通过抗酸涂片比较诱导痰与咳出痰在肺结核诊断中的应用

Comparison of induced versus expectorated sputum for diagnosis of pulmonary tuberculosis by acid-fast smear.

作者信息

Merrick S T, Sepkowitz K A, Walsh J, Damson L, McKinley P, Jacobs J L

机构信息

Division of Infectious Disease, New York Hospital-Cornell Medical Center, NY 10021, USA.

出版信息

Am J Infect Control. 1997 Dec;25(6):463-6. doi: 10.1016/s0196-6553(97)90068-7.

DOI:10.1016/s0196-6553(97)90068-7

PMID:9437484

Abstract

OBJECTIVE

To evaluate the sensitivity of induced versus expectorated sputum for the diagnosis of pulmonary tuberculosis by acid-fast smear.

METHODS

We performed a retrospective review of data on patients with cultures from respiratory secretions that were positive for Mycobacterium tuberculosis. We analyzed data on the 114 patients with positive cultures during a 4-year period in an urban tertiary care academic medical center.

RESULTS

Sputum samples had been obtained for 103 of the 114 patients with cultures positive for tuberculosis. Forty-four of the 114 patients were HIV seropositive. Overall 33 of 79 patients (42%) had positive acid-fast smears of expectorated sputum, and 6 of 24 (25%) had positive smears of induced sputum (p = 0.21). When data were analyzed for subgroups by HIV serostatus, there was no significant difference in the results. Estimated cost of sputum induction for 1 year was approximately $45,000.

CONCLUSIONS

We found sputum induction to be costly, and induced sputum offered no advantage over routine expectorated sputum for the diagnosis of pulmonary tuberculosis.

摘要

目的

通过抗酸染色涂片评估诱导痰与咳痰对肺结核诊断的敏感性。

方法

我们对呼吸道分泌物培养出结核分枝杆菌呈阳性的患者数据进行了回顾性分析。我们分析了一家城市三级医疗学术中心4年间114例培养结果呈阳性患者的数据。

结果

114例培养出结核呈阳性的患者中，103例获取了痰液样本。114例患者中有44例HIV血清学检测呈阳性。总体而言，79例咳痰患者中有33例（42%）抗酸染色涂片呈阳性，24例诱导痰患者中有6例（25%）涂片呈阳性（p = 0.21）。按HIV血清学状态对亚组数据进行分析时，结果无显著差异。诱导痰1年的估计成本约为45,000美元。