Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University Bundang Hospital, Seoul, Korea.
Int J Tuberc Lung Dis. 2010 Jul;14(7):852-8.
The real-time polymerase chain reaction (RT-PCR) has increasingly been used for the detection of various micro-organisms, including mycobacteria.
To determine the role of RT-PCR in confirming the diagnosis of tuberculosis (TB) when acid-fast bacilli (AFB) smear results in sputum samples were not available (i.e., no sputum or negative smear results).
We analysed the data of consecutive patients whose bronchial aspirate (BA) was tested for RT-PCR for the diagnosis of TB from January 2006 to April 2008. Computed tomography (CT), bronchoscopy and tissue biopsies were performed in all patients for confirmatory diagnosis, and BA was collected for microbiological analyses and RT-PCR. Final diagnoses were based on microbiological or clinicopathological criteria.
Final diagnoses were made in 136 patients, and TB was confirmed in 77 (including 65 culture-positive patients). RT-PCR was positive in 51.9% (40/77) of the confirmed TB patients. More TB patients (20.8%) were detected using RT-PCR than using BA-AFB stain (40 vs. 20, P < 0.001). Of the 77 TB patients, 44 (57.1%) were detected within a few days using a combination of BA-AFB and RT-PCR.
Real-time RT-PCR of bronchial aspirate seems to be useful for the rapid diagnosis of TB in suspects with smear-negative TB sputum or no sputum.
实时聚合酶链反应（RT-PCR）已越来越多地用于检测各种微生物，包括分枝杆菌。
当痰标本中无法获得抗酸杆菌（AFB）涂片结果（即无痰或阴性涂片结果）时，确定 RT-PCR 在确认结核病（TB）诊断中的作用。
我们分析了 2006 年 1 月至 2008 年 4 月连续接受支气管抽吸物（BA）RT-PCR 检测以诊断 TB 的患者的数据。所有患者均进行 CT、支气管镜检查和组织活检以进行确诊，并采集 BA 进行微生物分析和 RT-PCR。最终诊断基于微生物学或临床病理标准。
136 例患者最终确诊，77 例（包括 65 例培养阳性患者）被确诊为 TB。在确诊的 TB 患者中，RT-PCR 阳性率为 51.9%（40/77）。使用 RT-PCR 检测到的 TB 患者（20.8%）多于 BA-AFB 染色（40 比 20，P<0.001）。在 77 例 TB 患者中，44 例（57.1%）在几天内通过 BA-AFB 和 RT-PCR 联合检测出来。
支气管抽吸物实时 RT-PCR 似乎可用于快速诊断痰涂片阴性或无痰的疑似 TB 患者的 TB。
