 The diagnostic value of polymerase chain reaction (PCR) in bronchioalveolar lavage

Yıl 2004, Cilt: 9 Sayı: 1, 7 - 12, 27.02.2013

Süleyman Güven Esra Yılmaz Hatice Kutbay Salim Sarıyıldız Levend Dalar Arman Poluman

Öz

Objectives:  In this study we investigated the diagnostic
value of polymerase chain reaction (PCR) which is fast
and highly specific in terms of isolating  the
Mycobacterium tuberculosis (M. tuberculosis) from the
bronchoalveolar lavage obtained by bronchoscopy
when tuberculosis is suspected in the patients with
negative sputum smears or when the sputum can not
be collected.
Method: Our cases consist of patients who can not
expectorate or have three respective negative sputum
samples taken at the morning after starvation.
Fiberoptic   broncoscopy was applied to all patients-under local anestesia-at the hospital. Lavages were
taken from bronchi, which were appropriate to the
lesion. Lavage samples were sent to the laboratory
without delay. Results were evaluated 2 days later.
Totally 47 cases from 3rd Thoracic Diseases Clinic of
Yedikule Thoracic Diseases and Thoracic Surgery
Education and Research Hospital were included in this
study. Thirty-five of the cases had a higher possibility
for tuberculosis, and the remaining 12 cases had no
evidence for tuberculosis (control group). In these
cases  M. tuberculosis complex DNA specific IS6110
field has been investigated by PCR and the results were
compared with the microbiological culture, lavage AFB.
Results: Twenty-one of 35 patients in the study group
had positive lavage PCR results. Fourteen patients had
negative lavage PCR results. Four of 21 lavage PCR-positive patients were found to be ARB positive by
lavage. Nine of  21 lavage PCR positive patients were
found to be ARB positive by culture. We had no false
positive results. All control cases were negative in
terms of AFB smear, culture, and lavage PCR.
Lavage PCR sensitivity and specificity calculations
were compared with ARB culture and lavage results.
Considering the culture positivity as gold standard, the
sensitivity and specificity of PCR were 60% and 100%
respectively.
Conclusion: PCR can be used as a supportive
diagnostic test providing rapid and accurate results, if
tuberculosis is suspected clinically and radiologicaly
in patients with three consecutive AFB smear-negative
sputum specimens or when the sputum can not be
collected.
Key words: Mycobacterium tuberculosis, polymerase chain
reaction, bronchioalveoar lavage

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