Evaluation of real-time PCR of patient pleural effusion for diagnosis of tuberculosis

被引：23

作者：

Rosso F. ^{[1
]}

Michelon C.T. ^{[2
]}

Sperhacke R.D. ^{[3
]}

Verza M. ^{[2
]}

Olival L. ^{[4
]}

Conde M.B. ^{[4
]}

Guerra R.L. ^{[4
]}

Zaha A. ^{[1
]}

Rossetti M.L.R. ^{[2
,5
]}

机构：

[1] Programa de Pás Graduação em Biologia Celular e Molecular, Universidade Federal Do Rio Grande Do sul, 91501-970 - Porto Alegre, Av. Bento Gonçalves

[2] Centro de Desenvolvimento Científico e Tecnolágico, Fundação Estadual de Produção e Pesquisa em Saúde, 90610-000, Porto Alegre, Av. Ipiranga

[3] Laboratário de Pesquisa em HIV1AIDS, Centro de Ciências da Saúde, Universidade de Caxias Do sul, 95070-560, Caxias do Sul, Rua Francisco Getúlio Vargas, 1130, Bloco S

[4] Instituto de Doenças Do Tárax, Universidade Federal Do Rio de Janeiro, 21941-913, Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 255

[5] Universidade Luterana Do Brasil, 92425-900, Canoas, Av. Farroupilha

来源：

BMC Research Notes | / 4卷 / 1期

关键词：

Pleural Effusion; Pleural Fluid; Nucleic Acid Amplification; Conventional Polymerase Chain Reaction; Pleural Biopsy;

D O I：

10.1186/1756-0500-4-279

中图分类号：

学科分类号：

摘要：

Background: Pleural tuberculosis (TB) diagnosis often requires invasive procedures such as pleural biopsy. The aim of this study was to evaluate the role of real-time polymerase chain reaction (PCR) for the IS6110 sequence of M. tuberculosis in pleural fluid specimens as a rapid and non-invasive test for pleural TB diagnosis. Findings. For this cross-sectional study, 150 consecutive patients with pleural effusion diagnosed by chest radiography, who were referred for diagnostic thoracocentesis and pleural biopsy and met eligibility criteria, had a pleural fluid specimen submitted for real-time PCR testing. Overall, 98 patients had pleural TB and 52 had pleural effusion secondary to other disease. TB diagnosis was obtained using acid-fast bacilli (AFB) smear or culture for mycobacteria and/or histopathologic examination in 94 cases and by clinical findings in 4 cases. Sensitivity, specificity, positive and negative predictive values of PCR testing for pleural TB diagnosis were 42.8% (95% CI 38.4 - 44.8), 94.2% (95% CI 85.8 - 98.0), 93.3% (95% CI 83.6 - 97.7), and 48.5% (95% CI 44.2 - 50.4), respectively. The real-time PCR test improved TB detection from 30.6% to 42.9% when compared to AFB smear and culture methods performed on pleural fluid specimens, although the best sensitivity was achieved by combining the results of culture and histopathology of pleural tissue specimens. Conclusion: The real-time PCR test of pleural fluid specimens is a useful and non-invasive additional assay for fast diagnosis of pleural TB. © 2011 Rosso et al.; licensee BioMed Central Ltd.

引用

共 25 条

[1] Berger H.W., Mejia E., Tuberculous pleurisy, Chest, 63, pp. 88-92, (1973)
[2] Nance K.V., Shermer R.W., Askin F.B., Diagnostic efficacy of pleural biopsy as compared with that of pleural fluid examination, Mod Pathol, 4, pp. 320-324, (1991)
[3] Valdes L., Alvarez D., San Jose E., Penela P., Valle J.M., Garcia-Pazos J.M., Suarez J., Pose A., Tuberculous pleurisy: A study of 254 patients, Archives of Internal Medicine, 158, 18, pp. 2017-2021, (1998)
[4] Gopi A., Madhavan S.M., Sharma S.K., Sahn S.A., Diagnosis and treatment of tuberculous pleural effusion in 2006, Chest, 131, 3, pp. 880-889, (2007)
[5] Light R.W., Update on tuberculous pleural effusion, Respirology, 15, pp. 451-458, (2010)
[6] Diacon A.H., Van De Wal B.W., Wyser C., Smedema J.P., Bezuidenhout J., Bolliger C.T., Walzl G., Diagnostic tools in tuberculous pleurisy: A direct comparative study, European Respiratory Journal, 22, 4, pp. 589-591, (2003)
[7] Updated Guidelines for the Use of Nucleic Acid Amplification Tests in the Diagnosis of Tuberculosis, MMWR, 58, pp. 7-10, (2009)
[8] Pai M., Flores L.L., Hubbard A., Riley L.W., Colford Jr. J.M., Nucleic acid amplification tests in the diagnosis of tuberculous pleuritis: A systematic review and meta-analysis, BMC Infectious Diseases, 4, (2004)
[9] Espy M.J., Uhl J.R., Sloan L.M., Buckwalter S.P., Jones M.F., Vetter E.A., Yao J.D.C., Wengenack N.L., Rosenblatt J.E., Cockerill III F.R., Smith T.F., Real-time PCR in clinical microbiology: Applications for routine laboratory testing, Clinical Microbiology Reviews, 19, 1, pp. 165-256, (2006)
[10] Morisson P., Neves D.D., Evaluation of adenosine deaminase in the diagnosis of pleural tuberculosis: A Brazilian meta-analysis, J Bras Pneumol, 34, pp. 217-224, (2008)

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