RAPID DETECTION OF MYCOBACTERIUM TUBERCULOSIS BY IS6110 PCR AND ITS CORRELATE WITH PRIMARY AND RETREATED CASES OF TUBERCULOUS PLEURAL EFFUSION
The diagnosis of tuberculous pleural effusion is still challenging due to the low number of bacilli in the pleural fluid specimen. Traditions methods for diagnosis of tuberculous pleural effusion are low sensitivity and time consuming. Nucleic Acid Amplification methods are rapid and sensitive has modified strategies for the detection of Mycobacterial DNA in tubercular pleural effusion cases. This study aims to investigate the rapid detection of Mycobacterium tuberculosis complex by IS6110 PCR in primary and retreated cases of tuberculous pleural effusion in tertiary care hospital in Northern India. Pleural fluid specimens were processed and examined by Ziehl Neelsen (ZN) staining for acid fast bacilli; detection of M. tuberculosis by BACTEC culture, and by amplification of IS6110 PCR for specific detection of M. tuberculosis complex in pleural fluids. Applicable statistical tests were performed was considered to be significant (p< 0.05). Out of 80 tuberculous pleural effusion, fifty nine (73.3%) cases where primary cases; and 21 (26.3%) cases were retreated cases (p < 0.05). The mean age of all patients was 30±13.4 yrs. Diagnostic sensitivity of AFB smear was 17.5%, BACTEC culture was 45% and 65% for IS6110 PCR. IS6110 PCR test was found to be much more sensitive than ZN staining and BACTEC culture (p < 0.05). Study reveals that the sensitivity and specificity of PCR for detection of M. tuberculosis in both primary and treated cases of tuberculous pleural effusion were alike. Improved case detection and effective treatment are mandatory key factors for better control of mycobacterial diseases.