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Deep Rajendrabhai Kothari, Nilesh Dutt, Palak Prajapati, Pankaj Garg, Mamta Patel,
Volume 18, Issue 3 (May-Jun 2024)
Abstract
Background: The sputum smear-negative pulmonary tuberculosis (PTB) is a diagnostic challenge for physicians. It has been shown that adenosine deaminase (ADA) activity increases in various body fluids of patients with tuberculosis (TB). A prospective clinical trial was conducted to determine the effectiveness of ADA activity in bronchoalveolar lavage (BAL) in subjects who have sputum smear-negative PTB.
Methods: A total of 29 patients (M/F: 15/14), mean age (36.8 years), were enrolled in our study from October 2021 to August 2022 after providing written consent. The mean duration of symptoms was 41.66 days. Out of 29 patients, 21 patients had BAL ADA 4.81±1.68 unit??, for whom AKT treatment was started and cured, while four patients with BAL ADA 4.50±2.86 unit? did not improve, and four patients with BAL ADA 6.52±1.16 whose AKT treatment is ongoing at present but clinically improved. The sensitivity of BAL ADA with the outcome of 29 patients is 75%, while for BAL CBNAAT, it is 80%. When we apply a formula for combined sensitivity for the parallel test, then it comes to 95%, which indicates a great number of patients gets the benefit when we apply both tests simultaneously.
Results: We conclude that ADA activity was significantly increased in BAL.
Conclusion: BAL ADA is a useful and effective investigation for the diagnosis of PTB.
Dr. Naila Begum, Dr. Karvi Agarwal, Dr. Amit Garg,
Volume 19, Issue 5 (9-2025)
Abstract
Background and Objectives:Colistin is regarded as the final resort for managing infections caused by multi-drug resistance (MDR) gram-negative bacilli (GNB). Minimum inhibitory concentration (MIC) is used to monitor the development of colistin resistance. This study aimed to assess the performance of Broth Microdilution Method (BMD) against routine Kirby-Bauer disk diffusion (KBDD) and automated BD Phoenix for the detection of in vitro activity of colistin against GNB
Methods: A cross-sectional study was done in the Department of Microbiology, LLRM Medical College, Meerut Uttar Pradesh from September 2023 to January 2024. KBDD method, BMD method & BD Phoenix (Becton Dickinson, USA) automated system were used in 320 GNB isolated from various clinical samples to detect Colistin susceptibility. MIC determined by BMD method was interpreted according to Clinical Laboratory Standards Institute (CLSI) 2023 guidelines.
Results: In our study,320 isolates of GNB were identified from the patients with a mean age of 45.34 years. A total of 320 isolates [145(45.31%) Escherichia coli, 124(38.75%) Klebsiella pneumoniae, 32(10.0%) Pseudomonas aeruginosa, and 19(5.93%) Acinetobacter baumannii complex] were tested simultaneously with all three methods for colistin susceptibility. The overall resistance to Colistin amongst GNB was found to be 17.18% by the gold standard BMD method, 15.31% by BD Phoenix, and 14.37% by KBDD.
Conclusion: BMD is the most cost-effective, authentic method for routine testing of colistin susceptibility as compared to other methods. The comparative analysis revealed that BMD is superior to other methods in detecting colistin susceptibility emphasizing its potential role in guiding clinicians for treatment decisions
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