Rapid diagnosis of tuberculosis by PCR IS6110 from blood in the central region of Tunisia.

Ahmed Ben Hadj Hassine, Manel Marzouk, Jalel Boukadida
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Abstract

Tuberculosis remains one of the leading causes of mortality worldwide. Microscopy and culture still the references of Tuberculosis diagnosis. Microscopy has a low sensitivity, specificity and culture is time consuming. For this reason, rapid and reliable diagnosis of the disease is required. We describe a retrospective comparison study of tuberculosis diagnosis by PCR IS6110 directly from blood samples of patients with suspected Tuberculosis with Acid-Fast-Bacilli and culture. From 80 patients enrolled, culture results were positive for 25, acid fast bacilli were positive for 15 and blood PCR were positive for 45. Comparing blood PCR result with acid fast bacilli, the sensitivity and specificity were respectively 35% and 87.5% (PPV = 9%, PNV = 21.1%) for PTB. The specificity of blood PCR was 100% (PNV = 72.73%), for EPTB. In comparison with culture blood PCR have a high sensitivity and specificity better than with the acid fast, they were respectively 57.89%, 100% for PTB and 50%, 100% for EPTB. This study is the first established in Tunisia and in Africa aiming to diagnose TB from blood. B-PCR results has shown a high correlation with culture that illustrates the usefulness of B-PCR as a rapid and early diagnostic, combined with others serological results B-PCR can be a solid, rapid and efficient TB diagnostic tools.

突尼斯中部地区血液IS6110聚合酶链反应快速诊断结核病
结核病仍然是全世界死亡的主要原因之一。镜检和培养仍是肺结核诊断的参考。显微镜检查灵敏度低,特异性低,培养耗时长。因此,需要对该病进行快速、可靠的诊断。我们描述了一项回顾性比较研究,通过PCR IS6110直接从抗酸杆菌和培养的疑似结核病患者的血液样本中诊断结核病。80例患者中培养阳性25例,抗酸杆菌阳性15例,血PCR阳性45例。血PCR检测结果与抗酸杆菌检测结果比较,检测PTB的敏感性为35%,特异性为87.5% (PPV = 9%, PNV = 21.1%)。血PCR检测EPTB的特异性为100% (PNV = 72.73%)。与培养血PCR相比,PCR检测PTB的灵敏度和特异性均高于抗酸法,分别为57.89%、100%和50%、100%。这项研究是突尼斯和非洲建立的第一个旨在通过血液诊断结核病的研究。B-PCR结果显示与培养高度相关,说明B-PCR作为快速和早期诊断的有效性,与其他血清学结果相结合,B-PCR可以成为一种可靠、快速和有效的结核病诊断工具。
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