SRL Diagnostics sees that spinal TB diagnostics has now reached a new realm with access to advanced tests like Hains, GeneXpert, Quantiferon Gold and ADA which are highly sensitive to detect the dreaded condition. The rapid and reliable identification of mycobacteria species and identifying multidrug-resistant tuberculosis strains are prerequisites for effective treatment and containment of the disease.
Although Quantiferon Gold and ADA are not essentially diagnostic tools, it helps in the analysis of TB in various clinical settings. However, the latest diagnostic tool is GeneXpert introduced this year and used for diagnosis of both pulmonary and extra-pulmonary TB. It is known for a 60-70% detection sensitivity. For TB culture MGIT 960 automated system is available since 2007. TB PCR or multiplex has been in existence for over a decade, Dr. BR Das, president-research & innovation, Mentor-Molecular Pathology and Clinical Research Services, SRL Diagnostics told Pharmabiz.
According to SRL, incidence of spine TB is on an upswing. While bone TB is about 50% of total reported cases, 30% are spine TB affecting commonly vertebral bone. The condition is rapidly on the rise in the developed countries affecting children and young adults. Genetic susceptibility to spinal tuberculosis is surfacing. Risk of developing tuberculosis is estimated to be 20–37 times greater in HIV infected cases. The total duration of the illness varies from few months to few years, with average disease phase ranging from 4 to 11 months.
A key challenge is the detection of spinal TB. Pathologists require site specific sample, especially when fine needle aspirations and Tru cut biopsies are attempted. However, a gold standard for TB diagnosis is culture. Histopathology examination can confirm a specific pattern recognised as commonly due to TB. But many a time, representative area may not be sampled and this feature will not be seen. Sample quantity at times for culture may not be sufficient. Molecular studies like GeneXpert, different types of Polymerized chain reaction (PCR) require only limited small volume sample and sans cold chain during sample transportation, he added.
GeneXpert is manufactured by Cephied and therefore patients need to access physicals or path labs to be able to detect spinal TB at the earliest because it is viewed as a destructive condition that can paralyse the body if ignored, said Dr. Das.
In the area of spinal TB diagnostics, SRL has a comprehensive battery of tests and is the leader in TB diagnosis in India. We have multiple modalities for diagnosis starting from basic- Acid fast bacilli stains, TB Culture, Drug sensitivity- First and second line, molecular studies like real time PCR- Mycoreal, Multiplex PCR (Mycotect), Hains and GeneXpert.We also offer Quantiferon Gold and ADA, said Dr Das.