D'Alessandro Adriana, de Waard Jacobus H
Laboratorio de Tuberculosis, Instituto de Biomedicina, Caracas, Venezuela.
Rev Chilena Infectol. 2008 Feb;25(1):37-40. Epub 2008 Feb 8.
Two commercial serological tests, Pathozyme-TB complex plus and Pathozyme-Myco IgG, were evaluated for their sensitivity and specificity in HIV negative patients with serum samples from pulmonary tuberculosis (TB) patients and tuberculin positive, healthy controls. The sensitivity for the two tests was 50 and 80% respectively and the specificity 95 and 80%. With a prevalence of pulmonary TB of 10% in symptomatic patients who consult our laboratory, the positive predictive values (PPV) for the two ELISA tests were 92 and 80%, and the negative predictive values (NPV) 98 and 80% respectively. In the same patient group, the AFB smear has a PPV of 100% and a NPV of 97%. We conclude that AFB smear is a better mass screening tool than ELISA in symptomatic patients who consult our laboratory. The test could be useful as a complementary test in excluding or confirming TB in selected, smear negative, symptomatic patients with high degree of clinical suspicion of active TB.
对两种商业血清学检测方法,即Pathozyme - TB复合物加和Pathozyme - Myco IgG,在HIV阴性患者中进行评估,这些患者的血清样本来自肺结核(TB)患者以及结核菌素阳性的健康对照者。这两种检测方法的敏感性分别为50%和80%,特异性分别为95%和80%。在到我们实验室就诊的有症状患者中,肺结核患病率为10%,这两种酶联免疫吸附测定(ELISA)检测的阳性预测值(PPV)分别为92%和80%,阴性预测值(NPV)分别为98%和80%。在同一患者组中,抗酸杆菌(AFB)涂片的PPV为100%,NPV为97%。我们得出结论,在到我们实验室就诊的有症状患者中,AFB涂片作为大规模筛查工具比ELISA更好。该检测方法在排除或确诊部分涂片阴性、有高度临床活动性结核怀疑的有症状患者的结核病时,作为一项补充检测可能有用。