Aliannejad Rasoul, Bahrmand Ahmadreza, Abtahi Hamidreza, Seifi Mahnaz, Safavi Enayat, Abdolrahimi Farid, Shahriaran Shahriyar
Thoracic Research Centre, Tehran University of Medical Sciences, Tehran, Iran; Department of Pulmonary, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Mycobacteriology, Pasteur Institute of Iran, Tehran, Iran.
Iran J Microbiol. 2016 Aug;8(4):238-242.
Tuberculosis (TB) is a major problem in the world. Treatment and control of TB needs detection of the (MT) in the proper samples. While smear doesn't have enough sensitivity, culture and PCR are expensive, time consuming and unavailable in many centers. Recent development of a rapid TB antigen detection test (PrTBK) at Pasteur Institute of Iran could give a simple way for diagnosis of TB in about two hours. In this test the antigen-antibody complex will change color when gold conjugated mouse anti-rabbit antibody detects specific MT cell wall antigen in suspected samples.
We evaluated the diagnostic accuracy of PrTBK for diagnosis of pulmonary TB in comparison with smear, culture and PCR techniques in 56 consecutive samples (47 BAL and 13 sputum samples) obtained from patients with clinical suspicion of active TB.
Twentynine patients (52%) were female and seven patients were HIV positive. PrTBK was positive in 17 culture positive and 4 culture negative samples (100% sensitivity, 89% specificity and 92% accuracy in comparison with culture method). In two out of four patients with negative culture who were positive for PrTBK, PCR and anti-tuberculosis drugs trial therapy responses were in favor of tuberculosis. If we take this finding into account, the accuracy of PrTBK will rise.
High sensitivity and accuracy of PrTBK test enable us to initiate treatment on the basis of this convenient and rapid test.
结核病是全球的一个主要问题。结核病的治疗与控制需要在合适的样本中检测结核分枝杆菌(MT)。虽然涂片检查灵敏度不足,培养和聚合酶链反应(PCR)成本高、耗时且在许多中心无法开展。伊朗巴斯德研究所近期研发的一种快速结核抗原检测试验(PrTBK)可为约两小时内诊断结核病提供一种简便方法。在该试验中,当金标鼠抗兔抗体检测到疑似样本中的特异性MT细胞壁抗原时,抗原 - 抗体复合物会变色。
我们在56份连续样本(47份支气管肺泡灌洗样本和13份痰液样本)中,将PrTBK与涂片、培养和PCR技术相比较,评估其对肺结核的诊断准确性,这些样本来自临床怀疑患有活动性结核病的患者。
29名患者(52%)为女性,7名患者HIV阳性。PrTBK在17份培养阳性样本和4份培养阴性样本中呈阳性(与培养方法相比,灵敏度为100%,特异性为89%,准确性为92%)。在4名培养阴性但PrTBK阳性的患者中,有2名患者的PCR及抗结核药物试验性治疗反应支持结核病诊断。如果考虑这一发现,PrTBK的准确性将会提高。
PrTBK试验的高灵敏度和准确性使我们能够基于这种便捷快速的检测开始治疗。