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

Yıl 2025, Cilt: 22 Sayı: 3, 562 - 566, 29.09.2025
https://doi.org/10.35440/hutfd.1755437

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

Etik Beyan

HRÜ/24.15.39

Kaynakça

  • 1. World Health Organization. Fourth WHO consultation on the translation of tuberculosis research into global policy guide-lines: meeting report, 15 February 2024. World Health Organ-ization, 2024.
  • 2. Afsar I, Gunes M, Er H, Sener AG. Comparison of culture, microscopic smear and molecular methods in diagnosis of tu-berculosis. Revista espanola de quimioterapia. 2018;31(5):435
  • 3. Riello FN, Brígido RTS, Araújo S, Moreira TA, Goulart LR, Gou-lart IMB. Diagnosis of mycobacterial infections based on acid-fast bacilli test and bacterial growth time and implications on treatment and disease outcome. BMC Infectious Diseases. 2016;16:1-10.
  • 4. Wang W-H, Takeuchi R, Jain S-H, Jiang Y-H, Watanuki S, Ohtaki Y, et al. A novel, rapid (within hours) culture-free diagnostic method for detecting live Mycobacterium tuberculosis with high sensitivity. EBioMedicine. 2020;60.
  • 5. Dong B, He Z, Li Y, Xu X, Wang C, Zeng J. Improved conven-tional and new approaches in the diagnosis of tuberculosis. Frontiers in Microbiology. 2022;13:924410.
  • 6. Abdulmajed O, Koç AN, Gültekin A, Atalay MA, Kılıç H. Klinik örneklerden mikobakteri türlerinin izolasyonunda klasik tani yöntemlerin karşilaştirilmasi ve primerantitüberküloz ilaçlara duyarliliklarinin belirlenmesi. Sağlık Bilimleri Dergisi. 2012;21(2):127-35.
  • 7. Alp A. Tüberkülozun laboratuvar tanısında güncel durum. Hacet Tıp Derg. 2011;42:28-33.
  • 8. Wei Z, Zhang X, Wei C, Yao L, Li Y, Zhang X, et al. Diagnostic accuracy of in-house real-time PCR assay for Mycobacterium tuberculosis: a systematic review and meta-analysis. BMC in-fectious diseases. 2019;19:1-11.
  • 9. Boldi M-O, Denis-Lessard J, Neziri R, Brouillet R, von-Garnier C, Chavez V, et al. Performance of microbiological tests for tuberculosis diagnostic according to the type of respiratory specimen: A 10-year retrospective study. Frontiers in Cellular and Infection Microbiology. 2023;13:1131241.
  • 10. Nolte FS, Metchock B, McGowan Jr JE, Edwards A, Okwumabua O, Thurmond C, et al. Direct detection of Mycobacterium tu-berculosis in sputum by polymerase chain reaction and DNA hybridization. Journal of clinical microbiology. 1993;31(7):1777-82.
  • 11. Kocagöz T, Yilmaz E, Ozkara S, Kocagöz S, Hayran M, Sachedeva M, et al. Detection of Mycobacterium tuberculosis in sputum samples by polymerase chain reaction using a simplified pro-cedure. Journal of clinical microbiology. 1993;31(6):1435-8.
  • 12. Ling DI, Zwerling AA, Pai M. GenoType MTBDR assays for the diagnosis of multidrug-resistant tuberculosis: a meta-analysis. European Respiratory Journal. 2008;32(5):1165-74.
  • 13. Zhuang Y, Wu X, Zhang X, Li G. Detection of Mycobacterium tuberculosis in sputum specimens of pulmonary tuberculosis by DNA amplification. Wei Sheng wu xue bao= Acta Microbio-logica Sinica. 1992;32(5):364-9.
  • 14. Chin DP, Yajko DM, Hadley WK, Sanders CA, Nassos PS, Madej JJ, et al. Clinical utility of a commercial test based on the polymerase chain reaction for detecting Mycobacterium tu-berculosis in respiratory specimens. American journal of res-piratory and critical care medicine. 1995;151(6):1872-7.
  • 15. Cheng VC-C, Yew WW, Yuen KY. Molecular diagnostics in tuberculosis. European Journal of Clinical Microbiology and Infectious Diseases. 2005;24:711-20.
  • 16. Greco S, Girardi E, Navarra A, Saltini C. Current evidence on diagnostic accuracy of commercially based nucleic acid ampli-fication tests for the diagnosis of pulmonary tuberculosis. Thorax. 2006;61(9):783-90.
  • 17. Cho SM, Shin S, Kim Y, Song W, Hong SG, Jeong SH, et al. A novel approach for tuberculosis diagnosis using exosomal DNA and droplet digital PCR. Clinical Microbiology and Infection. 2020;26(7):942-e1.
  • 18. Visca D, Ong CWM, Tiberi S, Centis R, D’ambrosio L, Chen B, et al. Tuberculosis and COVID-19 interaction: a review of bio-logical, clinical and public health effects. Pulmonology. 2021;27(2):151-65.
  • 19. Klinkenberg E, Manissero D, Semenza JC, Verver S. Migrant tuberculosis screening in the EU/EEA: yield, coverage and lim-itations. European respiratory journal. 2009;34(5):1180-9.
  • 20. Coker R, Bell A, Pitman R, Zellweger JP, Heldal E, Hayward A, et al. Tuberculosis screening in migrants in selected European countries shows wide disparities. European Respiratory Jour-nal. 2006;27(4):801-7.
  • 21. Hardie RM, Watson JM. Screening migrants at risk of tubercu-losis. BMJ: British Medical Journal. 1993;307(6918):1539.
  • 22. Barnard M, Albert H, Coetzee G, O'Brien R, Bosman ME. Rapid molecular screening for multidrug-resistant tuberculosis in a high-volume public health laboratory in South Africa. Ameri-can journal of respiratory and critical care medicine. 2008;177(7):787-92.
  • 23. Marco MH, Ahmedov S, Castro KG. The global impact of COVID-19 on tuberculosis: a thematic scoping review, 2020–2023. PLOS Global Public Health. 2024;4(7):e0003043.
  • 24. Nalunjogi J, Mucching-Toscano S, Sibomana JP, Centis R, D'Ambrosio L, Alffenaar J-W, et al. Impact of COVID-19 on di-agnosis of tuberculosis, multidrug-resistant tuberculosis, and on mortality in 11 countries in Europe, Northern America, and Australia. A Global Tuberculosis Network study. Int J In-fect Dis. 2023;130 Suppl 1:S25-S29.

