Detection of Mycobacterium tuberculosisin bronchoalveolar lavage from patients with sputum smear‐negative pulmonary tuberculosis using a polymerase chain reaction assay

Autor: LIAM, CK, CHEN, YC, YAP, SF, SRINIVAS, P, POI, PJH
Zdroj: Respirology; June 1998, Vol. 3 Issue: 2 p125-129, 5p
Abstrakt: Abstract The objective of this study was to evaluate the utility of a polymerase chain reaction (PCR) assay in detecting Mycobacterium tuberculosisin bronchoalveolar lavage (BAL) specimens of patients suspected of having active pulmonary tuberculosis (TB) but who were sputum smear‐negative. Patients undergoing investigation for suspected pulmonary TB at the University Hospital, Kuala Lumpur, and who were sputum smear‐negative underwent fibreoptic bronchoscopy and BAL. One portion of each lavage specimen was submitted for smear examination for acid‐fast bacilli and mycobacterial culture and the other portion assayed by PCR for the presence of a 562‐base pair DNA segment belonging to the insertion sequence IS986, unique to the M. tuberculosiscomplex. As controls, lavage specimens from patients with other lung lesions were also similarly tested. The PCR assay gave a positivity rate of 80.9% (55 of 68) compared with 8.8% of smear examination and 7.4% of culture for detecting M. tuberculosisin BAL specimens. The assay was positive in two of 45 BAL specimens from 35 control subjects. The PCR assay was more sensitive than smear and culture in detecting M. tuberculosisin BAL specimens of patients with sputum smear‐negative pulmonary TB.
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