García-Elorriaga G, Gracida-Osorno C, Carrillo-Montes G, González-Bonilla C

Language: English
References: 47
Page: 240-245
PDF size: 129.63 Kb.

ABSTRACT

Objective. To evaluate the effectiveness of nested polymerase chain reaction (PCR) for diagnosis of extrapulmonary tuberculosis (ETB), as well as the impact of PCR results on clinical management. Materials and Methods. We conducted a study of nested PCR tests in 45 patients and a review of patient hospital files, calculating sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results. PCR was positive in 51% of cases; PCR sensitivity for diagnosing TB was 86%, specificity was 79%, PPV was 76%, and NPV was 88%. When solely analyzing urine samples, sensitivity and NPV increased to 100%. PCR exerted an influence on management in 27% of patients. Conclusions. PCR for rapid diagnosis of extrapulmonary TB has an adequate effect, which improves when performed on urine. The results of PCR exerted an acceptable impact on the clinical management of these patients.

REFERENCES

1. Murray PR, Rosenthal KS, Kobayashi GS. Medical Microbiology. 5th ed. Philadelphia (PA): Elsevier- Mosby, 2005.

2. Middlebrook G, Riggiardo Z, Tiggertt W. Automatable radiometric detection of growth of M. tuberculosis in selective media. Am Rev Resp Dis 1977;115:1066.

3. Anargyros P, Astill DS, Lim IS. Comparison of improved BACTEC and L-J media for culture of Mycobacteria from clinical specimens. J Clin Microbiol 1990;28:1288-1291.

4. Kaneko K, Onodera O, Miyatake T, Tsuji S. Rapid diagnosis of tuberculous meningitis by polymerase chain reaction (PCR). Neurology 1990;40:1617-1618.

5. Bhigjee AI, Padayachee R, Paruk H, Hallwirth-Pillay KD, Marais S, Connoly C. Diagnosis of tuberculous meningitis: clinical and laboratory parameters. Int J Infect Dis 2007;11:348-354.

6. Desaid D, Nataraj G, Kulkarni S, Bichile L, Mehta P, Baveja S, et al. Utility of the polymerase chain reaction in the diagnosis of tuberculous meningitis. Res Microbiol 2006;157(10):967-970.

7. Gopi A, Madhavan SM, Sharma SK, Sahn SA. Diagnosis and treatment of tuberculous pleural effusion in 2006. Chest 2007;131:880.

8. Caws M, Wilson SM, Clough C, Drobniewski F. Role of IS6110-targeted PCR, culture, biochemical, clinical, and immunological criteria for diagnosis of tuberculous meningitis. J Clin Microbiol 2000;38:3150-3155.

9. Juan RS, Sánchez-Suárez C, Rebollo MJ, Folgueira D, Palenque E, Ortuño B, et al. Interferon gamma quantification in cerebrospinal fluid compared with PCR for the diagnosis of tuberculous meningitis. J Neurol 2006;253(10):1323-1330.

10. Neggi SS, Anand R, Pasha ST, Gupta S, Basir SF, Khare S, et al. Diagnostic potential of IS6110, 38kDa, 65kDa and 85B sequence-based polymerase chain reaction in the diagnosis of Mycobacterium tuberculosis in clinical samples. Indian J Med Microbiol 2007;25:43.

11. Rafi W, Venkataswamy MM, Ravi V, Chandramuki A. Rapid diagnosis of tuberculous meningitis: A comparative evaluation of in-house PCR assays involving three mycobacterial DNA sequences, IS6110, MPB-64 and 65 kDa antigen. J Neurol Sci 2007;252:163-168.

12. Rafi W, Venkataswamy MM, Nagarathna S, Satischandra P, Chandramuki A. Role of IS6110 uniplex PCR in the diagnosis of tuberculous meningitis: experience at a tertiary neurocentre. Int J Tuberc Lung Dis 2007;11:209-214.

13. Chakravorty S, Sen MK, Tyagy JS. Diagnosis of extrapulmonary tuberculosis by smear, culture, and PCR using universal sample processing technology. J Clin Microbiol 2005;43:4357-4362.

