Comparing the Diagnostic Efficacy of Tuberculosis (TB) Polymerase Chain Reaction (PCR) With Culture Of Tb Bacilli Using Radiometric Assay In Detection Of Genital Tuberculosis (GTB) In Infertile Women

Abstract

Objective: Assessment of the diagnostic value of Radiometric Assay (BACTEC) in comparison with PCR in diagnosis of genital tuberculosis and correlation of the clinical and hysterolaparoscopic findings in cases found positive for genital tuberculosis by TB PCR and/or BACTEC. Methodology: This study was carried out at Assisted Reproductive Centre of KLES Dr. Prabhakar Kore Hospital and MRC, Belgaum. Hysterolaparoscopy was done in the preovulatory period between the 6 th -10 th days of the cycle. Endometrial curettings were sent in normal saline for both TB PCR and BACTEC and HPR in formalin. Clinical and hysterolaparoscopic findings were analyzed in cases found to be positive for genital tuberculosis by TB PCR and/or BACTEC. Results: The diagnosis of genital tuberculosis was confirmed in 14 of the 61 enrolled cases (22.95%) by TB PCR and/or TB BACTEC and/or histopathology of endometrial curettings. Of the 14 positive cases, 13 cases (92.85%) were positive by PCR, two cases (14.28%) were positive by BACTEC, of which one case (7.14%) was positive by both PCR and BACTEC. None of the cases had histopathological evidence of mycobacterial infection. Out of 14 positive cases, eight (57.14%) PCR positive cases had positive correlation with hysterolaparoscopy. None of the BACTEC positive cases had hysterolaparoscopic features suggestive of GTB. Conclusion: Though culture is the gold standard for diagnosis of genital tuberculosis, further research is needed definitively to conclude the diagnosis of genital tuberculosis as it is paucibacillary.