Araj G F, Talhouk R S, Itani L Y, Jaber W, Jamaleddine G W
Department of Pathology and Laboratory Medicine, American University of Beirut, Lebanon.
Int J Tuberc Lung Dis. 2000 Sep;4(9):877-81.
American University of Beirut Medical Center, Lebanon.
To assess the performance of a polymerase chain reaction (PCR) using primers that flank 542 bp within IS6110 in Mycobacterium tuberculosis (TB) vs. microscopy and BACTEC culture, in the diagnosis of tuberculosis.
A total of 82 clinical respiratory pulmonary specimens and 73 samples from BACTEC vials were tested by the three methods.
Of 24 smear-positive culture-positive (SP-CP) and 11 smear-negative culture-positive (SN-CP) TB specimens, PCR detected 83% and 64%, respectively. Among 17 specimens yielding mycobacteria other than tuberculosis (MOTT), the PCR was positive in 33% SP-CP and 14% SN-CP specimens. Among the 73 BACTEC vials, PCR was positive in 36 of 38 (95%) yielding culture-positive TB, and in one of 20 (5%) yielding culture positive MOTT. None of the 30 smear-negative culture-negative (SN-CN) clinical specimens and 15 of the CN vials were positive by PCR. The overall sensitivity of PCR was 77% and 95% for TB detection in respiratory specimens and BACTEC vials, respectively, and the specificity was 94% in both.
Because a substantial number of TB cases are missed, especially in SN-CP specimens, a PCR-based assay utilizing these primers cannot be used reliably, alone, in clinical laboratory diagnosis of mycobacterial respiratory infections.
黎巴嫩贝鲁特美国大学医疗中心。
评估使用结核分枝杆菌（TB）IS6110内542 bp侧翼引物的聚合酶链反应（PCR）与显微镜检查和BACTEC培养法在结核病诊断中的性能。
采用这三种方法对82份临床呼吸道肺部标本和73份来自BACTEC培养瓶的样本进行检测。
在24份涂片阳性培养阳性（SP-CP）和11份涂片阴性培养阳性（SN-CP）的结核标本中，PCR分别检测出83%和64%。在17份培养出非结核分枝杆菌（MOTT）的标本中，PCR在33%的SP-CP标本和14%的SN-CP标本中呈阳性。在73个BACTEC培养瓶中，PCR在38份培养阳性结核标本中的36份（95%）呈阳性，在20份培养阳性MOTT标本中的1份（5%）呈阳性。30份涂片阴性培养阴性（SN-CN）临床标本和15份培养瓶标本中，PCR均未呈阳性。PCR对呼吸道标本和BACTEC培养瓶中结核检测的总体敏感性分别为77%和95%，特异性均为94%。
由于大量结核病例被漏诊，尤其是在SN-CP标本中，仅使用这些引物的基于PCR的检测方法不能可靠地用于临床实验室对分枝杆菌呼吸道感染的诊断。
