Comprehensive study of changes in Acid-Fast Bacilli Sputum Positive Patients Following Anti tubercular treatment attending OPD in A Tertiary Care Hospital in Northern India

INTRODUCTION: Pulmonary Tuberculosis (PTB) with detectable Mycobacterium tuberculosis in the sputum is a major source of transmission. The cure is declared through sputum smear examination for Acid-fast-bacilli without performing culture. The aim of this study was to investigate the new pulmonary tuberculosis cases declared cured by sputum smear conversion under NTEP (National tuberculosis elimination program). METHOD: In this study were conducted in the department of Microbiology, School of health sciences, C.S.J.M. University, Kanpur. Sputum samples were be collected, M.L.C. hospital, G.S.V.M. medical college, Kanpur.  As the source of the sample for this study 198 Random patient samples of sputum received during 6 months will be studied, from the Department of Microbiology, M.L.C. hospital, G.S.V.M. College, Kanpur. All cases whose sputum sample has been sent to the Department of Microbiology, M.L.C. hospital, G.S.V.M. College, Kanpur for Ziehl-Neelsen staining investigation. RESULTS: A total of 198 patients were identified as presumptive Tuberculosis cases from April 2024 to September 2024. Among these all the sputum smear microscopically Acid-Fast-Bacilli confirmed Pulmonary tuberculosis were taken, and all were new Tuberculosis patients who were never treated for Tuberculosis before, or had taken anti-TB drugs for less than 1 month as in inclusion criteria. The patients were having referring health facility. After 6 months of treatment, 125(63%) patients were declared cured by sputum smear microscopy. CB-NAAT was performed on all the patients further after microscopically AFB confirmed pulmonary tuberculosis of these patients. The objective of this test was to identify the DR-TB and DS-TB. The demographic and clinical data of these 198 patients with relatively few (8.0%) patients were smokers with a male predominance. The prevalence of diabetes mellitus was low (12.6%), and none of these patients were positive for HIV. Majority of the chest radiographs showed non-cavitary pulmonary infiltrates (94.4%), and cavities were seen in only (8.9%) of cases. More than half of the patients belonged to low-income groups. DISCUSSION The results show that the presence of viable Mycobacterium tuberculosis bacilli is less likely if none or one of the four factors is present. Hence, medical resources can be saved by applying the four factors to predict the results of mycobacterial culture. CONCLUSION: Acid-Fast-Bacilli smear alone should not be used to assess treatment failure and careful examination of microbiologic status, including culture and drug susceptibility testing, is needed before making changes to retreatment specimens or empirical second-line anti-TB specimens in these patients. .