Comparative Study between Polymerase Chain Reaction and Different Rapid Tests for Detection of Mycobacterium Infection.

The objective of this work is to reach a sensitive and rapid method for the laboratory diagnosis of active tuberculosis disease in patients and latent TB infection in household contacts and healthy community controls. We recruited 86 subjects divided into 3 groups: Thirty six patients with suspected active TB (Twenty four suspected pulmonary TB cased and 12 suspected extrapulmonary TB cases). 28 household contacts of confirmed pulmonary TB patients and 22 healthy community controls. Methods: For diagnosis of active tuberculosis the following tests were evaluated: Ziehl-Neelsen (Z-N) staining and culture on Lownestein-Jensen (L-j), tuberculin skin test (TST), nested polymerase chain reaction (PCR) assay on separated peripheral blood mononuclear cells (PBMCs), antibody detection by Immunchromatographic test (ICT), and JFN assay by QuantiFERON TB Gold In-Tube method for diagnosis of latent tuberculosic the following tests were evaluated: TST and Quantiferon TB Gold (In-tube method). The results showed that in pulmonary TB group, TST was the most sensitive test (92.3%), while QFT-Gold IT plus ZN was the most sensitive combined test (100%). In extrapulmonary TB group, TST, nested PCR and QFT-Gold IT were the most sensitive single tests (75%) while QFT-Gold IT plus ZN was the most sensitive combines test (100%). For diagnosis of LTBI: QFT-Gold IT was as sensitive as the TST. TST was 54.5% specific, while QFT Gold-IT was 94.5% specific TST showed that the exposure in the contacts group increased the risk of infection in the contacts group 0.9 times more than the control group (OR, 0,9m 95% Cl, 0.25-3.22; P=0.85). by QFT-Gold IT, exposure increased the risk of infection in the contacts group 8.4 times more than the control group (OR, 8.4; 95% Cl, 0.9-195.63; P=0.028). In household contacts group the concordance between TST and QFT-Gold IT was poor (64.3%, with a k value of 0.230.18). In conclusion, using QFT-Gold IT plus ZN staining is very helpful in the diagnosis of active TB disease. For diagnosis of LTBl. QuantiFERON-TB Gold In-Tube method is more helpful than Tuberculin skin test.

[1]  E. Hershfield,et al.  Targeted Tuberculin Testing and Treatment of Latent Tuberculosis Infection , 2013, Pediatric Clinical Practice Guidelines & Policies.

[2]  Z. Memish,et al.  Saudi guidelines for testing and treatment of latent tuberculosis infection , 2010, Annals of Saudi medicine.

[3]  N. Kim,et al.  Usefulness of the whole-blood interferon-gamma release assay for diagnosis of extrapulmonary tuberculosis. , 2009, Diagnostic microbiology and infectious disease.

[4]  S. Tasaka,et al.  Accuracy of an interferon-gamma release assay to detect active pulmonary and extra-pulmonary tuberculosis. , 2008, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[5]  R. Adegbola,et al.  Comparison of two interferon gamma release assays in the diagnosis of Mycobacterium tuberculosis infection and disease in The Gambia , 2007, BMC infectious diseases.

[6]  T. Keil,et al.  Interferon-gamma release assays improve the diagnosis of tuberculosis and nontuberculous mycobacterial disease in children in a country with a low incidence of tuberculosis. , 2007, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[7]  K. Steingart,et al.  Commercial Serological Antibody Detection Tests for the Diagnosis of Pulmonary Tuberculosis: A Systematic Review , 2007, PLoS medicine.

[8]  R. Adegbola,et al.  Surprisingly High Specificity of the PPD Skin Test for M. tuberculosis Infection from Recent Exposure in The Gambia , 2006, PloS one.

[9]  W. El-Sadr,et al.  Sensitivity Analysis and Potential Uses of a Novel Gamma Interferon Release Assay for Diagnosis of Tuberculosis , 2006, Journal of Clinical Microbiology.

[10]  T. Nakayama,et al.  Novel Technique of Quantitative Nested Real-Time PCR Assay for Mycobacterium tuberculosis DNA , 2006, Journal of Clinical Microbiology.

[11]  D. Çolak,et al.  Evaluation of the ICT Tuberculosis test for the routine diagnosis of tuberculosis , 2006, BMC infectious diseases.

[12]  J. Yim,et al.  Discrepancy between the tuberculin skin test and the whole-blood interferon gamma assay for the diagnosis of latent tuberculosis infection in an intermediate tuberculosis-burden country. , 2005, JAMA.

[13]  J. Lundgren,et al.  Prospective Evaluation of a Whole-Blood Test Using Mycobacterium tuberculosis-Specific Antigens ESAT-6 and CFP-10 for Diagnosis of Active Tuberculosis , 2005, Clinical Diagnostic Laboratory Immunology.

[14]  S. Zanetti,et al.  PCR-based detection of the Mycobacterium tuberculosis complex in urine of HIV-infected and uninfected pulmonary and extrapulmonary tuberculosis patients in Burkina Faso. , 2005, Journal of medical microbiology.

[15]  H. Mohtady,et al.  Evaluation of a rapid bacteriophage-based method for the detection of Mycobacterium tuberculosis in clinical samples. , 2003, Journal of medical microbiology.

[16]  J. Herrmann,et al.  Diagnostic value of a nested polymerase chain reaction assay on peripheral blood mononuclear cells from patients with pulmonary and extra-pulmonary tuberculosis. , 2001, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[17]  S. Chanteau,et al.  Predictive values of the ICT Tuberculosis test for the routine diagnosis of tuberculosis in Madagascar. , 2000, The International Journal of Tuberculosis and Lung Disease.

[18]  L. Ward,et al.  Nested-PCR using MPB64 fragment improves the diagnosis of pleural and meningeal tuberculosis. , 2000, Revista da Sociedade Brasileira de Medicina Tropical.