Assessment of the N-PCR Assay in Diagnosis of Pleural Tuberculosis Detection of M.tuberculosis in Pleural Fluid and Sputum Collected in Tandem 英文参考文献.docVIP
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Assessment of the N-PCR Assay in Diagnosis of Pleural Tuberculosis Detection of M.tuberculosis in Pleural Fluid and Sputum Collected in Tandem 英文参考文献
AssessmentoftheN-PCRAssayinDiagnosisofPleural
Tuberculosis:DetectionofM.tuberculosisinPleuralFluid
andSputumCollectedinTandem
ParameetKumar1,ManasK.Sen2,DevendraS.Chauhan3,VishwaM.Katoch4,SarmanSingh5,
HanumanthappaK.Prasad1*
1DepartmentofBiotechnology,AllIndiaInstituteofMedicalSciences,NewDelhi,India,2DepartmentofPulmonaryCriticalCareandSleepMedicine,VardhmanMahavir
Medical College (VMMC) and Safdarjung Hospital, New Delhi, India, 3National JALMA Institute of Leprosy and Other Mycobacterial Diseases, Tajganj, Agra, India,
4DepartmentofHealthResearch(MinistryofHealthFamilyWelfare)andIndianCouncilofMedialResearch,RamalingaswamiBhawan,AnsariNagar,NewDelhi,India,
5DivisionofClinicalMicrobiology,DepartmentofLaboratoryMedicine,AllIndiaInstituteofMedicalSciences,NewDelhi,India
Abstract
Background:Thenonspecificclinicalpresentationandpaucibacillarynatureoftuberculouspleuritisremainsachallengefor
diagnosis.Diagnosisoftuberculouspleuraleffusiondependsonthedemonstrationofthepresenceoftuberclebacilliinthe
sputum,pleuralfluid,orpleuralbiopsyspecimen,ordemonstrationofgranulomainpleurabyhistologicalexamination.We
examinedtheclinicalutilityofthediagnosisofpleuraltuberculosisusingtheinhouseN-PCRassay,AFBsmearmicroscopy
andculture.Besidespleuralfluidtheinclusionofsputumintheefficacyofdiagnosisofpleuraltuberculosiswasscrutinized.
Methodology/Principal Findings: Pleural fluid and sputum samples of 58 tuberculous and 42 non-tuberculous pleural
effusion patients were processed for AFB smear microscopy, culture and the N-PCR assay. Mycobacteria were detected
exclusivelyintuberculouspleuraleffusionsamples.Noneofthenon-tuberculouspleuraleffusionsampleswerepositivefor
mycobacteria. Comparative analysis showed that the N-PCR assay had thehighest sensitivity. Inclusion of sputum along
withpleuralfluidincreasedN-PCRsensitivityfrom51.7to70.6%(p,0.0001).ThisimprovedsensitivitywasreflectedinAFB
smearmicroscopyandisolationbyculture.Thesensitivityenhancedoninclusionofsputumfrom3.4(p=0.50)to10.3%
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