Hindi
  • Wednesday | 27-October-2021

Microbiology

Microbiology

Dr Manpreet Bhalla Head of Department   
Dr. V. P. Myneedu Senior Consultant Microbiologist  
Dr Ajoy Kumar Verma  Specialist Grade I Microbiologist  
Dr Ritu Singhal Specialist Grade I Microbiologist  
Dr Niti Singh NRL Microbiologist  
Dr Gavish Kumar FIND Microbiologist  
Dr. Neena Garg NRL Microbiologist  
Residents Two Senior and Four Junior Residents (DNB)  
 
   The Department of Microbiology is well equipped to provide diagnostic and research support in the areas of Mycobacteriology, Bacteriology, Mycology, Serology, Parasitology and Molecular Biology.
 
     Molecular diagnostic services in TB are provided for Rifampcin by GeneXpert and 1st line and 2nd line drugs by Line probe assay.
 
    Whole Genome Sequencing technology system has also been established in institute with support from Central TB Division for epidemiological surveillance.
 
   Liquid culture and sensitivity testing facility for first and second line anti-tubercular drugs is available along with extended drugs (i.e. Linezolid, Clofazimine, Bedaquiline and Delaminid).
 
    The Department is involved in several extra-mural and intra-mural Mycobacteriology research projects from ICMR/ DBT/ FIND and other partners in collaboration with other premier institutes and has diagnostic capacity to strengthen services in the field of Mycobacteriology. Various articles are regularly published in reputed National and International journals.
 
     Department of Microbiology, NITRD was assessed and accredited in accordance with the standard ISO 15189:2012 “ Medical Laboratories Requirements for Quality and Competency in the field of Medical Testing in Mycobacteriology, Issue date:-3/11/2018 till 2/11/2021.
 
      The World Health Organization and Global Laboratory Initiative have recognized the National Institute of Tuberculosis and Respiratory Diseases in New Delhi, India as a National Center of Excellence for WHO / GLI TB Supranational reference laboratory network. Trainings are regularly conducted by the Department in collaboration with International Union against Tuberculosis and Lung diseases (IUATLD), WHO and SAARC countries as and when required by the Ministry of Health and Family Welfare India.
 
 
List of equipments
Biological Safety Cabinet ESCO Labculture Class II, NuAire class I biological safety cabinets, GeneXpert System, BACTEC™ MGIT™ 960, Rota 6R-V/Fm refrigerated centrifuge, Grant Inspissator, Vertical autoclave, Refrigerated Centrifuges, Kahn’s shaker, Incubator, Walk in incubator, Walk in cold room, Vortex mixer, Deep freezers, Refrigerator, Vortex Mixer, GT blot 48 Assay, twincubator, thermocycler, hot air oven, PCR hoods, Microscan rapid bacterial identification system, ELISA reader and washer,Miseq whole sequencer system with 22 supporting equipments. This year NTM Equipments - Gel Doc Machine, PCR Hood, Spectrophotometer, Gel Electrophoresis have been added.
 
The various sections of Department are.
 
MYCOBACTERIOLOGY CULTURE & SUSCEPTIBILITY SYSTEM
      A well established section under supervision of HOD Microbiology/ section incharge is supported by 2 Microbiologist (NRL), 2 regular technicians and 5 NRL lab technicians. The section performs smear microscopy, processing of samples, solid/liquid Culture , identification and Drug Susceptibility Testingfor extended drugs.
 
     As per the International Bio-safety Guidelines, the Department has the facility of a BSL-3 laboratory to handle culture and drug sensitivity by MGIT960 Liquid culture System where culture and drug sensitivity for first and second line anti-tubercular drugs by liquid culture for patients. (MGIT) is carried out along with extended DST, if required and is certified by SNRL Antwerp Belgium.Linezolid, Clofazimine Bedaquiline and Delaminid susceptibility has been started and is already certified by SNRL.
 
      The section has also been involved in the accreditation & renewal of FL-LPA, SL-LPA, first line LC-DST, second line LC-DST certification of the 8 different states of India including IRLs at Delhi, Chandigarh, Haryana, Punjab, Himachal, Jammu and Kashmir, Ladakh and Bihar.
 
NON-TUBERCULOUS MYCOBACTERIAL SYSTEM
Started in October 2011, with staff of one Specialist Microbiologist and one Regular Technician, identification of all Mycobacteria are routinely done in the section until the species level by the conventional method using various biochemical tests and rapid immune-chromatographic test. The section is also conducting confirmation of NTMs by molecular technology. Since last two years, the section has standardized and initiated minimum inhibitory concentration and drug susceptibility for NTMs. The section is a tertiary level referral centre for NTM for all states of NRL and receives samples/ cultures for identification.
 
LINE PROBE ASSAY SYSTEM
Started in October 2011, under supervision of one Specialist Microbiologist supported by one bio-technologist ,one regular technician and 2 technicians (NRL), the LPA facility has the strength to conduct DNA extraction, amplification and hybridization of more than 40 samples or cultures for first-line and second line along with mutations per day. Samples are received from LRS-DR-TB centre (four districts of Delhi), J & K andSikkim (as hand holding).
 
GENE XPERT SYSTEM
Started in October 2016, under supervision of HOD Microbiology supported by one Regular Technician, the section is conducting over 80 tests per day. Section has one 16 module machine and one 4 module machines each.
 
