Nucleic acid amplification test and bronchoscopy improve the diagnostic accuracy of smear-negative tuberculosis

P. C. Chou, Chun Hua Wang, C. D. Huang, Y. L. Lo, K. Y. Lee, C. T. Yu, S. M. Lin, H. C. Lin, H. P. Kuo

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

OBJECTIVE: To determine whether the nucleic acid amplification (NAA) test on specimens collected by bronchoscopy improves the diagnostic accuracy of pulmonary tuberculosis (PTB) in sputum-negative patients. DESIGN: Bronchoscopy was performed among smear-negative PTB suspects to collect respiratory specimens to assess the efficacy and accuracy of the Amplified Mycobacterium Tuberculosis Direct (AMTD) test in the diagnosis of PTB. RESULTS: In 105 PTB suspects, 80 were finally excluded, of whom two were false-AMTD-positive. PTB (n = 25) was diagnosed in 10 patients culture-positive for Mycobacterium tuberculosis (7/105 bronchial wash/ bronchoalveolar lavage [BW/BAL] specimens, 6/315 expectorated sputum specimens [2 positive in 2 patients; 1 positive in 2 patients], and one with both), and in 15 patients with improvement after anti-tuberculosis treatment. Among the 25 PTB patients, 20 were AMTD- positive, of whom four were culture-positive. Three AMTD-negative patients were culture-positive. The sensitivity and specificity of AMTD were respectively 80.0% and 97.5%. The diagnostic yield was higher in respiratory specimens obtained at bronchoscopy and measured by AMTD than in conventional sputum or BW/BAL culture. CONCLUSION: NAA testing on specimens collected using bronchoscopy provides a highly efficient and reliable approach in the diagnosis of PTB in smear-negative PTB suspects.

Original languageEnglish
Pages (from-to)1674-1679
Number of pages6
JournalInternational Journal of Tuberculosis and Lung Disease
Volume16
Issue number12
DOIs
Publication statusPublished - Dec 1 2012
Externally publishedYes

Fingerprint

Nucleic Acid Amplification Techniques
Bronchoscopy
Pulmonary Tuberculosis
Mycobacterium tuberculosis
Tuberculosis
Sputum
Bronchoalveolar Lavage
Nucleic Acids
Sensitivity and Specificity

Keywords

  • Bronchoscopy
  • Nucleic acid amplification test
  • Pulmonary tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

Cite this

Nucleic acid amplification test and bronchoscopy improve the diagnostic accuracy of smear-negative tuberculosis. / Chou, P. C.; Wang, Chun Hua; Huang, C. D.; Lo, Y. L.; Lee, K. Y.; Yu, C. T.; Lin, S. M.; Lin, H. C.; Kuo, H. P.

In: International Journal of Tuberculosis and Lung Disease, Vol. 16, No. 12, 01.12.2012, p. 1674-1679.

Research output: Contribution to journalArticle

@article{25b2f0565aa649639784e71bf998da44,
title = "Nucleic acid amplification test and bronchoscopy improve the diagnostic accuracy of smear-negative tuberculosis",
abstract = "OBJECTIVE: To determine whether the nucleic acid amplification (NAA) test on specimens collected by bronchoscopy improves the diagnostic accuracy of pulmonary tuberculosis (PTB) in sputum-negative patients. DESIGN: Bronchoscopy was performed among smear-negative PTB suspects to collect respiratory specimens to assess the efficacy and accuracy of the Amplified Mycobacterium Tuberculosis Direct (AMTD) test in the diagnosis of PTB. RESULTS: In 105 PTB suspects, 80 were finally excluded, of whom two were false-AMTD-positive. PTB (n = 25) was diagnosed in 10 patients culture-positive for Mycobacterium tuberculosis (7/105 bronchial wash/ bronchoalveolar lavage [BW/BAL] specimens, 6/315 expectorated sputum specimens [2 positive in 2 patients; 1 positive in 2 patients], and one with both), and in 15 patients with improvement after anti-tuberculosis treatment. Among the 25 PTB patients, 20 were AMTD- positive, of whom four were culture-positive. Three AMTD-negative patients were culture-positive. The sensitivity and specificity of AMTD were respectively 80.0{\%} and 97.5{\%}. The diagnostic yield was higher in respiratory specimens obtained at bronchoscopy and measured by AMTD than in conventional sputum or BW/BAL culture. CONCLUSION: NAA testing on specimens collected using bronchoscopy provides a highly efficient and reliable approach in the diagnosis of PTB in smear-negative PTB suspects.",
keywords = "Bronchoscopy, Nucleic acid amplification test, Pulmonary tuberculosis",
author = "Chou, {P. C.} and Wang, {Chun Hua} and Huang, {C. D.} and Lo, {Y. L.} and Lee, {K. Y.} and Yu, {C. T.} and Lin, {S. M.} and Lin, {H. C.} and Kuo, {H. P.}",
year = "2012",
month = "12",
day = "1",
doi = "10.5588/ijtld.11.0672",
language = "English",
volume = "16",
pages = "1674--1679",
journal = "International Journal of Tuberculosis and Lung Disease",
issn = "1027-3719",
publisher = "International Union against Tubercul. and Lung Dis.",
number = "12",

