Rajalahti I, Vuorinen P, Nieminen M M, Miettinen A
Department of Pulmonary Diseases, Tampere University Hospital, Finland.
J Clin Microbiol. 1998 Apr;36(4):975-8. doi: 10.1128/JCM.36.4.975-978.1998.
Three hundred twenty-four sputum specimens from 151 patients with suspected active pulmonary tuberculosis were tested for the presence of the Mycobacterium tuberculosis complex with auramine fluorochrome stain and automated PCR assay (Roche Cobas Amplicor Mycobacterium Tuberculosis Test [MTB]). The results were compared with those of the conventional Löwenstein-Jensen tube culture and the BACTEC radiometer liquid culture. A total of 76 specimens from 32 patients were culture positive for M. tuberculosis. In addition, 37 specimens from 15 patients were smear and culture positive for other Mycobacterium species but negative by the present nucleic acid amplification method and thus were not included in the comparison. Compared with culture, the sensitivities, specificities, and positive and negative predictive values for acid-fast smear were 67, 98, 93, and 91% and those for the Cobas Amplicor MTB were 83, 99, 97, and 95%, respectively. When three consecutive sputum specimens per patient could be obtained, the sensitivity of the Cobas Amplicor MTB improved to 91%, whereas the sensitivity of the acid-fast smear remained unchanged.
对151例疑似活动性肺结核患者的324份痰标本进行检测，采用金胺荧光染色和自动聚合酶链反应检测法（罗氏Cobas Amplicor结核分枝杆菌检测[MTB]）检测结核分枝杆菌复合群的存在情况。将结果与传统的罗氏培养基培养法和BACTEC放射性测量仪液体培养法的结果进行比较。共有32例患者的76份标本培养出结核分枝杆菌呈阳性。此外，15例患者的37份标本涂片和培养出其他分枝杆菌呈阳性，但采用目前的核酸扩增方法检测为阴性，因此未纳入比较。与培养法相比，抗酸涂片的敏感性、特异性、阳性预测值和阴性预测值分别为67%、98%、93%和91%，Cobas Amplicor MTB的相应值分别为83%、99%、97%和95%。当每位患者能够获得连续三份痰标本时，Cobas Amplicor MTB的敏感性提高到91%，而抗酸涂片的敏感性保持不变。
