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. 1994 Apr;32(4):918–923. doi: 10.1128/jcm.32.4.918-923.1994

Direct detection of Mycobacterium tuberculosis complex in respiratory specimens by a target-amplified test system.

G E Pfyffer 1, P Kissling 1, R Wirth 1, R Weber 1
PMCID: PMC263163  PMID: 8027344

Abstract

A total of 938 respiratory specimens (633 sputa, 249 bronchial and tracheal aspirates, and 56 bronchoalveolar lavages) from 589 patients were tested for direct detection of Mycobacterium tuberculosis complex by the Gen-Probe amplified Mycobacterium tuberculosis direct test (MTD), and the results were compared with those of the conventional methods of fluorescence microscopy and cultivation (solid and radiometric media). One series of specimens (n = 515) was decontaminated with N-acetyl-L-cysteine (NALC)-NaOH: the other one (n = 423) was decontaminated with sodium dodecyl (lauryl) sulfate (SDS)-NaOH. Of the specimens decontaminated with NALC, 39 were MTD and culture positive, 455 were MTD and culture negative, 18 were MTD positive and culture negative, and 3 were MTD negative and culture positive, indicating a sensitivity of 92.9% and a specificity of 96.2% for the MTD. Of the specimens decontaminated with SDS, 35 were MTD and culture positive, 372 were MTD and culture negative, 15 were MTD positive and culture negative, and 1 was MTD negative and culture positive, indicating a sensitivity of 97.2% and a specificity of 96.1% for the MTD. After resolution of discrepant results by review of the patients' clinical data, the sensitivity of the MTD was 93.9%, the specificity was 97.6%, the positive predictive value was 80.7%, and the negative predictive value was 99.3% for the NALC series; the corresponding values were 97.4, 96.9, 76.0, and 99.7%, respectively, for the SDS series. In conclusion, the MTD is a highly sensitive and specific technique for detecting M. tuberculosis complex within hours in both smear-positive and smear-negative respiratory specimens.

