Institute of Medicine, Chung Shan Medical University, No.110 Sec.1 Jianguo N. Rd.,Taichung, Taiwan.
Braz J Infect Dis. 2012 May-Jun;16(3):242-9.
The diagnostic efficacy of the BDProbeTEC ET Mycobacterium tuberculosis (MTB) complex direct detection assay (DTB) performed on bronchoalveolar lavage (BAL) specimens and sputum smears was compared with acid-fast bacilli (AFB) smear microscopy.
AFB smear microscopy, DTB and culture results of 286 patients with pulmonary tuberculosis were retrospectively reviewed. A total of 120 patients provided expectorated sputum samples, and 166 patients provided BAL specimens. Culture results and clinical diagnosis were used as gold standards.
The sensitivity and specificity of the DTB assay in detecting MTB in sputum specimens was significantly higher compared to AFB smear microscopy (83.7% and 82.4%, vs. 75.6%, and 41.2%, respectively). The sensitivity and specificity of the DTB assay in detecting MTB in sputum samples was 77.2% and 100% compared to clinical diagnosis, while AFB smear had a sensitivity and specificity of 70.3% and 26.3%, respectively. Compared to culture, DTB had a sensitivity and specificity of 82.8% and 93.2%, respectively, in detecting MTB from BAL specimens; AFB smear had a sensitivity and specificity of 41.9% and 87.7%, respectively. Compared to clinical diagnosis, DTB had a sensitivity and specificity of 67.2% and 100%, respectively, in detecting MTB from BAL specimens; AFB smear had a sensitivity and specificity of 34.8% and 79.5%, respectively.
The superior performance of the DTB assay relative to AFB smear microscopy makes it a valuable tool to enable early diagnosis of MTB, thereby improving patient care and reducing transmission.
比较支气管肺泡灌洗液（BAL）标本和痰涂片上 BDProbeTEC ET 分枝杆菌（MTB）复合直接检测（DTB）与抗酸杆菌（AFB）涂片显微镜检查的诊断效果。
回顾性分析 286 例肺结核患者的 AFB 涂片显微镜检查、DTB 和培养结果。共 120 例患者提供了咳痰样本，166 例患者提供了 BAL 标本。培养结果和临床诊断作为金标准。
DTB 检测痰标本中 MTB 的敏感性和特异性明显高于 AFB 涂片显微镜检查（分别为 83.7%和 82.4%，75.6%和 41.2%）。DTB 检测痰标本中 MTB 的敏感性和特异性与临床诊断相比分别为 77.2%和 100%，而 AFB 涂片的敏感性和特异性分别为 70.3%和 26.3%。与培养相比，DTB 检测 BAL 标本中 MTB 的敏感性和特异性分别为 82.8%和 93.2%；AFB 涂片分别为 41.9%和 87.7%。与临床诊断相比，DTB 检测 BAL 标本中 MTB 的敏感性和特异性分别为 67.2%和 100%；AFB 涂片分别为 34.8%和 79.5%。
DTB 检测相对于 AFB 涂片显微镜检查具有更好的性能，使其成为一种有价值的工具，可实现 MTB 的早期诊断，从而改善患者护理并减少传播。
