Ozkutuk Aydan, Terek Gulfem, Coban Huseyin, Esen Nuran
Department of Microbiology and Clinical Microbiology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
Jpn J Infect Dis. 2007 May;60(2-3):73-5.
The simplest, cheapest, and fastest diagnostic method for tuberculosis (TB) is the detection of acid-fast bacilli (AFB) by microscopy. The algorithm advised for the diagnosis of TB recommends examination of three consecutive sputum specimens from TB suspects for the presence of AFB. In the present study, we evaluated the contribution of each specimen to the final detection of TB suspect patients with culture-proven disease. The collection and analysis of retrospective data on patients with culture-proven pulmonary TB, from June 2002 to August 2006 at Dokuz Eylul University Hospital, Turkey, have enabled us to assess the value of examining two sputum specimens in diagnosing this disease. AFB were detected from one or more sputum specimens with direct microscopy in 42% of the cases. An analysis of results of smear examination showed that 97% of AFB were detected from the first specimen and only 3% were obtained from the second smear. The third specimen did not have any additional diagnostic value for the detection of AFB by microscopy. As a conclusion the present study shows that examining two sputum smears is sufficient for the early detection of AFB in our laboratory.
结核病（TB）最简单、最便宜且最快的诊断方法是通过显微镜检测抗酸杆菌（AFB）。推荐的结核病诊断算法建议对结核病疑似患者的三份连续痰标本进行检查，以确定是否存在抗酸杆菌。在本研究中，我们评估了每份标本对最终确诊为培养确诊疾病的结核病疑似患者的贡献。对2002年6月至2006年8月在土耳其多库兹艾吕尔大学医院确诊为肺结核患者的回顾性数据进行收集和分析，使我们能够评估检查两份痰标本对诊断该疾病的价值。42%的病例通过直接显微镜检查在一份或多份痰标本中检测到抗酸杆菌。涂片检查结果分析表明，97%的抗酸杆菌是从第一份标本中检测到的，只有3%是从第二份涂片中获得的。第三份标本对通过显微镜检测抗酸杆菌没有任何额外的诊断价值。因此，本研究表明，在我们实验室检查两份痰涂片足以早期检测抗酸杆菌。
