Current concepts of diagnosis for mycobacterial infections in female genital tract

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Review Article

Author Details : Pooja S. Gangania, Dakshina Bisht, Varsha A. Singh

Volume : 4, Issue : 1, Year : 2017

Article Page : 7-13

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Abstract

Female genital tuberculosis is a very common cause of infertility not only in India but in other developing countries also. The organ which gets most affected is fallopian tubes (90-100%), followed by endometrium (50-60%), ovaries (20-30%), cervix (5-15%) and vulva vagina (1%). The mode of transmission to the genital tract usually is the haematogenous spread from pulmonary or other sites of tuberculosis. As mycobacterium tuberculosis remains one of the leading cause of female infertility, the mycobacterium species other than tuberculosis (MOTT) are found to be increasingly important pathogens causing genital infections and infertility. The lack of symptoms makes it difficult to diagnose and there are no accepted guidelines for their diagnosis. It shows low sensitivity to bacteriological tests and has poor specificity to most immunological and serological investigations. The samples which are to be taken are menstrual blood, endometrial and ovarian tissues. Diagnosis involves sample collection, processing followed by decontamination and homogenization, staining by stains like ZN, kinyoun and fluorochrome are preferred. Culture techniques involves both liquid and solid medium. For solid culture the media commonly used are L-J egg media, L-J with para-nitobenzoic acid, Middlebrook 7H11 or 7H10, TK medium. Liquid culture is rapid and automated which involves TREK/ESP, MB/BacT system, BACTEC MGIT 960 (Mycobacteria Growth Indicator Tubes), BACTEC 460. Species identification is done by both phenotypic (Biochemicals, Pigmentation, Optimal temperature & time) and genotypic (Micro seq 500 systems, Accuprobe, Inmo-LiPA Mycobacteria assay) techniques. Non culture based methods includes antigen detection methods, phase assay etc. and molecular techniques NAAT (nucleic acid amplification test) along with other newer techniques.

Keywords: Female Genital Tuberculosis, Female Infertility, MTBC, NTM, Deteriorated Fallopian Tubes, Endometrium, NAAT (Nucleic Acid Amplification Test)

How to cite : Gangania P S, Bisht D, Singh V A, Current concepts of diagnosis for mycobacterial infections in female genital tract. Indian J Microbiol Res 2017;4(1):7-13

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