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Selected References

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  1. Beck-Sagué C., Dooley S. W., Hutton M. D., Otten J., Breeden A., Crawford J. T., Pitchenik A. E., Woodley C., Cauthen G., Jarvis W. R. Hospital outbreak of multidrug-resistant Mycobacterium tuberculosis infections. Factors in transmission to staff and HIV-infected patients. JAMA. 1992 Sep 9;268(10):1280–1286. doi: 10.1001/jama.1992.03490100078031. [DOI] [PubMed] [Google Scholar]
  2. Bloom B. R., Murray C. J. Tuberculosis: commentary on a reemergent killer. Science. 1992 Aug 21;257(5073):1055–1064. doi: 10.1126/science.257.5073.1055. [DOI] [PubMed] [Google Scholar]
  3. Brisson-Noel A., Aznar C., Chureau C., Nguyen S., Pierre C., Bartoli M., Bonete R., Pialoux G., Gicquel B., Garrigue G. Diagnosis of tuberculosis by DNA amplification in clinical practice evaluation. Lancet. 1991 Aug 10;338(8763):364–366. doi: 10.1016/0140-6736(91)90492-8. [DOI] [PubMed] [Google Scholar]
  4. Brisson-Noël A., Gicquel B., Lecossier D., Lévy-Frébault V., Nassif X., Hance A. J. Rapid diagnosis of tuberculosis by amplification of mycobacterial DNA in clinical samples. Lancet. 1989 Nov 4;2(8671):1069–1071. doi: 10.1016/s0140-6736(89)91082-9. [DOI] [PubMed] [Google Scholar]
  5. Clarridge J. E., 3rd, Shawar R. M., Shinnick T. M., Plikaytis B. B. Large-scale use of polymerase chain reaction for detection of Mycobacterium tuberculosis in a routine mycobacteriology laboratory. J Clin Microbiol. 1993 Aug;31(8):2049–2056. doi: 10.1128/jcm.31.8.2049-2056.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Dooley S. W., Jarvis W. R., Martone W. J., Snider D. E., Jr Multidrug-resistant tuberculosis. Ann Intern Med. 1992 Aug 1;117(3):257–259. doi: 10.7326/0003-4819-117-3-257. [DOI] [PubMed] [Google Scholar]
  7. Eisenach K. D., Sifford M. D., Cave M. D., Bates J. H., Crawford J. T. Detection of Mycobacterium tuberculosis in sputum samples using a polymerase chain reaction. Am Rev Respir Dis. 1991 Nov;144(5):1160–1163. doi: 10.1164/ajrccm/144.5.1160. [DOI] [PubMed] [Google Scholar]
  8. Fauville-Dufaux M., Vanfleteren B., De Wit L., Vincke J. P., Van Vooren J. P., Yates M. D., Serruys E., Content J. Rapid detection of tuberculous and non-tuberculous mycobacteria by polymerase chain reaction amplification of a 162 bp DNA fragment from antigen 85. Eur J Clin Microbiol Infect Dis. 1992 Sep;11(9):797–803. doi: 10.1007/BF01960878. [DOI] [PubMed] [Google Scholar]
  9. Forbes B. A., Hicks K. E. Direct detection of Mycobacterium tuberculosis in respiratory specimens in a clinical laboratory by polymerase chain reaction. J Clin Microbiol. 1993 Jul;31(7):1688–1694. doi: 10.1128/jcm.31.7.1688-1694.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. French G. L., Chan C. Y., Cheung S. W., Oo K. T. Diagnosis of pulmonary tuberculosis by detection of tuberculostearic acid in sputum by using gas chromatography-mass spectrometry with selected ion monitoring. J Infect Dis. 1987 Aug;156(2):356–362. doi: 10.1093/infdis/156.2.356. [DOI] [PubMed] [Google Scholar]
  11. Frieden T. R., Sterling T., Pablos-Mendez A., Kilburn J. O., Cauthen G. M., Dooley S. W. The emergence of drug-resistant tuberculosis in New York City. N Engl J Med. 1993 Feb 25;328(8):521–526. doi: 10.1056/NEJM199302253280801. [DOI] [PubMed] [Google Scholar]
  12. Jonas V., Alden M. J., Curry J. I., Kamisango K., Knott C. A., Lankford R., Wolfe J. M., Moore D. F. Detection and identification of Mycobacterium tuberculosis directly from sputum sediments by amplification of rRNA. J Clin Microbiol. 1993 Sep;31(9):2410–2416. doi: 10.1128/jcm.31.9.2410-2416.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Morgan M. A., Horstmeier C. D., DeYoung D. R., Roberts G. D. Comparison of a radiometric method (BACTEC) and conventional culture media for recovery of mycobacteria from smear-negative specimens. J Clin Microbiol. 1983 Aug;18(2):384–388. doi: 10.1128/jcm.18.2.384-388.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Muranishi H., Nakashima M., Isobe R., Ando T., Shigematsu N. Measurement of tuberculostearic acid in sputa, pleural effusions, and bronchial washings. A clinical evaluation for diagnosis of pulmonary tuberculosis. Diagn Microbiol Infect Dis. 1990 May-Jun;13(3):235–240. doi: 10.1016/0732-8893(90)90065-4. [DOI] [PubMed] [Google Scholar]
  15. Nolte F. S., Metchock B., McGowan J. E., Jr, Edwards A., Okwumabua O., Thurmond C., Mitchell P. S., Plikaytis B., Shinnick T. Direct detection of Mycobacterium tuberculosis in sputum by polymerase chain reaction and DNA hybridization. J Clin Microbiol. 1993 Jul;31(7):1777–1782. doi: 10.1128/jcm.31.7.1777-1782.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Shawar R. M., el-Zaatari F. A., Nataraj A., Clarridge J. E. Detection of Mycobacterium tuberculosis in clinical samples by two-step polymerase chain reaction and nonisotopic hybridization methods. J Clin Microbiol. 1993 Jan;31(1):61–65. doi: 10.1128/jcm.31.1.61-65.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Soini H., Skurnik M., Liippo K., Tala E., Viljanen M. K. Detection and identification of mycobacteria by amplification of a segment of the gene coding for the 32-kilodalton protein. J Clin Microbiol. 1992 Aug;30(8):2025–2028. doi: 10.1128/jcm.30.8.2025-2028.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Wolinsky E. Statement of the Tuberculosis Committee of the Infectious Diseases Society of America. Clin Infect Dis. 1993 May;16(5):627–628. doi: 10.1093/clind/16.5.627. [DOI] [PubMed] [Google Scholar]

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