Burman W J, Reves R R
Department of Public Health, Denver Health and Hospital Authority, CO, USA.
Clin Infect Dis. 2000 Dec;31(6):1390-5. doi: 10.1086/317504. Epub 2000 Nov 17.
We reviewed reports of false-positive cultures for Mycobacterium tuberculosis and here propose guidelines for detecting and managing patients with possible false-positive cultures. Mechanisms of false-positive cultures included contamination of clinical devices, clerical errors, and laboratory cross-contamination. False-positive cultures were identified in 13 (93%) of the 14 studies that evaluated > or = 100 patients; the median false-positive rate was 3.1% (interquartile range, 2.2%-10.5%). Of the 236 patients with false-positive cultures reported in sufficient detail, 158 (67%) were treated, some of whom had toxicity from therapy, as well as unnecessary hospitalizations, tests, and contact investigations. Having a single positive culture was a sensitive but nonspecific criterion for detecting false-positive cultures. False-positive cultures for M. tuberculosis are not rare but are infrequently recognized by laboratory and clinical personnel. Laboratories and tuberculosis control programs should develop procedures to identify patients having only 1 positive culture. Such patients should be further evaluated for the possibility of a false-positive culture.
我们回顾了结核分枝杆菌培养假阳性的报告，并在此提出检测和管理可能存在培养假阳性患者的指南。培养假阳性的机制包括临床设备污染、文书错误和实验室交叉污染。在评估≥100例患者的14项研究中，有13项（93%）发现了培养假阳性；假阳性率中位数为3.1%（四分位间距为2.2%-10.5%）。在报告细节充分的236例培养假阳性患者中，158例（67%）接受了治疗，其中一些患者出现了治疗毒性反应，以及不必要的住院、检查和接触者调查。仅有一次培养阳性是检测培养假阳性的一个敏感但非特异性的标准。结核分枝杆菌培养假阳性并不罕见，但实验室和临床人员很少识别出来。实验室和结核病控制项目应制定程序来识别仅有一次培养阳性的患者。此类患者应进一步评估培养假阳性的可能性。
