Wang Jann-Yuan, Lee Li-Na, Hsu Hsiao-Leng, Hsueh Po-Ren, Luh Kwen-Tay
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
J Clin Microbiol. 2006 Mar;44(3):716-9. doi: 10.1128/JCM.44.3.716-719.2006.
The performance of the DR. MTBC PCR-based assay and the BD ProbeTec ET Mycobacterium tuberculosis Complex Direct Detection (DTB) assay for the direct detection of Mycobacterium tuberculosis was evaluated using 1,066 consecutive clinical respiratory samples collected from 494 patients who did not have old cases of pulmonary tuberculosis and were not receiving antituberculosis treatment at National Taiwan University Hospital from January to February 2005. The results of both assays were compared to the "gold standard" of combined culture results and clinical diagnosis. The overall sensitivity and specificity of the DR. MTBC Screen assay were 56.6% and 98.9%, respectively, and of the DTB assay were 63.2% and 98.4%, respectively. The positive and negative predictive values for the DR. MTBC Screen assay were 84.5% and 95.4%, respectively, and for the DTB assay were 81.7% and 96.0%, respectively. The DR. MTBC Screen assay produced 11 false-positive results for 11 patients, including three samples yielding non-M. tuberculosis mycobacteria (one each for M. abscessus, a mixture of M. abscessus and M. chelonae, and unidentified non-tuberculosis mycobacteria). The DTB assay produced 15 false-positive results for 13 patients, including five samples from four patients yielding non-tuberculosis mycobacteria (two for M. abscessus, one for a mixture of M. abscessus and M. chelonae, and two for unidentified non-tuberculosis mycobacteria). This study demonstrated that the DR. MTBC Screen assay has a similar diagnostic value but fewer false-positive results than the DTB assay for respiratory specimens.
采用2005年1月至2月间从台湾大学医院连续收集的1066份临床呼吸道样本,对494例既往无肺结核病史且未接受抗结核治疗的患者,评估基于PCR的DR. MTBC检测法和BD ProbeTec ET结核分枝杆菌复合群直接检测(DTB)法直接检测结核分枝杆菌的性能。将两种检测方法的结果与培养结果和临床诊断相结合的“金标准”进行比较。DR. MTBC筛查检测法的总体敏感性和特异性分别为56.6%和98.9%,DTB检测法的总体敏感性和特异性分别为63.2%和98.4%。DR. MTBC筛查检测法的阳性预测值和阴性预测值分别为84.5%和95.4%,DTB检测法的阳性预测值和阴性预测值分别为81.7%和96.0%。DR. MTBC筛查检测法对11例患者产生了11例假阳性结果,其中包括3份样本检出非结核分枝杆菌(脓肿分枝杆菌1份、脓肿分枝杆菌与龟分枝杆菌混合菌1份、未鉴定的非结核分枝杆菌1份)。DTB检测法对13例患者产生了15例假阳性结果,其中包括来自4例患者的5份样本检出非结核分枝杆菌(脓肿分枝杆菌2份、脓肿分枝杆菌与龟分枝杆菌混合菌1份、未鉴定的非结核分枝杆菌2份)。本研究表明,对于呼吸道标本,DR. MTBC筛查检测法与DTB检测法具有相似的诊断价值,但假阳性结果更少。