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AFB XDR Screen- Sputum / BAL/ Other respiratory samples
Also known as: AFB XDR Screen by Hain LPA, Pulmonary
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Tuberculosis is a chronic respiratory tract infection causing fever, cough and weight loss. It is commonly caused by Mycobacterium tuberculosis (M.tb). Many diagnostic techniques are available for diagnosis of tuberculosis which include staining, culture and nucleic acid detection. Among nucleic acid detection techniques are polymerase chain reaction (PCR), Cartridge based nucleic acid amplification technique (CBNAAT), Line probe assay (LPA), Next generation sequencing (NGS).
With increase in drug resistance in tuberculosis patient many patients would require testing of second line drugs.
LPA is based on DNA strip technology. It is approved by WHO for testing pulmonary samples and M.tb culture isolates.
In addition to detection of M.tb it can detect resistance to quinolone and aminoglycoside group of antibiotics
The AFB XDR Screen- Sputum / BAL/ Other Respiratory Samples is a crucial diagnostic test designed to detect the presence of Mycobacterium tuberculosis (M.tb) DNA in respiratory samples and identify mutations associated with resistance to various antibiotics.
This test is particularly valuable in cases of extensively drug-resistant tuberculosis (XDR-TB), as it employs DNA strip technology approved by the World Health Organization (WHO) and the Government of India for testing pulmonary samples and M.tb culture isolates.
By analysing sputum, bronchoalveolar lavage (BAL), or other respiratory samples, the AFB XDR Screen provides essential information for diagnosing tuberculosis, detecting drug resistance, and monitoring treatment response. This test is a powerful tool in the fight against TB, especially in high-risk populations and those suspected of having drug-resistant strains of the disease.
Written by: Dr Vishal Wadhwa, M.D, D.N.B Microbiology, Medical Affairs
Reasons for Undergoing the AFB XDR Screen- Sputum / BAL/ Other Respiratory Samples
There are several reasons why your doctor may recommend the AFB XDR Screen- Sputum / BAL/ Other Respiratory Samples:
- Diagnosing Tuberculosis: To detect the presence of M.tb in respiratory samples, especially if you have symptoms like cough, fever, weight loss, and night sweats.
- Detecting Drug Resistance: To identify mutations that confer resistance to first-line and second-line antibiotics, including isoniazid (INH), ethionamide (ETH), fluoroquinolones (FLQ), and second-line injectable drugs (SLID) like aminoglycosides.
- Monitoring Treatment Response: To assess the effectiveness of your current TB treatment and adjust the regimen if drug resistance is detected.
- High-Risk Populations: If you have a higher risk of TB, such as close contact with TB patients, a weakened immune system (e.g., HIV/AIDS), or if you are a healthcare worker or resident of a long-term care facility.
List of Parameters Considered During the AFB XDR Screen- Sputum / BAL/ Other Respiratory Samples
The AFB XDR Screen- Sputum / BAL/ Other Respiratory Samples measures several key parameters:
- Presence of M.tb DNA: Indicates whether you are infected with M.tb.
- Mutations Associated with Drug Resistance:
- Isoniazid (INH) Resistance: Mutations in the katG and fabG1 genes, and the oxyR-ahpC intergenic region.
- Ethionamide (ETH) Resistance: Mutations in the inhA promoter.
- Fluoroquinolone (FLQ) Resistance: Mutations in the gyrA and gyrB quinolone resistance determining regions (QRDR).
- Second-Line Injectable Drugs (SLID) Resistance: Mutations in the rrs gene and the eis promoter region.
- Aminoglycosides Resistance: Mutations affecting drugs like amikacin, kanamycin, capreomycin, and viomycin.
AFB XDR Screen- Sputum / BAL/ Other Respiratory Samples Preparation
To prepare for the AFB XDR Screen- Sputum / BAL/ Other Respiratory Samples, follow these steps:
- Oral Hygiene: Rinse your mouth thoroughly with clean water before providing the sputum sample.
- Sputum Collection: Cough vigorously to expel mucus from your lower respiratory tract, aiming to collect secretions without contamination from oral sputum. Collect the sample in a screw-capped container.
- No Fasting Required: You do not need to fast before the test.
- Pure Culture: If a pure culture of M.tb is available, it can be submitted at the time of booking the test.
AFB XDR Screen- Sputum / BAL/ Other Respiratory Samples Results & Interpretation
The results of the AFB XDR Screen- Sputum / BAL/ Other Respiratory Samples can be interpreted as follows:
- M.tb Detected: Indicates the presence of M.tb DNA in the sample, suggesting TB infection.
- M.tb Not Detected: Suggests the absence of M.tb DNA, but due to the test's sensitivity not being 100%, a repeat test on a fresh sample or culture may be advised.
- Resistance to Fluoroquinolones Detected: Indicates mutations associated with resistance to fluoroquinolones, suggesting you may not respond to these drugs.
- Resistance to Aminoglycosides Detected: Indicates mutations associated with resistance to aminoglycosides, suggesting you may not respond to these drugs. Phenotypic confirmation is advisable for both types of resistance.
Home Collection for AFB XDR Screen- Sputum / BAL/ Other Respiratory Samples Near You
Metropolis Healthcare offers a convenient home sample collection service for the AFB XDR Screen- Sputum / BAL/ Other Respiratory Samples. A trained phlebotomist will come to your doorstep to collect the respiratory samples, ensuring comfort and safety while maintaining high standards of sample handling and testing accuracy.
With timely and reliable results, you can take proactive steps in managing your health. Metropolis is committed to providing accessible healthcare, which underscores their dedication to providing quality diagnostic solutions conveniently at home.
