberculosis within 2 hours.

References

Natarajan A, Beena P, Devnikar AV, Mali SJIJoT. A systemic review on tuberculosis. 2020;67(3):295- 311.

Organization WH. WHO consolidated guidelines on drug-resistant tuberculosis treatment: World Health Organization; 2019.

Das D, Das S, Pandey M, Bhattacharyay DJEJoMP. In silico analysis of phytochemicals from Mucuna pruriens (L.) DC against Mycobacterium tuberculosis causing tuberculosis. 2020;31(4):19-24.

Koupaei M, Naimi A, Moafi N, Mohammadi P, Tabatabaei FS, Ghazizadeh S, et al. Clinical characteristics, diagnosis, treatment, and mortality rate of TB/COVID-19 coinfectetd patients: a systematic review. 2021;8:2188.

Guler SA, Bozkus F, Inci MF, Kokoglu OF, Ucmak H, Ozden S, et al. Evaluation of pulmonary and extrapulmonary tuberculosis in immunocompetent adults: a retrospective case series analysis. 2015;24(1):75-9.

Quradha MM, Khan R, Rehman M-u-, Abohajeb AJNpr. Chemical composition and in vitro anticancer, antimicrobial and antioxidant activities of essential oil and methanol extract from Rumex nervosus. 2019;33(17):2554-9.

Purohit M, Mustafa TJJoc, JCDR dr. Laboratory diagnosis of extra-pulmonary tuberculosis (EPTB) in resource-constrained setting: state of the art, challenges and the need. 2015;9(4):EE01.

Horne DJ, Kohli M, Zifodya JS, Schiller I, Dendukuri N, Tollefson D, et al. Xpert MTB/RIF and Xpert MTB/RIF Ultra for pulmonary tuberculosis and rifampicin resistance in adults. 2019(6).

Kohli M, Schiller I, Dendukuri N, Yao M, Dheda K, Denkinger CM, et al. Xpert MTB/RIF Ultra and Xpert MTB/RIF assays for extrapulmonary tuberculosis and rifampicin resistance in adults. 2021(1).

Little KM, Pai M, Dowdy DWJPO. Costs and consequences of using interferon-? release assays for the diagnosis of active tuberculosis in India. 2015;10(4):e0124525.

Baumann R, Kaempfer S, Chegou NN, Oehlmann W, Spallek R, Loxton AG, et al. A subgroup of latently Mycobacterium tuberculosis infected individuals is characterized by consistently elevated IgA responses to several mycobacterial antigens. 2015;2015.

Chihota V, Grant A, Fielding K, Ndibongo B, Van Zyl A, Muirhead D, et al. Liquid vs. solid culture for tuberculosis: performance and cost in a resource- constrained setting. 2010;14(8):1024-31.

Iram S, Zeenat A, Hussain S, Yusuf NW, Aslam MJPjoms. Rapid diagnosis of tuberculosis using Xpert MTB/RIF assay-Report from a developing country. 2015;31(1):105.

Boehme CC, Nabeta P, Hillemann D, Nicol MP, Shenai S, Krapp F, et al. Rapid molecular detection of tuberculosis and rifampin resistance. 2010;363(11):1005-15.

Escobar-Gutierrez A, Amezcua-Chavarria ME, Pasten-Sanchez S, Ramirez-Casanova E, Cazares J, Granados G, et al. Enzyme-linked immunosorbent assay (ELISA) with mycobacterial crude antigens for the sero-epidemiological diagnosis of active tuberculosis. 1996;64(4):417-27.

Wani AA, Kait RJSJMPS. Tuberculosis (TB) Silent Killer, Challenges and Stategies to Manage Tuberculosis during COVID-19 Pandemic: A Review. 2021;7(11):571-4.

Laifangbam S, Singh HL, Singh N, Devi K, Singh NJKUmj. A comparative study of fluorescent microscopy with Ziehl-Neelsen staining and culture for the diagnosis of pulmonary tuberculosis. 2009;7(27):226-30.

Stover CK, Warrener P, VanDevanter DR, Sherman DR, Arain TM, Langhorne MH, et al. A small- molecule nitroimidazopyran drug candidate for the treatment of tuberculosis. 2000;405(6789):962-6.

Li H, Javid BJNRI. Antibodies and tuberculosis: finally coming of age? 2018;18(9):591-6.

Bae W, Park KU, Song EY, Kim SJ, Lee YJ, Park JS, et al. Comparison of the sensitivity of QuantiFERON-TB Gold In-Tube and T-SPOT. TB according to patient age. 2016;11(6):e0156917.

Weiss M, Somma D, Karim F, Abouihia A, Auer C, Kemp J, et al. Cultural epidemiology of TB with reference to gender in Bangladesh, India and Malawi [Special section on gender and TB]. 2008;12(7):837-47.

Allotey P, Gyapong MJTIJoT, Disease L. Gender in tuberculosis research [Special section on gender and TB]. 2008;12(7):831-6.

Richomme C, Boadella M, Courcoul A, Durand B, Drapeau A, Corde Y, et al. Exposure of wild boar to Mycobacterium tuberculosis complex in France since 2000 is consistent with the distribution of bovine tuberculosis outbreaks in cattle. 2013;8(10):e77842.

Bam N, Karn RJJoIoMN. IgM and IgG antibodies in tuberculosis. 2009;31(3):34-40.

Organization WH. Drug-resistant TB: surveillance and response: supplement to global tuberculosis report 2014. World Health Organization; 2014.

Alvarez-Uria G, Azcona JM, Midde M, Naik PK, Reddy S, Reddy RJTr, et al. Rapid diagnosis of pulmonary and extrapulmonary tuberculosis in HIV- infected patients. Comparison of LED fluorescent microscopy and the geneXpert MTB/RIF assay in a district hospital in India. 2012;2012.

Chang K, Lu W, Wang J, Zhang K, Jia S, Li F, et al. Rapid and effective diagnosis of tuberculosis and rifampicin resistance with Xpert MTB/RIF assay: a meta-analysis. 2012;64(6):580-8.

Ioannidis P, Papaventsis D, Karabela S, Nikolaou S, Panagi M, Raftopoulou E, et al. Cepheid GeneXpert MTB/RIF assay for Mycobacterium tuberculosis detection and rifampin resistance identification in patients with substantial clinical indications of tuberculosis and smear-negative microscopy results. 2011;49(8):3068-70.

Karigoudar rm, karigoudar mh, wavare sm, kakhandki l, bagali sjijop, sciences p. Use of cartridge based nucleic acid amplification test for rapid detection of mycobacterium tuberculosis in pulmonary and extrapulmonary tuberculosis. 2021;13(2):29-33.

Boehme CC, Nicol MP, Nabeta P, Michael JS, Gotuzzo E, Tahirli R, et al. Feasibility, diagnostic accuracy, and effectiveness of decentralised use of the Xpert MTB/RIF test for diagnosis of tuberculosis and multidrug resistance: a multicentre implementation study. 2011;377(9776):1495-505.

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Published

2024-01-31

How to Cite

1.
Shahida Hussain, Sultan S, Riaz S, Hussain H, lal C. Role of Culture Free Rapid ImmunoAssay (ELISA) and Genexpert (MTB/RIF) Technology in the Diagnosis of Tuberculosis. Proceedings S.Z.M.C [Internet]. 2024 Jan. 31 [cited 2024 Dec. 21];38(1):09-15. Available from: https://proceedings-szmc.org.pk/index.php/szmc/article/view/416