바로가기메뉴

본문 바로가기 주메뉴 바로가기

Tuberculosis & Respiratory Diseases

Article Contents

Prev Next
e-Submission

Vol.57 No.6
Citation Share

Usefulness of PCR Test for M. tuberculosis for the Differentiation of Pulmonary Tuberculosis and Nontuberculous Mycobacterial Lung Disease in Patients with Smear-Positive Sputum

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2004, v.57 no.6, pp.528-534













& (2004). Usefulness of PCR Test for M. tuberculosis for the Differentiation of Pulmonary Tuberculosis and Nontuberculous Mycobacterial Lung Disease in Patients with Smear-Positive Sputum. Tuberculosis & Respiratory Diseases, 57(6), 528-534.
  • Downloaded
  • Viewed
PDF Download

Abstract

Background : Microscopic examination of sputum smears for acid-fast bacilli (AFB) is the most important and rapid diagnostic test for pulmonary tuberculosis. However, the AFB observed on the smear may represent either M. tuberculosis or nontuberculous mycobacteria (NTM). This study examined the clinical usefulness of a polymerase chain reaction test for M. tuberculosis (TB-PCR) for the differentiation of pulmonary tuberculosis and NTM lung disease in patients with smear-positive sputums in a tertiary hospital in Korea. Material and Methods : From January, 2003 to December, 2003, 826 AFB smear-positive and culture-positive sputum specimens were collected from 299 patients. Results : NTM were recovered from 26.6% (220/826) of the smear-positive sputum specimens and 23.4% (70/299) of the patients with smear-positive sputum. All the patients with isolated NTM had clinically significant NTM lung disease; 38 patients (54.3%) had M. avium and 26 patients (37.1%). had M. abscessus. In the patients with pulmonary tuberculosis, 78.7% of the patients (74/94) showed TB-PCR positivity, and all the patients with NTM lung disease showed negative results on the TB-PCR test (p<0.001). A positive result of the TB-PCR test on the sputum or bronchial washing fluid specimens was able to predict pulmonary tuberculosis with 88.4% sensitivity, 100% specificity, a 100% positive predictive value and a 79.7% negative predictive value for the patients with smear-positive sputum. Conclusion : The TB-PCR test for sputum specimens or bronchial washing fluid specimens could be useful for differentiating pulmonary tuberculosis and NTM lung disease for the patients with smear-positive sputum in Korea. (Tuberc Respir Dis 2004; 57:528-534)

keywords
Mycobacterium tuberculosis, Atypical mycobacteria, Polymerase chain reaction, Korea, Mycobacterium tuberculosis, Atypical mycobacteria, Polymerase chain reaction, Korea

Reference

1.

American Thoracic Society, (2000) Diagnostic Standards and Classification of Tuberculosis in Adults and Children,

2.

World Health Organization, (2003) Treatment of Tuber- culosis Guidelines for national programmes,

3.

Korean Academy of Tuberculosis and Respiratory Diseases, (1997) Diagnostic standards of pulmonary tuber- culosis,

4.

Schluger NW, (2001) Changing approaches to the diagnosis of tuberculosis,

5.

American Thoracic Society, (1997) Rapid diagnostic tests for tuberculosis: what is the appropriate use? ,

6.

Centers for Disease Control and Prevention, (2000) Update:Nucleic acid amplification tests for tuber- culosis,

7.

Korean Center for Disease Control and Prevention, (2004) Guidelines for the control of tuberculosis 2004,

8.

Koh WJ, (2003) Recovery Rate of Nontuberculous My- cobacteria from Acid-Fast-Bacilli Smear-Positive Sputum Specimens,

9.

Kim CS, (1997) The Usefulness of PCR Study in AFB Smear Negative Patients on Admission,

10.

Kyong TY, (1998) Cummulative Positive Rate of Consecutive Sputum Polymerase Chain Reaction in Pulmonary Tuberculosis,

11.

Baek SH, (2001) How Reliable is Sputum PCR Test in the Diagnosis of Pulmonary Tuberculosis When Sputum Smear is Negative? ,

12.

Park MH, (1996) The Diagnostic Value of Bronchoalveolar lavage fluid microscopic study and PCR in Pulmonary tuberculosis,

13.

Mo EK, (1998) The Clinical Utility of Polymerase Chain Reaction in the Bronchoalveolar Lavage Fluid for the Detection of Mycobacteria,

14.

Lee J, (2001) Clinical Utility of Bronchial Washing PCR for IS6110 and Amplicor for the Rapid Diagnosis of Active Pulmonary Tuberculosis in Smear Negative Patients,

15.

Lee H, (2000) Species identification of mycobacteria by PCR-restriction fragment length polymorphism of the rpoB gene,

16.

Koh WJ, (2003) Clinical significance of nontuberculous mycobacteria isolated from respiratory specimens,

17.

Piersimoni C, (2003) Relevance of commercial amplification methods for direct detection of My- cobacterium tuberculosis complex in clinical samples,

18.

Centers for Disease Control and Prevention, (1996) Nucleic acid amplification tests for tuberculosis,

19.

Chan W, (1971) Bac- teriological measures for the detection of cases of pulmonary tuberculosis,

20.

Blair EB, (amrevrespirdis1976) Computer files and analyses of laboratory data from tuberculosis pati- ents Analyses of six years' data on sputum specimens,

21.

Levy H, (1989) A reevaluation of sputum microscopy and culture in the diagnosis of pulmonary tuberculosis,

22.

Kim BJ, (2004) Differential identification of Mycobacterium tuberculosis complex and nontuberculous mycobacteria by duplex PCR assay using the RNA polymerase gene(rpoB),

Tuberculosis & Respiratory Diseases

e-Submission OA Policy