AFB XDR Screen by Hain LPA, Pulmonary Price
Metropolis Healthcare is a leading diagnostics centre and pathology lab in India equipped with the latest state-of-the-art technologies that provides the AFB XDR Screen by Hain LPA, Pulmonary with a clear pricing structure.
The AFB XDR Screen by Hain LPA, Pulmonary Price in Mumbai is ₹ 5,875 .
We are committed to deliver accurate and quality results from the best labs in India with complete transparency regarding test cost and turnaround time. No matter where you are, we strive to offer patients high-quality service that is affordable and accessible.
Frequently Asked Questions
This test has been approved by WHO and also by Govt. of India as a follow up test post detection of resistance by first line LPA and Xpert Mtb/Rif.
In addition to detection of M.tb it can detect resistance to quinolone (levofloxacin, moxifloxacin) and aminoglycoside (amikacin, Kanamycin, capreomycin, viomycin) group of antibiotics
What does AFB XDR Screen by Hains Line Probe Assay - Sputum / BAL/ Other respiratory samples measure
This test detects DNA of Mtb and mutations which can lead to resistance towards levofloxacin, moxifloxacin, amikacin, Kanamycin, capreomycin and viomycin.
During the test patient will be advised to rinse the mouth with clean water and then expectorate sputum with a deep cough. Aim is to get secretions from the lower respiratory tract which are not contaminated with sputum. Sputum sample will be collected in a screw capped container.
Test can be booked if pure culture of M.tb is provided at the time of booking
M.tb detected - This means that the DNA of M.tb is present in sample and patient is likely to be suffering from tuberculosis.
M.tb Not detected - This means that the DNA of M.tb is absent in sample and patient is unlikely to suffer from tuberculosis. However, sensitivity of this test is not 100%. Repeat test on fresh sample or culture may be advised by doctor to the patient
Resistance to Fluoroquinolone detected - This implies that patient is unlikely to respond to fluoroquniolone treatment. However confirmation with phenotypic is advisable
Resistance to Aminoglycosides detected- This implies that patient is unlike to respond to aminoglycoside treatment (check report for comments on individual antibiotics from aminoglycosides class). However confirmation with phenotypic is advisable
There is no need to get ready for the test other than to rinse your mouth thoroughly with water before taking a sputum sample.
The patient will be instructed to rinse their mouth with water before coughing vigorously to expel mucus during the test. The goal is to collect lower respiratory tract secretions free of sputum contamination. A sputum sample will be collected In a jar with a screw-on lid.
If a pure culture of M.TB is submitted at the time of booking, a test can be scheduled.
Acid-Fast Bacillus Test
Based on the initial findings, the following tests might be recommended -
- ZN Stain.
- Sputum Culture.
- Pleural Fluid for AFB.
- Bronchial Washing.
- MTB PCR
The AFB XDR Screen- Sputum / BAL/ Other Respiratory Samples is a diagnostic test that detects the presence of Mycobacterium tuberculosis (M.tb) DNA and identifies mutations associated with resistance to various antibiotics. It is specifically designed for detecting extensively drug-resistant tuberculosis (XDR-TB).
Is home sample collection available for the AFB XDR Screen- Sputum / BAL/ Other respiratory samples?
Yes, home sample collection is available for the AFB XDR Screen - Sputum / BAL/ Other Respiratory Samples. A trained phlebotomist will collect your samples at home, ensuring safety, comfort, and high standards of accuracy.
There are no "normal" levels for AFB XDR Screen- Sputum / BAL/ Other Respiratory Samples, as the test detects the presence or absence of M.tb DNA and specific mutations. The presence of M.tb DNA indicates infection, while the absence suggests no infection detected by this test.
The AFB XDR Screen- Sputum / BAL/ Other Respiratory Samples is used to diagnose tuberculosis, detect drug resistance, and monitor treatment response, particularly in cases where drug resistance is suspected or confirmed.
The frequency of testing for the AFB XDR Screen- Sputum / BAL/ Other Respiratory Samples depends on clinical judgment and the patient's risk factors. Generally, it is performed when tuberculosis is suspected based on symptoms or exposure history, or when monitoring treatment response in known tuberculosis cases.
The timing of the AFB XDR Screen- Sputum / BAL/ Other Respiratory Samples is not specific to any particular time of day but should be coordinated with your healthcare provider's schedule and the laboratory's operational hours.
No, fasting is not required for the AFB XDR Screen- Sputum / BAL/ Other Respiratory Samples.
Before getting tested for AFB XDR Screen- Sputum / BAL/ Other Respiratory Samples, patients should ensure proper oral hygiene before providing the sputum sample and follow any specific instructions provided by their healthcare provider or the laboratory.
The parameters included in AFB XDR Screen- Sputum / BAL/ Other Respiratory Samples are presence of M.tb DNA and mutations associated with resistance to isoniazid, ethionamide, fluoroquinolones, second-line injectable drugs, and aminoglycosides.
The AFB XDR Screen- Sputum / BAL/ Other Respiratory Samples should be done when tuberculosis is suspected based on symptoms, exposure history, or when monitoring treatment response in known tuberculosis cases, especially if drug resistance is a concern.
The time required for the AFB XDR Screen- Sputum / BAL/ Other Respiratory Samples can vary depending on the laboratory and their processing procedures. Typically, samples are collected within 30 minutes.
The turnaround time for receiving the reports for the AFB XDR Screen- Sputum / BAL/ Other Respiratory Samples can vary depending on the lab. Usually, results are available within a week after the sample is received. Check with your healthcare provider or the laboratory for their specific reporting timelines.
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