Reliability of PCR Testing Versus Culture Testing in Tuberculosis Diagnosis: A Six-Year Retrospective Study

Öz

Background: Tuberculosis (TB) remains a global health challenge, particularly in regions with high migration rates like Şanlıurfa, Türkiye. Rapid and accurate diagnosis is essential to improve treat-ment outcomes and reduce transmission. This study evaluated the reliability of Polymerase Chain Reaction (PCR) testing compared to culture testing, the gold standard, in pulmonary TB diagnosis. Materials and Methods: This retrospective study analyzed the records of 1,231 patients diag-nosed with pulmonary TB at the Şanlıurfa Tuberculosis Dispensary between January 2018 and June 2022. Patient demographics, clinical findings, and diagnostic test results were collected. Sensitivity and specificity of PCR and acid-fast bacilli (ARB) smear tests were calculated using culture results as the reference standard. Statistical significance was set at p<0.05. Results: The majority of patients were male (60.3%) and over 18 years old (94.5%). PCR showed a sensitivity of 97% and a specificity of 88%, while ARB had a sensitivity of 77% and a specificity of 99%. PCR and culture concordance was statistically significant across ethnic groups (p=0.001). Common clinical findings included pleural effusion (18.14%) and atelectasis (15.02%). Conclusions: PCR demonstrates high sensitivity and acceptable specificity, supporting its use as a rapid diagnostic tool for pulmonary TB, particularly in resource-limited settings. However, culture testing remains indispensable for definitive diagnosis. Keywords: Tuberculosis, PCR Testing, Culture Testing, Diagnostic Reliability

Anahtar Kelimeler

• Tuberculosis
• PCR Testing
• Culture Testing
• Diagnostic Reliability

Etik Beyan

HRÜ/24.15.39

PCR ve Kültür Testlerinin Tüberküloz Tanısındaki Güvenilirliği: Altı Yıllık Geriye Dönük Çalışma

Öz

Amaç: Tüberküloz (TB), özellikle yüksek göç oranlarına sahip bölgelerde küresel bir sağlık sorunu olmaya devam etmektedir. Tedavi sonuçlarını iyileştirmek ve bulaşmayı azaltmak için hızlı ve doğru tanı şarttır. Bu çalışmada, akciğer tüberkülozu tanısında altın standart olan kültür testiyle karşılaştırıldığında PCR testinin güvenilirliği değerlendirilmiştir. Materyal ve Metod: Bu retrospektif çalışmada, Ocak 2018 ile Haziran 2022 tarihleri arasında Şanlıurfa Verem Savaş Dispanseri'nde akciğer tüberkülozu tanısı alan 1.231 hastanın kayıtları analiz edilmiştir. Hasta demografik özellikleri, klinik bulgular ve tanı test sonuçları toplanmıştır. PCR ve aside dirençli basil (ARB) yayma testlerinin duyarlılığı ve özgüllüğü, kültür sonuçları referans standart olarak kullanılarak hesaplanmıştır. İstatistiksel anlamlılık p<0,05 olarak belirlenmiştir. Bulgular: Hastaların çoğunluğu erkek (%60,3) ve 18 yaşın üzerinde (%94,5) idi. PCR %97 duyarlılık ve %88 özgüllük gösterirken, ARB %77 duyarlılık ve %99 özgüllük göstermiştir. PCR ve kültür uyumu etnik gruplar arasında istatistiksel olarak anlamlı bulunmuştur (p=0,001). Yaygın klinik bulgular arasında plevral efüzyon (%18,14) ve atelektazi (%15,02) yer almaktadır. Sonuç: PCR yüksek duyarlılık ve kabul edilebilir özgüllük göstermekte olup, özellikle kaynakların kısıtlı olduğu durumlarda akciğer tüberkülozu için hızlı bir tanı aracı olarak kullanımını destekle-mektedir. Bununla birlikte, kültür testi kesin tanı için vazgeçilmez olmaya devam etmektedir.

Anahtar Kelimeler

• Tüberküloz
• PCR Testi
• Kültür Testi
• Tanı Güvenilirliği

Destekleyen Kurum

HARRAN UNİVERSİTESİ

Etik Beyan

HRÜ/24.15.39

Kaynakça

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