}

TY - JOUR

T1 - Nucleic acid amplification test and bronchoscopy improve the diagnostic accuracy of smear-negative tuberculosis

AU - Chou, P. C.

AU - Wang, Chun Hua

AU - Huang, C. D.

AU - Lo, Y. L.

AU - Lee, K. Y.

AU - Yu, C. T.

AU - Lin, S. M.

AU - Lin, H. C.

AU - Kuo, H. P.

PY - 2012/12/1

Y1 - 2012/12/1

N2 - OBJECTIVE: To determine whether the nucleic acid amplification (NAA) test on specimens collected by bronchoscopy improves the diagnostic accuracy of pulmonary tuberculosis (PTB) in sputum-negative patients. DESIGN: Bronchoscopy was performed among smear-negative PTB suspects to collect respiratory specimens to assess the efficacy and accuracy of the Amplified Mycobacterium Tuberculosis Direct (AMTD) test in the diagnosis of PTB. RESULTS: In 105 PTB suspects, 80 were finally excluded, of whom two were false-AMTD-positive. PTB (n = 25) was diagnosed in 10 patients culture-positive for Mycobacterium tuberculosis (7/105 bronchial wash/ bronchoalveolar lavage [BW/BAL] specimens, 6/315 expectorated sputum specimens [2 positive in 2 patients; 1 positive in 2 patients], and one with both), and in 15 patients with improvement after anti-tuberculosis treatment. Among the 25 PTB patients, 20 were AMTD- positive, of whom four were culture-positive. Three AMTD-negative patients were culture-positive. The sensitivity and specificity of AMTD were respectively 80.0% and 97.5%. The diagnostic yield was higher in respiratory specimens obtained at bronchoscopy and measured by AMTD than in conventional sputum or BW/BAL culture. CONCLUSION: NAA testing on specimens collected using bronchoscopy provides a highly efficient and reliable approach in the diagnosis of PTB in smear-negative PTB suspects.

AB - OBJECTIVE: To determine whether the nucleic acid amplification (NAA) test on specimens collected by bronchoscopy improves the diagnostic accuracy of pulmonary tuberculosis (PTB) in sputum-negative patients. DESIGN: Bronchoscopy was performed among smear-negative PTB suspects to collect respiratory specimens to assess the efficacy and accuracy of the Amplified Mycobacterium Tuberculosis Direct (AMTD) test in the diagnosis of PTB. RESULTS: In 105 PTB suspects, 80 were finally excluded, of whom two were false-AMTD-positive. PTB (n = 25) was diagnosed in 10 patients culture-positive for Mycobacterium tuberculosis (7/105 bronchial wash/ bronchoalveolar lavage [BW/BAL] specimens, 6/315 expectorated sputum specimens [2 positive in 2 patients; 1 positive in 2 patients], and one with both), and in 15 patients with improvement after anti-tuberculosis treatment. Among the 25 PTB patients, 20 were AMTD- positive, of whom four were culture-positive. Three AMTD-negative patients were culture-positive. The sensitivity and specificity of AMTD were respectively 80.0% and 97.5%. The diagnostic yield was higher in respiratory specimens obtained at bronchoscopy and measured by AMTD than in conventional sputum or BW/BAL culture. CONCLUSION: NAA testing on specimens collected using bronchoscopy provides a highly efficient and reliable approach in the diagnosis of PTB in smear-negative PTB suspects.

KW - Bronchoscopy

KW - Nucleic acid amplification test

KW - Pulmonary tuberculosis

UR - http://www.scopus.com/inward/record.url?scp=84870358432&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84870358432&partnerID=8YFLogxK

U2 - 10.5588/ijtld.11.0672

DO - 10.5588/ijtld.11.0672

M3 - Article

C2 - 23131268

AN - SCOPUS:84870358432

VL - 16

SP - 1674

EP - 1679

JO - International Journal of Tuberculosis and Lung Disease

JF - International Journal of Tuberculosis and Lung Disease

SN - 1027-3719

IS - 12

ER -