WHOLE GENOME SEQUENCING SYSTEM
Initiated in 2017, under supervision of one Specialist Microbiologist supported by one Biotechnoogist, the section has MiSEQ sequencer along with 20 other equipments. Currently the section is under process of standardizing and performing limited tests as per CTD mandate.
 
BACTERIOLOGY
The section under supervision of one Specialist Microbiologist and two regular technicians performs identification and drug susceptibility for all bacteria. The section has now fully automated bacterial identification and sensitivity system (MICROSCAN). The section is also conducting tests received for infection control surveillance.
 
MYCOLOGY
The section under supervision of one Specialist Microbiologist and one regular technicians performs routine KOH microscopy, india ink preparation and fungal isolation (Moulds and yeast) as per standard guidelines. Aspergillus IgG serology is done by ELISA. There is collaboration with Mycology Department of AIIMS for confirmation of Non-sporulating fungi by molecular methods.
 
SEROLOGY
Tests are conducted for HIV, HBsAg, HCV and Typhoid (Widal)
 
PARASITOLOGY
Stool examination for ova/ cyst using standard guidelines is performed routinely.
 
Xpert® Xpress SARS-CoV-2
Tests conducted under the supervision of HOD as Nodal Officer NITRD (designated by ICMR), One NRL Microbiologist (Coordinator), One Senior Resident and existing staff of Department.
 
 
 
NATIONAL REFERENCE LABORATORY- EQA SECTION
NITRD is one of the six NRL’s under NTEP. The NRLs work closely with different IRLs, supervise their activities, undertake training of the staff and support the states under them for diagnostic services till they are certified.
 
Presently seven states of North India (Jammu and Kashmir, Punjab, Chandigarh, Himachal, Bihar, Haryana, Ladakh and Delhi) are allotted to the NRL. In addition to this one more state of Sikkim is being supported by NRL for various diagnostic techniques till further notice by Central TB division of India.
 
NRL regularly participates in the external quality assessment programme (proficiency testing) of WHO-GLI Supranational Reference Laboratory Network (Antwerp, Belgium) for TB drug susceptibility testing and demonstrated good proficiency for Ist line and IInd line TB drug susceptibility testing by phenotypic and genotypic methods.
 
On sight evaluations (OSEs) is being carried out for all states which included IRL’s, CBNAAT sites and  DTC/DMC of various districts. On site panel testing of Lab. persons including Microbiologists, STLS/LTs is being conducted during the visits. Annual   Proficiency testing of all laboratoriesis being conducted for the LPA and Liquid culture wherever applicable. 
 
Trainings done
         ·         Hand holding support for improving diagnostic service delivery to NTEP of IRL, AIIMS 
         ·         Handholding in LPA , LC DST and streaming the work in Bihar State
         ·         Online TRUENAAT Training for all the sites of the Jammu province
       ·     No other trainings could be conducted this year due to COVID Pandemic and restrictions in movements.
 Ongoing research projects
  •  Pyrazinamide resistance in Mycobacterium tuberculosis isolates from MDR suspects and identification of mutations by sequencing.
  •  Multi -center clinical study to assess the performance of the xpert MTB/XDR assay for INH  and second line resistance detection.
  •  Comprehensive approach on NTM Species Identification, drug susceptibility testing methods, and strengthening NE States laboratories.
  • To investigate the diagnostic utility of multiplex micro-beads immunoassay in TB diagnosis.
  •  TB Alliance funded project titled “Validation of Pretomanid MIC Testing “.
Publications
  1. Divya Anthwal, Rakesh Kumar Gupta, Narayan Sivaramakrishnan Gomathi, Srikanth Prasad Tripathy, Dasarathi Das, Sanghamitra Pati, Nikita Panwalkar, Prabha Desikan, Kiran Bala, Urvashi B. Singh, Manpreet Bhalla, Ritu Singhal, Ajoy Kumar Verma, Khalid Umar Khayyam, Vithal Prasad Myneedu, Rohit Sarin. Sandeep Sharma, Avi Kumar Bansal, Umesh D. Gupta, Sripad A. Patil, Abhinav, Goyal, Ashawant Gupta, Manjula Singh, Nalini Kant Gupta, Sagarika Haldar, Jaya Sivaswami Tyagi, Evaluation of ‘TBDetect’ sputum microscopy kit for improved detection of Mycobacterium tuberculosis: a multi-centric validation study. Clinical Microbiology and Infection Aug 2020.
  2. Dr Sushil Kumar Munjal1, Swapnil Naryan Pahade1 and Ajoy Kumar Verma2 . Co-existence of intestinal parasites and pulmonary tuberculosis from tertiary care referral center. IJCA September 2020; 9: 23116-23119.
  3. Raj Yadav1 , Jyoti Arora2 , Manpreet Bhalla3*Laboratory Diagnosis of Tuberculosis: Conventional and Newer MethodsInternational Journal of Science and Research (IJSR) ISSN: 2319-7064 ResearchGate*Corresponding Author: Manpreet BhallaVolume 9 Issue 10, October 2020 Impact Factor (2018): 0.28 | SJIF (2019): 7.583:319-324.
  4. Amit Aggarwal, Manpreet Bhalla and Khan Hena Fatima*Detection of New Delhi metallo-beta-lactamase enzyme gene blaNDM-1 associated with the Int-1 gene in Gram-negative bacteria collected from the effluent treatment plant of a tuberculosis care hospital in Delhi, India Access Microbiology,April 2020.