Added diagnostic value of 16S rRNA gene pan-mycobacterial PCR for nontuberculous mycobacterial infections: a 10-year retrospective study

Autor: Andenmatten Simon, Laurent P. Nicod, Jesica Mazza-Stalder, Jaton Katia, Opota Onya, Greub Gilbert
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Microbiology (medical)
medicine.medical_specialty
Genes
rRNA
Humans
Microscopy/methods
Molecular Diagnostic Techniques/methods
Mycobacterium Infections
Nontuberculous/diagnosis
Nontuberculous Mycobacteria/genetics
Nontuberculous Mycobacteria/isolation & purification
Polymerase Chain Reaction/methods
Predictive Value of Tests
RNA
Ribosomal
16S/genetics
Retrospective Studies
Sensitivity and Specificity
Time Factors
16S rRNA gene
Acid-fast bacilli
Auramine staining
Extra-pulmonary infection
Infection
Microscopy
Molecular diagnostics
Mycobacteria
Mycobacterial culture
Nontuberculous mycobacteria
Pan-mycobacterial PCR
Polymerase chain reaction
Pulmonary infection
Mycobacterium Infections
Nontuberculous
Gastroenterology
Polymerase Chain Reaction
law.invention
Medical microbiology
law
Positive predicative value
Internal medicine
RNA
Ribosomal
16S
Medicine
Gene
biology
business.industry
Retrospective cohort study
Nontuberculous Mycobacteria
General Medicine
16S ribosomal RNA
biology.organism_classification
Infectious Diseases
Molecular Diagnostic Techniques
Original Article
business
Zdroj: European journal of clinical microbiology & infectious diseases, vol. 38, no. 10, pp. 1873-1881
European Journal of Clinical Microbiology & Infectious Diseases
Popis: The diagnosis of mycobacterial infections has been dramatically improved by the introduction of molecular methods aimed to reduce the time to diagnosis as compared with culture. The broad range pan-mycobacterial PCR can detect all the mycobacterial species directly from clinical specimens. We aimed to evaluate its usefulness and its clinical added value for the diagnosis of nontuberculous mycobacterial (NTM) infections. We performed a retrospective study (2003–2013) including 952 samples taken from 639 patients with clinical suspicion of NTM infection. The performance of smear microscopy, PCR and culture was established using clinical data to investigate discrepant results. We also compared the time to microbial diagnosis between the direct PCR and culture. The sensitivity, specificity, positive and negative predictive values of the PCR were 61.6% (53.5–69.1), 99.1% (98.2–99.6), 92.8% (85.8–96.5) and 93.4% (91.6–94.9), respectively, when considering all specimens. When considering smear-positive specimens and smear-negative specimens, the sensitivity was 81.6% and 40%, respectively. The sensitivity for pulmonary and extra-pulmonary smear-positive specimens was 85.2% versus 72.7%. The median time to identification at species level was 35 days (SD, 17.67) for culture and 6 days (SD, 2.67) for the PCR (when positive), which represents a 29-day shorter time to results (p
Databáze: OpenAIRE
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