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

Yıl 2025, Cilt: 22 Sayı: 3, 562 - 566, 29.09.2025
https://doi.org/10.35440/hutfd.1755437

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.

Etik Beyan

HRÜ/24.15.39

Destekleyen Kurum

HARRAN UNİVERSİTESİ

Kaynakça

  • 1. World Health Organization. Fourth WHO consultation on the translation of tuberculosis research into global policy guide-lines: meeting report, 15 February 2024. World Health Organ-ization, 2024.
  • 2. Afsar I, Gunes M, Er H, Sener AG. Comparison of culture, microscopic smear and molecular methods in diagnosis of tu-berculosis. Revista espanola de quimioterapia. 2018;31(5):435
  • 3. Riello FN, Brígido RTS, Araújo S, Moreira TA, Goulart LR, Gou-lart IMB. Diagnosis of mycobacterial infections based on acid-fast bacilli test and bacterial growth time and implications on treatment and disease outcome. BMC Infectious Diseases. 2016;16:1-10.
  • 4. Wang W-H, Takeuchi R, Jain S-H, Jiang Y-H, Watanuki S, Ohtaki Y, et al. A novel, rapid (within hours) culture-free diagnostic method for detecting live Mycobacterium tuberculosis with high sensitivity. EBioMedicine. 2020;60.
  • 5. Dong B, He Z, Li Y, Xu X, Wang C, Zeng J. Improved conven-tional and new approaches in the diagnosis of tuberculosis. Frontiers in Microbiology. 2022;13:924410.
  • 6. Abdulmajed O, Koç AN, Gültekin A, Atalay MA, Kılıç H. Klinik örneklerden mikobakteri türlerinin izolasyonunda klasik tani yöntemlerin karşilaştirilmasi ve primerantitüberküloz ilaçlara duyarliliklarinin belirlenmesi. Sağlık Bilimleri Dergisi. 2012;21(2):127-35.
  • 7. Alp A. Tüberkülozun laboratuvar tanısında güncel durum. Hacet Tıp Derg. 2011;42:28-33.
  • 8. Wei Z, Zhang X, Wei C, Yao L, Li Y, Zhang X, et al. Diagnostic accuracy of in-house real-time PCR assay for Mycobacterium tuberculosis: a systematic review and meta-analysis. BMC in-fectious diseases. 2019;19:1-11.
  • 9. Boldi M-O, Denis-Lessard J, Neziri R, Brouillet R, von-Garnier C, Chavez V, et al. Performance of microbiological tests for tuberculosis diagnostic according to the type of respiratory specimen: A 10-year retrospective study. Frontiers in Cellular and Infection Microbiology. 2023;13:1131241.
  • 10. Nolte FS, Metchock B, McGowan Jr JE, Edwards A, Okwumabua O, Thurmond C, et al. Direct detection of Mycobacterium tu-berculosis in sputum by polymerase chain reaction and DNA hybridization. Journal of clinical microbiology. 1993;31(7):1777-82.
  • 11. Kocagöz T, Yilmaz E, Ozkara S, Kocagöz S, Hayran M, Sachedeva M, et al. Detection of Mycobacterium tuberculosis in sputum samples by polymerase chain reaction using a simplified pro-cedure. Journal of clinical microbiology. 1993;31(6):1435-8.
  • 12. Ling DI, Zwerling AA, Pai M. GenoType MTBDR assays for the diagnosis of multidrug-resistant tuberculosis: a meta-analysis. European Respiratory Journal. 2008;32(5):1165-74.
  • 13. Zhuang Y, Wu X, Zhang X, Li G. Detection of Mycobacterium tuberculosis in sputum specimens of pulmonary tuberculosis by DNA amplification. Wei Sheng wu xue bao= Acta Microbio-logica Sinica. 1992;32(5):364-9.