14. Stephen P, Sharon L, Catanzaro A. Clinical efficacy of amplified M. tuberculosis direct test for the diagnosis of pulmonary tuberculosis. Am J Respir Crit Care Med 1996;153:1606-1610.

15. Barnes P. Rapid diagnostic test of tuberculosis: progress but no gold standard. Am J Respir Crit Care Med 1997;155:1497-1498.

16. American Thoracic Society. Diagnostic standards and classification of tuberculosis in adults and children. Am J Respir Crit Care Med 2000;161:1376-1395.

17. Centers for Disease Control and Prevention: Reported Tuberculosis in the United States. 1997. Atlanta (GA): Centers for Disease Control and Prevention, 1998.

18. Ozkutuk A, Kirdar S, Ozden S, Esen N. Evaluation of Cobas Amplicor MTB test to detect Mycobacterium tuberculosis in pulmonary and extrapulmonary specimens. New Microbiol 2006;29:269-273.

19. Delgado-Morales M, Chávez-Macías LG, Olvera-Rabiela JE, López-Luna J, Carrera-González E, Manrique-Ortega J. Algunos datos de la neurotuberculosis obtenidos de la revisión de 13 689 autopsias. Patologia 1992;30:139-143.

20. Donald PR, Schaaf HS, Schoeman JF. Tuberculous meningitis and miliary tuberculosis: the Rich focus revisited. J Infect 2005:50:193-195.

21. Seth P, Ahuja GK, Bhanu NV, Behari M, Bhowmik S, Broor S, et al. Evaluation of polymerase chain reaction for rapid diagnosis of clinically suspected tuberculous meningitis. Tuber Lung Dis 1996;77: 353-357.

22. Norma Oficial Mexicana. NOM-006-SSA2-1993. Para la prevención y control de la tuberculosis en la atención primaria a la salud. Mexico: Secretary of Health, 1993.

23. Chomczynski P. A reagent for the single-step simultaneous isolation of RNA, DNA and proteins from cell and tissue samples. Biotechniques 1993; 15:532-537.

24. Borremans, M, de Wit L, Volckaert G, Ooms J, de Bruyn J, Huygen K, van Vooren JP, Stelandre M, Verhofstadt R, Content J, et al. Cloning, sequence determination, and expression of a 32-kilodalton-protein gene of Mycobacterium tuberculosis. Infect Immun 1989;57:3123-3130.

25. Parra CA, Londoño LP, Del Portillo P, Patarroyo ME. Isolation, characterization, and molecular cloning of a specific Mycobacterium tuberculosis antigen gene: identification of a species-specific sequence. Infect Immun 1991;59:3411-3417.

26. Thierry D, Brisson-Noel A, Vincent-Levy-Frebault V, Nguyen S, Guesdon JL, Gicquel B. Characterization of a Mycobacterium tuberculosis insertion sequence, IS6110, and its application in diagnosis. J Clin Microbiol 1990;28:2668-2673.

27. Del Portillo P, Murillo LA, Patarroyo ME. Amplification of a species-specific DNA fragment of Mycobacterium tuberculosis and its possible use in diagnosis. J Clin Microbiol 1991;29:2163-2168.

28. Kitaura H, Ohara N, Matsuo T, Tasaka H, Kobayashi K, Yamada T. Cloning, sequencing and expression of the gene for alpha antigen from Mycobacterium intracellulare and use of PCR for the rapid identification of Mycobacterium intracellulare. Biochem Biophys Res Commun 1993;196:1466-1473.

29. Matsuo K, Yamaguchi R, Yamazaki A, Tasaka H, Terasaka K, Yamada T. Cloning and expression of the gene for the cross-reactive alpha antigen of Mycobacterium kansasii. Infect Immun 1990;58:550-556.

30. Matsuo K, Yamaguchi R, Yamazaki A, Tasaka H, Yamada T. Cloning and expression of the Mycobacterium bovis BCG gene for extracellular alpha antigen. J Bacteriol 1988;170:3847-3854.

