Citation Information :
Bhatia R, Dayal R, Pipariya D, Kumar P, Nayak M, Goyal A, Bhatnagar S, Agarwal D. Detection of Mycobacterium tuberculosis in Buccal Swab Specimens in Children with Pulmonary Tuberculosis Using Cartridge-based Nucleic Acid Amplification Test. Pediatr Inf Dis 2021; 3 (4):131-134.
Aim and objective: The study was designed to detect Mycobacterium tuberculosis (M.tb) in buccal swab specimens using cartridge-based nucleic acid amplification test (CBNAAT) in children suffering from pulmonary tuberculosis (TB) and to compare with CBNAAT results with gastric aspirate (GA) and sputum specimen.
Materials and methods: This observational study included children ≤15 years of age attending Department of Pediatrics of a tertiary care hospital diagnosed as presumptive pulmonary TB. Gastric aspirate/induced sputum (IS) sample and buccal swab were collected from all the study subjects and subjected to CBNAAT. Acid-fast bacilli (AFB) microscopy was also performed on GA/IS samples.
Results: Fifty presumptive cases of pulmonary TB were enrolled in the study. Fifteen (30%) buccal swab samples and 41 (82%) GA/IS samples were positive for CBNAAT. Gastric aspirate was positive in 23/24 (98%) subjects which was significantly higher as compared to buccal swab results (p = 0.0001). Induced sputum was positive in 18/26 (69.2%) samples which was comparable to buccal swab results (p < 0.092). AFB microscopy was positive in only 10 (5%) subjects. Rifampicin resistance was demonstrated in 9 (18%) subjects on GA/IS and 4 (8%) cases on buccal swab detected by CBNAAT.
Conclusion: Buccal swabs can be used to detect M.tb in children with pulmonary TB. The results were statistically comparable to IS but inferior to GA specimen. It can serve as simple and convenient alternative method.
World Health Organization: Global Tuberculosis Report 2018. Available from http://apps.who.int. Accessed on 25th December, 2018.
Please DM. No more gastric aspirate to diagnose pulmonary tuberculosis in children. Clin Infect Dis 2017;65(12):2158. DOI: 10.1093/cid/cix712.
Shenai S, Amisano D, Ronacher K, et al. Exploring alternative biomaterials for diagnosis of pulmonary tuberculosis in HIV-negative patients by use of the GeneXpert MTB/RIF assay. J Clin Microbiol 2013;51(12):4161–4166. DOI: 10.1128/JCM.01743-13.
Wilbur AK, Salter Kubatko L, Hurtado AM, et al. Vitamin D receptor gene polymorphisms and susceptibility M. tuberculosis in native paraguayans. Tuberculosis 2007;87(4):329–337. DOI: 10.1016/j.tube.2007.01.001.
Wood RC, Luabeya AK, Weigel KM, et al. Detection of Mycobacterium tuberculosis DNA on the oral mucosa of tuberculosis patients. Sci Rep 2015;5(1):8668. DOI: 10.1038/srep08668.
Silva CAM, Danelishvili L, McNamara M, et al. Interaction of Mycobacterium leprae with human airway epithelial cells: adherence, entry, survival, and identification of potential adhesins by surface proteome analysis. Infect Immun 2013;81(7):2645–2659. DOI: 10.1128/IAI.00147-13.
Yamazaki Y, Danelishvili L, Wu M, et al. The ability to form biofilm influences Mycobacterium avium invasion and translocation of bronchial epithelial cells. Cell Microbiol 2006;8(5):806–814. DOI: 10.1111/j.1462-5822.2005.00667.x.
Geier H, Mostowy S, Cangelosi GA, et al. Autoinducer-2 triggers the oxidative stress response in Mycobacterium avium, leading to biofilm formation. Appl Environ Microbiol 2008;84(6):1798–1804. DOI: 10.1128/AEM.02066-07.
Freeman R, Geier H, Weigel KM, et al. Roles for cell wall glycopeptidolipid in surface adherence and planktonic dispersal of Mycobacterium avium. Appl Environ Microbiol 2006;72(12):7554–7558. DOI: 10.1128/AEM.01633-06.
Wilbur AK, Engel GA, Rompis A, et al. From the mouths of monkeys: detection of mycobacterium tuberculosis complex DNA from buccal swabs of synanthropic macaques. Am J Primatol 2012;74(7):676–686. DOI: 10.1002/ajp.22022.
Kumar A, Gupta D, Nagaraja S, et al. Updated National Guidelines for Pediatric Tuberculosis in India, 2012. https://www.indianpediatrics.net/mar2013/. Accessed on 26th May, 2019.
WHO Automated real time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance. Xpert MTB? RIF for the diagnosis of pulmonary and extrapulmonary TB in adults andchildren. WHO/HTN/TB/2013.16. Geneva, Switzerland, WHO, 2013. http.//apps.who.int/iris Accessed on 5th March, 2019.
Engel GA, Wilbur AK, Westmark A, et al. Naturally acquired Mycobacterium tuberculosis complex in laboratory pig-tailed macaques. Emerg Microbes Infec 2012;1(10):e30. DOI: 10.1038/emi.2012.31.
Singh S, Singh A, Prajapati S, et al. MTB/RIF assay can be used on archived gastric aspirate and induced sputum samples for sensitive diagnosis of pediatric tuberculosis. BMC microbial 2015;15(1):191. DOI: 10.1186/s12866-015-0528.
Bates M, O'Grady J, Maeurer M, et al. Assessment of the Xpert MTB/RIF assay for diagnosis of tuberculosis with gastric lavage aspirates in children in sub-saharan Africa: a prospective descriptive study. Lancet Infect Dis 2013;13(1):36–42. DOI: 10.1016/S1473-3099(12)70245-1.
Jimenez MR, Martin SG, Tato LMP, et al. Induced sputum versus gastric lavage for the diagnosis of pulmonary tuberculosis in children. BMC Infect Dis 2013;13(1):222. DOI: 10.1186/1471-2334-13-222.
Sharma SK, Kohli M, Yadav RN, et al. Evaluating the diagnostic accuracy of Xpert MTB/RIF assay in pulmonary tuberculosis. PLoS ONE 2015;10(10):e0141011. DOI: 10.1371/journal.pone.0141011.