  • 14. Chin DP, Yajko DM, Hadley WK, Sanders CA, Nassos PS, Madej JJ, et al. Clinical utility of a commercial test based on the polymerase chain reaction for detecting Mycobacterium tu-berculosis in respiratory specimens. American journal of res-piratory and critical care medicine. 1995;151(6):1872-7.
  • 15. Cheng VC-C, Yew WW, Yuen KY. Molecular diagnostics in tuberculosis. European Journal of Clinical Microbiology and Infectious Diseases. 2005;24:711-20.
  • 16. Greco S, Girardi E, Navarra A, Saltini C. Current evidence on diagnostic accuracy of commercially based nucleic acid ampli-fication tests for the diagnosis of pulmonary tuberculosis. Thorax. 2006;61(9):783-90.
  • 17. Cho SM, Shin S, Kim Y, Song W, Hong SG, Jeong SH, et al. A novel approach for tuberculosis diagnosis using exosomal DNA and droplet digital PCR. Clinical Microbiology and Infection. 2020;26(7):942-e1.
  • 18. Visca D, Ong CWM, Tiberi S, Centis R, D’ambrosio L, Chen B, et al. Tuberculosis and COVID-19 interaction: a review of bio-logical, clinical and public health effects. Pulmonology. 2021;27(2):151-65.
  • 19. Klinkenberg E, Manissero D, Semenza JC, Verver S. Migrant tuberculosis screening in the EU/EEA: yield, coverage and lim-itations. European respiratory journal. 2009;34(5):1180-9.
  • 20. Coker R, Bell A, Pitman R, Zellweger JP, Heldal E, Hayward A, et al. Tuberculosis screening in migrants in selected European countries shows wide disparities. European Respiratory Jour-nal. 2006;27(4):801-7.
  • 21. Hardie RM, Watson JM. Screening migrants at risk of tubercu-losis. BMJ: British Medical Journal. 1993;307(6918):1539.
  • 22. Barnard M, Albert H, Coetzee G, O'Brien R, Bosman ME. Rapid molecular screening for multidrug-resistant tuberculosis in a high-volume public health laboratory in South Africa. Ameri-can journal of respiratory and critical care medicine. 2008;177(7):787-92.
  • 23. Marco MH, Ahmedov S, Castro KG. The global impact of COVID-19 on tuberculosis: a thematic scoping review, 2020–2023. PLOS Global Public Health. 2024;4(7):e0003043.
  • 24. Nalunjogi J, Mucching-Toscano S, Sibomana JP, Centis R, D'Ambrosio L, Alffenaar J-W, et al. Impact of COVID-19 on di-agnosis of tuberculosis, multidrug-resistant tuberculosis, and on mortality in 11 countries in Europe, Northern America, and Australia. A Global Tuberculosis Network study. Int J In-fect Dis. 2023;130 Suppl 1:S25-S29.
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Göğüs Hastalıkları, Klinik Mikrobiyoloji
Bölüm Araştırma Makalesi
Yazarlar

Hamdiye Turan 0000-0002-5959-542X

Erken Görünüm Tarihi 12 Eylül 2025
Yayımlanma Tarihi 29 Eylül 2025
Gönderilme Tarihi 1 Ağustos 2025
Kabul Tarihi 8 Eylül 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 22 Sayı: 3

Kaynak Göster

Vancouver Turan H. Reliability of PCR Testing Versus Culture Testing in Tuberculosis Diagnosis: A Six-Year Retrospective Study. Harran Üniversitesi Tıp Fakültesi Dergisi. 2025;22(3):562-6.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty