Improved diagnostic power by combined interferon-gamma release assay and nested-PCR in tuberculous pleurisy in high tuberculosis prevalence area

Abstract The conventional acid fast bacilli (AFB) smear and Mycobacterium tuberculosis (M.tb) culture of pleural effusion and tuberculin skin test (TST) in tuberculous pleurisy are unable to meet clinical needs because of their low sensitivities and specificities. To evaluate the diagnostic accuraci...

Full description

Saved in:

Bibliographic Details
Published in:	FEMS immunology and medical microbiology 2012-12, Vol.66 (3), p.393-398
Main Authors:	Gao, Yan, Ou, Qinfang, Huang, Fuli, Wang, Sen, Shen, Lei, Shen, Yaojie, Wu, Jing, Zheng, Jian, Weng, Xinhua, Zhang, Wenhong, Shao, Lingyun
Format:	Article
Language:	eng
Subjects:	Adolescent Adult Aged Aged, 80 and over Bacilli Bacterial diseases Biological and medical sciences Child China - epidemiology Clinical Laboratory Techniques - methods Cross-Sectional Studies Culture Diagnosis Diagnostic systems Epidemics Female Fundamental and applied biological sciences. Psychology gamma -Interferon Gold Human bacterial diseases Humans Immunoassay Immunoassays Infectious diseases Interferon Interferon-gamma Release Tests - methods Male Medical sciences Microbiology Middle Aged Mycobacterium tuberculosis nested‐PCR Pleural effusion Pleurisy Polymerase Chain Reaction - methods QuantiFERON TB Gold In‐Tube test Sensitivity analysis Sensitivity and Specificity Skin tests Time Factors Tuberculin Tuberculosis Tuberculosis and atypical mycobacterial infections Tuberculosis, Pleural - diagnosis Tuberculosis, Pleural - epidemiology tuberculous pleurisy γ-Interferon
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Abstract The conventional acid fast bacilli (AFB) smear and Mycobacterium tuberculosis (M.tb) culture of pleural effusion and tuberculin skin test (TST) in tuberculous pleurisy are unable to meet clinical needs because of their low sensitivities and specificities. To evaluate the diagnostic accuracies of QuantiFERON TB Gold In-Tube test (QFT-GIT) and nested-PCR in tuberculous pleurisy, we conducted a cross-sectional study in regions of China with a high tuberculosis (TB) epidemic. Seventy-eight participants were enrolled: 58 TB patients with diagnosis of confirmed or probable tuberculous pleurisy and 20 non-TB patients with a diagnosis of other non-TB diseases. The positive rates of AFB smear and M.tb culture in the pleural effusion were 5.8% (2/42) and 10.6% (5/47), respectively. The sensitivity and specificity of QFT-GIT were 93.1% (54/58) and 90.0% (18/20), whereas those of TST were 68.5% (37/54) and 86.7% (13/15), respectively; the sensitivity of QFT-GIT was significantly higher than TST (P = 0.013). The sensitivity and specificity of M.tb-specific nested-PCR in pleural effusion were 94.8% (55/58) and 90.0% (18/20), respectively, with a turnaround time of 7 h. Furthermore, combined QFT-GIT and nested-PCR detection improves the specificity to 100% with a sensitivity of up to 90.0%. This combination of immunoassay and molecular detection holds promise for the clinical diagnosis of tuberculous pleurisy.
ISSN:	0928-8244 1574-695X 2049-632X