Gambaran Validitas Pemeriksaan Complex Specific Cocktail Antigen Mycobacterium tuberculosis (ESAT-6, CFP-10, MPT-64) Metode Rapid Immunochromatography pada Bahan Pemeriksaan Sputum dan Serum Penderita Tuberkulosis Paru

Hendra Subroto, Ida Parwati, Dewi Kartika Turbawaty, Bachti Alisjahbana

Abstract


Penegakan diagnosis tuberkulosis (TB) paru penting dalam mengurangi morbiditas dan mortalitas. Diagnosis laboratorium TB paru berdasar atas pemeriksaan BTA dan kultur M. tuberculosis memiliki sensitivitas rendah. Terdapat pemeriksaan cocktail antigen TB rapid immunochromatography (ICT) yang mendeteksi antigen ESAT-6, CFP-10, MPT-64 yang disekresikan oleh M. tuberculosis. Tujuan penelitian menganalisis validitas pemeriksaan cocktail antigen TB metode rapid ICT sputum dan serum penderita TB paru terhadap kultur Ogawa. Penelitian dilaksanakan Juli–Oktober 2014 di RSUP Dr. Hasan Sadikin Bandung. Bentuk penelitian adalah observasional deskriptif khusus dengan rancangan penelitian potong lintang. Subjek penelitian penderita yang datang ke Poliklinik Pulmonologi atau Poliklinik DOTS, didiagnosis TB paru. Sebanyak 68 sputum dan serum dari 33 kultur sputum M. tuberculosis positif dan 35 kultur negatif dilakukan pemeriksaan cocktail antigen TB rapid ICT. Angka positivitas cocktail antigen TB rapid ICT sputum 54,4%; serum tanpa pemanasan 0%. Pada serum dilakukan pemanasan pada suhu 56oC selama 30 menit untuk menghilangkan aktivitas antibodi dan didapatkan angka positivitas sebesar 19,1%. Nilai sensitivitas dan spesifisitas pemeriksaan untuk sputum 93,9% dan 82,8%, untuk serum tanpa pemanasan 0% dan 100%, serta serum dengan pemanasan 24,2% dan 85,7%.  Validitas pemeriksaan sputum memiliki sensitivitas tinggi dan spesifisitas sedang, untuk serum memiliki sensitivitas rendah dan spesifisitas tinggi. [MKB. 2017;49(3):178–85]

Kata kunci: Cocktail antigen TB rapid ICT, kultur Ogawa, mikroskopik BTA, tuberkulosis paru, serum, sputum

 

Validity of Complex Specific Cocktail Antigen Mycobacterium tuberculosis (ESAT-6, CFP-10, MPT-64) Rapid Immunochromatography Method on Sputum and Serum Samples from Patient with Pulmonary Tuberculosis

Early diagnosis of pulmonary tuberculosis (TB) is very important in reducing morbidity and mortality. The current diagnosis of TB includes direct staining (acid fast bacilli) or M. tuberculosis culture, but these examinations have a low sensitivity. An assay using rapid ICT cocktail antigen TB is currently available for diagnosing TB. This method can detect ESAT-6, CFP-10, and MPT-64 antigen which is secreted by M. tuberculosis. The aim of this study was to analyze the validity of cocktail antigen TB rapid ICT using sputum and serum with Ogawa culture. This was a cross-sectional descriptive observational study. Sputum and serum were collected from patients who were diagnosed as lung TB suspects in the lung and DOTS Clinic of Dr. Hasan Sadikin General Hospital Bandung during the period of July–December 2014 in . Cocktail antigen TB detection assay using two kind of samples (sputum and serum) were evaluated. A total of 68 subjects of33 subjects presented positive culture and 35 presented negative cultures. Positivity rates for sputum and serum were 54.4% and 0%, respectively. Heated sputum assay had a sensitivity of 93.9% and specificity of 82.8%, Serum assay presented a sensitivity of 0% and specificity  of100%.  Serum were modified by heating at 56oC for 30 minutes. The positivity rate of heated serum was 19.1%. The result of modified serum assay showed a sensitivity  of 24.2% and specificity of 85.7%. Conclusion: the sensitivity of the sputum assay is high and the specificity is medium. The sensitivity of this serum assay is low and the specificity is high. [MKB. 2017;49(3):178–85]

