Real-time PCR assay for the diagnosis of pleural tuberculosis

Colombia Medica (Online)

Martha Alejandra Casallas-Rivera¹  Ana María Cardenas Bernal¹  Enrique Prieto Diago²  Paola Santander²  Luis Fernando Giraldo-Cadavid³ 

[1] 1 Universidad de la Sabana. Chía, Colombia2 Internal Medicine, Hospital Universitario de la Samaritana. Bogotá, Colombia;Hospital Universitario de la Samaritana. Bogotá, Colombia;Universidad de la Sabana. Chía, Colombia

关键词: Diagnostic Tests;    pleural effusion;    Mycobacterium tuberculosis;    tuberculosis pleural;    validation studies;    Real-Time Polymerase Chain Reaction;    Ziehl-Neelsen;    likelihood ratios;   

DOI  :  

学科分类：医学（综合）

来源: Universidad del Valle * Facultad de Salud / Universidad del Valle, Faculty of Health

【 摘 要 】

Introduction :  The diagnosis of pleural tuberculosis requires an invasive and time-consuming reference method. Polymerase chain reaction (PCR) is rapid, but validation in pleural tuberculosis is still weak. Objective :  To establish the operating characteristics of real-time polymerase chain reaction (RT-PCR) hybridization probes for the diagnosis of pleural tuberculosis. Method : The validity of the RT-PCR hybridization probes was evaluated compared to a composite reference method by a cross-sectional study at the Hospital Universitario de la Samaritana. 40 adults with lymphocytic pleural effusion were included. Pleural tuberculosis was confirmed (in 9 patients) if the patient had at least one of three tests using the positive referencemethod : Ziehl-Neelsen or Mycobacterium tuberculosis culture in fluid or pleural tissue, or pleural biopsy with granulomas. Pleural tuberculosis was ruled out (in 31 patients) if all three tests were negative. The operating characteristics of the RT-PCR, using the Mid-P Exact Test, were determined using the OpenEpi 2.3 Software (2009).Results:  The RT-PCR hybridization probes showed a sensitivity of 66.7% (95% CI: 33.2%-90.7%) and a specificity of 93.5% (95% CI: 80.3%-98.9%). The PPV was 75.0% (95% CI: 38.8%-95.6%) and a NPV of 90.6% (95% CI: 76.6%-97.6%). Two false positives were found for the test, one with pleural mesothelioma and the other with chronic pleuritis with mesothelial hyperplasia. Conclusions : The RT-PCR hybridization probes had good specificity and acceptable sensitivity, but a negative value cannot rule out pleural tuberculosis.

【 授权许可】

CC BY