Clinical utility of a commercial test based on the polymerase chain reaction for detecting Mycobacterium tuberculosis in respiratory specimens
Autor: | Philip C. Hopewell, P S Nassos, D M Yajko, Daniel P. Chin, W K Hadley, C A Sanders, J J Madej |
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Rok vydání: | 1995 |
Předmět: |
Male
Pulmonary and Respiratory Medicine Pathology medicine.medical_specialty Time Factors Tuberculosis Critical Care and Intensive Care Medicine Polymerase Chain Reaction Sensitivity and Specificity law.invention Mycobacterium tuberculosis Predictive Value of Tests law medicine Humans Tuberculosis Pulmonary Polymerase chain reaction Lung medicine.diagnostic_test biology business.industry Respiratory disease Sputum medicine.disease biology.organism_classification medicine.anatomical_structure Bronchoalveolar lavage Evaluation Studies as Topic Female Reagent Kits Diagnostic medicine.symptom business Bronchoalveolar Lavage Fluid Respiratory tract |
Zdroj: | American Journal of Respiratory and Critical Care Medicine. 151:1872-1877 |
ISSN: | 1535-4970 1073-449X |
Popis: | Several studies have reported using methods based on polymerase chain reaction (PCR) to detect Mycobacterium tuberculosis in respiratory tract specimens. However, little is known about the actual clinical utility of PCR-based tests, and it is uncertain if PCR technology can be transferred to the clinical laboratory. To determine its utility, we evaluated a commercially developed PCR test system in a clinical laboratory using consecutive respiratory tract specimens. Microscopic examination of smears stained with acid-fast bacilli (AFB), culture, and a PCR-based test (Amplicor Mycobacterium tuberculosis assay; Roche Molecular Systems) were used to evaluate 535 consecutive sputum and bronchoalveolar lavage specimens from 227 patients. A clinical case definition of tuberculosis was used as the reference-standard to determine the utility of all diagnostic tests. For all specimens from patients with a new or a treatment-failure case of pulmonary tuberculosis, the positivity rate of PCR (58%) was similar to that of culture (56%) (p0.90) and substantially greater than microscopic examination of AFB-stained smears (22%) (p0.001). PCR and culture detected M. tuberculosis in 46 and 43%, respectively, of the specimens from patients who did not have AFB on microscopic examination of their respiratory tract specimens (p0.90). PCR had a false positive rate of 0.8%. In several instances, PCR detected M. tuberculosis when culture did not; and vice versa. The clinical utility of this PCR-based test is similar to that of culture for detecting M. tuberculosis in respiratory tract specimens.(ABSTRACT TRUNCATED AT 250 WORDS) |
Databáze: | OpenAIRE |
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