31. Ohara N, Matsuo K, Yamaguchi R, Yamazaki A, Tasaka H, Yamada T. Cloning and sequencing of the gene for alpha antigen from Mycobacterium avium and mapping of B-cell epitopes. Infect Immun 1993;61:1173-1179.

32. Gori A, Franzetti F, Marchetti G, Catozzi L, Corbellino M. Specific detection of Mycobacterium tuberculosis by mtp40 nested PCR. J Clin Microbiol 1996;34:2866-2867.

33. Galen RS, Gambino RS. Beyond normality: the predictive value and efficiency of medical diagnosis. New York (NY): John Wiley and Sons, 1975.

34. Sharma SK, Mohan A. Extrapulmonary tuberculosis. Indian J Med Res 2004;120:316-353.

35. Folgueira L, Delgado R, Palenque E, Noriega AR. Polymerase chain reaction for rapid diagnosis of tuberculous meningitis in AIDS patients. Neurology 1994;44:1336-1338.

36. Nguyen LN, Kox LF, Pham LD, Kuijper S, Kolk AH. The potential contribution of the polymerase chain reaction to the diagnosis of tuberculous meningitis. Arch Neurol 1996;53:771-776.

37. Kolk AH, Kox LF, van Leeuwen J, Kuijper S, Hansen HM. Clinical utility of the polymerase chain reaction in the diagnosis of extrapulmonary tuberculosis. Eur Resp J 1998;11(6):1222-1226.

38. Conaty SJ, Claxton AP, Enoch DA, Hayward AC, Lipman MC, Gillespie SH. The interpretation of nucleic acid amplification tests for tuberculosis: do rapid tests change treatment decisions? J Infect 2005;50:187-192.

39. Hemal AK, Gupta NP, Rajeev TP, Kumar R, Dar L, Seth P. Polymerase chain reaction in clinically suspected genitourinary tuberculosis: comparison with intravenous urography, bladder biopsy, and urine acid fast bacilli. Urology 2000;56:570-574.

40. Torrea G, van de Perre P, Ouedraogo M, Zouqba A, Sawadogo A, Dinqtoumda B, et al. PCR-based detection of the M. tuberculosis complex in urine of HIV-infected and uninfected pulmonary and extrapulmonary tuberculosis patients in Burkina Faso. J Med Microbiol 2005;54(Pt 1):39-44.

41. Nakajima H, Hatamura T, Ikemoto T, Ueda K, Nakagawa T, Shimizu A. Evaluation of the polymerase chain reaction for diagnosis of tuberculous meningitis. Rinsho Byori 1995;43:843-846.

42. Takahashi T, Nakayama T, Tamura M, Ogawa K, Tsuda H, Morita A. Nested polymerase chain reaction for assessing the clinical course of tuberculous meningitis. Neurology 2005;64:1789-1793.

43. Portillo-Gómez L, Morris SL, Panduro A. Rapid and efficient detection of extra-pulmonary M. tuberculosis by PCR analysis. Int J Tuberc Lung Dis 2000;4:361-370.

44. Moguel-Morán MC, Hernández DA, Peña Montes de Oca PM, Gallegos-Arreola MP, Flores-Martínez SE. Detection of M. tuberculosis by polymerase chain reaction in a selected population in northwestern Mexico. Rev Panam Salud Publica 2000;7:389-394.

45. Kato-Maeda M, Bobadilla-del Valle M, Martínez-Gamboa A, Hernández-Cruz A, Ramírez-Mora I, Cerón-Enríquez N, et al. Eficacia e impacto de la prueba de la reacción en cadena de la polimerasa en el diagnóstico de tuberculosis extrapulmonar. Rev Invest Clin 2002;54:509-514.

46. Wise GJ, Shteynshiyuger A. An update on lower urinary tract tuberculosis. Curr Urol Rep 2008;9:305-313.

47. Rahman ML, Basher A, Rashid M, Islam M, Kuddus R, Arif SM, et al. Central nervous system tuberculosis and adjuvant corticosteroid therapy. Mymensingh Med J 2009;18:47-51.