Phillips R O, Sarfo F S, Osei-Sarpong F, Boateng A, Tetteh I, Lartey A, Adentwe E, Opare W, Asiedu K B, Wansbrough-Jones M
Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
J Clin Microbiol. 2009 Apr;47(4):924-6. doi: 10.1128/JCM.01842-08. Epub 2009 Feb 9.
In a previous study, we reported that the sensitivity of PCR targeting the IS2404 insertion sequence of Mycobacterium ulcerans was 98% when it was applied to 4-mm punch biopsy samples of Buruli lesions. Fine-needle aspiration (FNA) is a less traumatic sampling technique for nonulcerated lesions, and we have studied the sensitivity of PCR using FNA samples. Fine-needle aspirates were taken with a 21-gauge needle from 43 patients diagnosed clinically with M. ulcerans disease. Four-millimeter punch biopsies were obtained for microscopy, culture, and PCR targeting the IS2404 insertion sequence. The sensitivity of PCR using samples obtained by FNA was 86% (95% confidence interval [95% CI], 72 to 94%) compared with that for PCR using punch biopsy samples. In this study, the sensitivities of culture and microscopy for punch biopsy samples were 44% (95% CI, 29 to 60%) and 26% (95% CI, 14 to 41%), respectively. This demonstrates that PCR on an FNA sample is a viable minimally invasive technique to diagnose M. ulcerans lesions.
在之前的一项研究中，我们报告称，将针对溃疡分枝杆菌IS2404插入序列的聚合酶链反应（PCR）应用于布氏溃疡病变的4毫米钻孔活检样本时，其敏感性为98%。细针穿刺抽吸术（FNA）对于未溃疡病变来说是一种创伤较小的采样技术，并且我们已经研究了使用FNA样本进行PCR的敏感性。用21号针从43例临床诊断为溃疡分枝杆菌病的患者身上获取细针抽吸物。获取4毫米的钻孔活检样本用于显微镜检查、培养以及针对IS2404插入序列的PCR。与使用钻孔活检样本进行PCR相比，使用FNA获取的样本进行PCR的敏感性为86%（95%置信区间[95%CI]，72%至94%）。在本研究中，钻孔活检样本的培养和显微镜检查敏感性分别为44%（95%CI，29%至60%）和26%（95%CI，14%至41%）。这表明对FNA样本进行PCR是诊断溃疡分枝杆菌病变的一种可行的微创技术。
