Performance Evaluation, Comparison and Degree of Effectiveness of Five Different Techniques for Detection and Isolation of Mycobacterium Tuberculosis

This study was aimed to evaluate and compare the clinical performance andeffectiveness of five different techniques for detection and isolation ofMycobacterium tuberculosis to determining the best technique for thedetection and isolation of MTB at resource limited province of Pakistan,Balochistan. A cross-sectional retrospective cohort study on 307 samplescollected from 2016 to 2018 was conducted at Fatima Jinnah General andChest Hospital Quetta (FJHQ). All the samples were cultured according tothe WHO protocol on LJ media and BACTEC 960 system. The fluorescencemicroscopy, ICT (MPT64 Kit) and ZN microscopy was used as confirmatorytechniques. IBM-SPSS version 23 was used to analyze the recorded data andcompute all the statistics. Multi Variate Binary Logistic Regression(MVBLR) analysis was used to determine the technique of choice best forthe detection and isolation of MTB in clinical isolates. The frequency ofpositive samples processed by BACTEC 960, ICT (MPT64 Kit), ZNMicroscopy, fluorescence Microscopy and LJ media culture were 39.7%(122/307), 38.1% (117/307), 39.4% (121/307), 39.1% (120/307) and 45.3%(139/307) respectively. The ICT (MPT64 Kit) and LJ media culture wasfound with lowest and highest recovery rate, sensitivity, specificity, PPV andNPV respectively. The overall comparative recovery rate was as follow ICT(MPT64 Kit) < fluorescence microscopy < ZN microscopy < BACTEC 960< LJ media. The LJ media has highest recovery rate and reversal time withminimum contamination rate of 14/351 (3.98 %) as compared to BACTEC960 system having the highest contamination rate of 46/351 (13.10 %) andexception of analyzing blood and urine samples. ICT (MPT64 Kit),fluorescence microscopy and ZN microscopy are found an essentialconfirmatory technique.