Performance of a Highly Sensitive Mycobacterium tuberculosis Complex Real-Time PCR Assay for Diagnosis of Pulmonary Tuberculosis in a Low-Prevalence Setting: a Prospective Intervention Study
Por:
Vinuesa, V, Borras, R, Briones, M, Clari, M, Cresencio, V, Gimenez, E, Munoz, C, Oltra, R, Servera, E, Scheelje, T, Tornero, C and Navarro, D
Publicada:
1 may 2018
Categoría:
Microbiology (medical)
Resumen:
The potential impact of routine real-time PCR testing of respiratory specimens from patients with presumptive tuberculosis in terms of diagnostic accuracy and time to tuberculosis treatment inception in low-prevalence settings remains largely unexplored. We conducted a prospective intervention cohort study. Respiratory specimens from 1,020 patients were examined by acid-fast bacillus smear microscopy, tested by a real-time Mycobacterium tuberculosis complex PCR assay (Abbott RealTime MTB PCR), and cultured in mycobacterial media. Seventeen patients tested positive by PCR (5 were acid-fast bacillus smear positive and 12 acid-fast bacillus smear negative), and Mycobacterium tuberculosis was recovered from cultures for 12 of them. Patients testing positive by PCR and negative by culture (n = 5) were treated and deemed to have responded to antituberculosis therapy. There were no PCR-negative/culture-positive cases, and none of the patients testing positive for nontuberculous mycobacteria (n = 20) yielded a positive PCR result. The data indicated that routine testing of respiratory specimens from patients with presumptive tuberculosis by the RealTime MTB PCR assay improves the tuberculosis diagnostic yield and may reduce the time to antituberculosis treatment initiation. On the basis of our data, we propose a novel mycobacterial laboratory algorithm for tuberculosis diagnosis.
Filiaciones:
Vinuesa, V:
Hosp Clin Univ, Inst Invest INCLIVA, Microbiol Serv, Valencia, Spain
Borras, R:
Hosp Clin Univ, Inst Invest INCLIVA, Microbiol Serv, Valencia, Spain
Univ Valencia, Sch Med, Dept Microbiol, Valencia, Spain
Briones, M:
Hosp Clin Univ, Inst Invest INCLIVA, Resp Med Dept, Valencia, Spain
Clari, M:
Hosp San Francisco de Borja, Microbiol Unit, Gandia, Spain
:
Hosp Francisco de Borja, Pneumol Unit, Gandia, Spain
Gimenez, E:
Hosp Clin Univ, Inst Invest INCLIVA, Microbiol Serv, Valencia, Spain
Munoz, C:
Hosp Clin Univ, Inst Invest INCLIVA, Resp Med Dept, Valencia, Spain
Oltra, R:
Hosp Clin Univ, Inst Invest INCLIVA, Infect Dis Unit, Valencia, Spain
Servera, E:
Hosp Clin Univ, Inst Invest INCLIVA, Resp Med Dept, Valencia, Spain
Scheelje, T:
Hosp Clin Univ, Inst Invest INCLIVA, Resp Med Dept, Valencia, Spain
:
Hosp San Francisco de Borja, Internal Med Serv, Gandia, Spain
Navarro, D:
Hosp Clin Univ, Inst Invest INCLIVA, Microbiol Serv, Valencia, Spain
Univ Valencia, Sch Med, Dept Microbiol, Valencia, Spain
Bronze, Green Published
|