Key words: Acid fast bacilli, cocktail antigen TB rapid ICT, pulmonary tuberculosis, Ogawa culture, sputum, serum


Keywords


Cocktail antigen TB rapid ICT, kultur Ogawa, mikroskopik BTA, tuberkulosis paru, serum, sputum

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References


Kalra M, Khuller G, Grover A, Behera D, Wanchu A, Verma I. Utility of a combination of RD1 and RD2 antigens as a diagnostic marker for tuberculosis. Diag Microbiol Infect Dis. 2010;66(2):153–61.

Kleinnijenhuis J, Oosting M, Joosten L, Netea M, Crevel RV. Innate immune recognition of Mycobacterium tuberculosis. Clin Dev Immunol. 2011;2011:405310.

Maurya A, Nag V, Kant S, Kushwaha R, Kumar M, Mishra V. Evaluation of an immunochromatographic test for discrimination between Mycobacterium tuberculosis complex & non tuberculous mycobacteria in clinical isolates from extra-pulmonary tuberculosis. Indian J Med Res. 2012;135(6):901–6.

Lightbody K, Ilghari D, Waters L, Carey G, Bailey M, Williamson R. Molecular features governing the stability and specificity of functional complex formation by Mycobacterium tuberculosis CFP-10/ESAT-6 family proteins. J Biol Chem. 2008; 283(25):17681–90.

Ganguly N, Siddiqui I, Sharma P. Role of M. tuberculosis RD-1 region encoded secretory proteins in protective response and virulence. Tuberculosis (Edinb). 2008; 88(6):510–7.

Feng T, Shou C, Shen L, Qian Y, Wu Z, Fan J. Novel monoclonal antibodies to ESAT-6 and CFP-10 antigens for ELISA-based diagnosis of pleural tuberculosis. Int J Tuberc Lung Dis. 2011;15(6):804–10.

Song F, Sun X, Wang X, Nai Y, Liu Z. Early diagnosis of tuberculous meningitis by an indirect ELISA protocol based on the detection of the antigen ESAT-6 in cerebrospinal fluid. Irish J Med Sci. 2014;183(1):85–8.

Kashyap R, Ramteke S, Morey S, Purohit H, Taori G, Daginawala H. Diagnostic value of early secreted antigenic target-6 for the diagnosis of tuberculous meningitis patients. Infection. 2009;37(6):508–13.

Toihir A, Rasolofo V, Andrianarisoa S, Ranjalahy G, Ramarokoto H. Validation of an immunochromatographic assay kit for the identification of the Mycobacterium tuberculosis complex. Memorias do Instituto Oswaldo Cruz. 2011;106(6):777–80.

Shen G, Chiou C, Hu S, Wu K, Chen J. Rapid identification of the Mycobacterium tuberculosis complex by combining the ESAT-6/CFP-10 immunochromatographic assay and smear morphology. J Clin Immunol. 2011;49(3):902.

Azzurri A, Kanaujia G, Sow O, Bah B, Diallo A, Prete GD. Serological markers of pulmonary tuberculosis and of response to anti-tuberculosis treatment in a patient population in Guinea. Int J Immunopathol Pharmacol. 2006;19(1):199–208.

Gustiani N, Parwati I, Tjandrawati A, Lismayanti L. Validitas pemeriksaan complex specific antigen Mycobacterium tuberculosis RD1-RD3 (antigen ESAT6, CFP10, dan MPT64) metode rapid immunochromatography pada sputum penderita tuberkulosis paru. MKB. 2014;46 (4):241–6.

Hadi N, Kabiri M. Detection of Mycobacterial antigen and antibody in patients with tuberculosis and their association with therapy. Iranian Red Crecscent Soc 2007;9:74–9.




DOI: http://dx.doi.org/10.15395/mkb.v49n3.1120

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