Diagnostic yield of polymerase chain reaction on induced sputum for pulmonary tuberculosis: A single-center retrospective cross-sectional study

Infectious Medicine Pub Date : 2025-08-12 DOI:10.1016/j.imj.2025.100197

Kiartipong Virapongsiri , Dararat Eksombatchai , Monruadee Chatreewarote , Viboon Boonsarngsuk

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Abstract

Background

Data on tuberculosis-polymerase chain reaction (TB-PCR) diagnostic yield in induced sputum (IS) samples is limited. This study was conducted to evaluate the diagnostic yield of TB-PCR in IS samples from patients with pulmonary TB and to identify factors that are associated with positive TB-PCR results.

Methods

This retrospective cross-sectional study was conducted at the Faculty of Medicine Ramathibodi Hospital. Patients who underwent IS collection for the diagnosis of pulmonary TB were included. Sputum specimens were obtained for acid-fast bacilli (AFB) smear, TB-PCR (Anyplex Seegene MTB/NTM real-time detection assay or Xpert MTB/RIF assay), and TB culture. Multivariate logistic regression analysis was performed to identify factors associated with IS TB-PCR positivity. The McNemar test was used to compare the diagnostic yield of each test.

Results

A total of 124 IS specimens of patients with pulmonary TB were evaluated. There were 65 (52.4%) men, with a mean age of 55.3 ± 19.5 years. The diagnostic yield of IS TB-PCR for the diagnosis of pulmonary TB was 31.5% (95% confidence interval [CI]: 23.2–39.7). The diagnostic yields were 34.4% (95% CI: 22.0–46.0) for Xpert MTB/RIF and 28.6% (95% CI: 17.8–40.2) for Anyplex MTB/NTM, with no significant difference between the two assays (p = 0.49). TB-PCR had a higher diagnostic yield than AFB smear (31.5% vs. 6.5%, p < 0.01). Logistic regression analysis showed that moderately advanced (adjusted odds ratio [aOR] = 3.73, 95% CI: 1.24–11.21, p = 0.019) and far advanced (aOR = 3.95, 95% CI: 1.05–14.82, p = 0.042) radiographic extent of disease were associated with positive IS TB-PCR.

Conclusions

Induced sputum TB-PCR is an effective initial method for patients with suspected pulmonary TB who are unable to produce reliable sputum, especially those with moderately advanced or far advanced radiographic extent of disease.

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诱导痰聚合酶链反应对肺结核的诊断率：一项单中心回顾性横断面研究

背景：诱导痰（IS）样本中结核聚合酶链反应（TB-PCR）诊断率的数据有限。本研究旨在评估TB- pcr在肺结核患者IS样本中的诊断率，并确定与TB- pcr阳性结果相关的因素。方法回顾性横断面研究在Ramathibodi医院医学院进行。接受IS采集诊断肺结核的患者也包括在内。取痰标本进行抗酸杆菌（AFB）涂片、TB- pcr （Anyplex Seegene MTB/NTM实时检测或Xpert MTB/RIF检测）和TB培养。进行多因素logistic回归分析以确定与IS结核- pcr阳性相关的因素。采用McNemar试验比较各试验的诊断率。结果共对124例肺结核患者的IS标本进行了评价。男性65例（52.4%），平均年龄55.3±19.5岁。IS - TB- pcr诊断肺结核的诊断率为31.5%（95%可信区间[CI]: 23.2 ~ 39.7）。Xpert MTB/RIF的诊断率为34.4% (95% CI: 22.0-46.0)， Anyplex MTB/NTM的诊断率为28.6% (95% CI: 17.8-40.2)，两种检测方法之间无显著差异（p = 0.49）。TB-PCR的诊断率高于AFB涂片（31.5% vs. 6.5%, p < 0.01）。Logistic回归分析显示，中度晚期（校正优势比[aOR] = 3.73, 95% CI: 1.24-11.21, p = 0.019）和极晚期（aOR = 3.95, 95% CI: 1.05-14.82, p = 0.042）疾病的放射学程度与IS - TB-PCR阳性相关。结论诱导痰结核- pcr对不能产生可靠痰液的疑似肺结核患者，特别是有中晚期或远晚期影像学表现的患者，是一种有效的初始检测方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infectious Medicine

CiteScore

1.40

自引率

0.00%

发文量