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.
Naila Begum , Amit Garg , Karvi Agarwal ,
Volume 19, Issue 5 (Sep-Oct 2025)
Abstract
Background: Colistin is regarded as the last resort for managing infections caused by multidrug-resistant (MDR) Gram-negative bacilli (GNB). The World Health Organization (WHO) includes colistin on its list of critically necessary antimicrobials. Minimum inhibitory concentrations (MICs) are used to monitor the development of colistin resistance. This study aimed to assess the performance of the Broth Microdilution Method (BMD) against routine Kirby-Bauer disk diffusion (KBDD) and automated BD Phoenix for the detection of the in vitro activity of colistin against GNB.
Methods: A cross-sectional study was conducted in the Department of Microbiology, LLRM Medical College, Meerut, Uttar Pradesh, from September 2023 to January 2024. The KBDD method, BMD method, and BD Phoenix (Becton Dickinson, USA) automated system were used to detect colistin susceptibility in 320 GNB isolated from various clinical samples. MIC determined by the BMD method was interpreted according to Clinical Laboratory Standards Institute (CLSI) 2023 guidelines.
Results: In our study, 320 isolates of GNB were identified from 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 among 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 in antibiotic therapy decisions.
goums.ac.ir
yahoo.com