International Journal of Science and Research (IJSR) ISSN (Online): 2319-7064 Index Copernicus Value (2015): 78.96 | Impact Factor (2015): 6.391 Volume 6 Issue 8, August 2017 www.ijsr.net Licensed Under Creative Commons Attribution CC BY Validity of Mycobacterium Tuberculosis Antigens Cocktail (ESAT-6, CFP-10, MPT 64) Serum Test in Diagnosing Adult and Pediatric Tuberculosis Dewi Kartika Turbawaty 1 , Hendra Subroto 2 , Verdiansah 3 , Arto Yuwono Soeroto 4 , Budi Setiabudiawan 5 , Ida Parwati 6 1, 2, 3, 6 Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Dept of Clinical Pathology 4 Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Dept of Internal Medicine 5 Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Dept of Pediatric Abstract: Background: The diagnosis of tuberculosis relies on the isolation of Mycobacterium tuberculosis (M. tuberculosis) from sputum culture but in pediatric patient it is difficult to take the sputum. For individuals such as children who are unable to produce sputum, invasive procedures may become necessary when noninvasive methods do not permit a diagnosis. The aim of this study was to determine the validity of M. tuberculosis antigens cocktail ESAT-6, CFP-10 and MPT64 (TB Antigens Cocktail) from serum specimens in Adult TB with Ogawa culture as a gold standard, and from serum specimen of pediatric TB patients with TB Scoring system as a gold standard. Subject and method : This is a cross sectional descriptive observational study. This study was held in Dr Hasan Sadikin General Hospital Bandung, Indonesia. Subjects were divided into two groups: adult TB and Pediatric TB. The sputum specimens from the first group were obtained Ziehl-Neelsen (ZN) stain and M. tuberculosis culture (Ogawa). The TB Antigens Cocktail rapid Immunochromatography (ICT) was performed on all serum samples from both grups. Result: A total of 68 Adult TB were enrolled in this study, the sensitivity, specificity, PPV and NPV of TB Antigens Cocktail were 24.2 %, 85.7%, 61.5% and 54.5%, respectively. From 61 children suspected with TB disease, the sensitivity, specificity, PPV and NPV of TB Antigens Cocktail were 30.7%, 86.3%, 80.0% and 41.3%, respectively. Conclusions: This study shown, Immunochromatography TB Antigens Cocktail (ESAT- 6, CFP-10 and MPT64) from serum sample has good specificity for diagnosing tuberculosis. Keywords: Adult pulmonary tuberculosis, Pediatric tuberculosis, TB antigen cocktail, serum. 1. Introduction Tuberculosis(TB) remains a major global health problem, in 2015 was one of the top 10 cause of death worldwide.(1) The early diagnosis of pulmonary tuberculosis (PTB) is very important in reducing morbidity and mortality. The diagnosis of PTB is based on sputum microscopy identification for acid-fast bacillus (AFB) and culture of M. tuberculosis . However there are 30% of patients who can not produce sputum sample as in adult PTB with HIV and pediatric tuberculosis patient.(2-4) Approximately 1 million children develop TB disease each year and at least 14% die in where the majority of these children are never diagnosed or treated for their TB disease.(5) Without adequate treatment, children with TB, especially those younger than 5 years, are at high risk of death.(6) Diagnosis of pediatric TB needs to be more in the clinician’s effort in obtaining medical history and physical examination because of the paucibaciller population of M. tuberculosis and the unspecific symptoms of disease. For individuals such as children who are unable to produce sputum (natural or induced), invasive procedures may become necessary when noninvasive methods do not permit a diagnosis. In the absence of a positive culture, the strongest evidence for TB in a child is recent exposure to an adult with active disease. The tuberculin skin test and chest radiography may be used to provide supportive information. Therefore Scoring system has been recommended by several government institution as helping tool to diagnose it.(7, 8) Diagnosis of TB using microscopy examination is less sensitive and can be found Mycobacterium other than tuberculosis. While, the isolation and identification of M. tuberculosis using culture is time consuming and require high skilled experts and safety precautions.(9, 10) The polymerase chain reaction (PCR) method is very expensive to apply in poor resource settings.(11, 12) Recently there is a test provided results by detecting the M. tuberculosis antigens cocktail ESAT-6, CFP-10, and MPT-64 using the lateral flow principle. Previous studies were found the M. tuberculosis antigens cocktail ESAT-6, CFP-10, and MPT- 64 in several body fluid.(13-16) Mycobacterium tuberculosis secretion of ESAT-6, CFP-10 and MPT-64 antigens coded by Regions of differences 1 (RD1) and RD2 genes. These regions of differences are located in the genome of M. tuberculosis but somehow are absent in many of the environmental mycobacteria.(17) Early secretory antigenic target-6 (ESAT-6) is expressed early during M. tuberculosis infection and it is essential for the bacteria to survive and spread in vivo.(18) In other hand, culture filtrate protein-10 (CFP-10) has been identified to be earliest protein produced by M. tuberculosis during culture in bacteriological media.(19) M. tuberculosis protein 64(MPT-64) is a secreted protein of M. tuberculosis and elicits specific response against M. tuberculosis.(20) Both Paper ID: ART20175960 DOI: 10.21275/ART20175960 362