Diagnosis of Tuberculosis by Conventional and Molecular Methods in Our Laboratory: A 4-Year Assessment

Öz

Objective: The aim of this study was to compare direct microscopy, culture and Polymerase Chain Reaction (PCR) methods and to present the antibiotic resistance profile of the last 4 years comparatively by conventional and molecular methods. Material and Method: Bacterial culture, EZN and PCR methods were applied to all samples. Direct rapid resistance test was performed for EZN positive samples. Results: 968 patients were included in the study. Culture was positive in 81 (8%), PCR in 78 (8%) and EZN in 39 (46%) patients. PCR performed on the same day in both respiratory and other samples showed very good agreement with culture, while EZN staining showed moderate agreement. It was observed that the rapid resistance test detected rifampicin resistance which was not detected in culture, and in the case of INH, culture antibiogram and rapid resistance test were fully compatible. Application of the rapid resistance test to every patient with positive EZN staining resulted in very early detection of resistance. Conclusion: It was concluded that PCR tests are useful in the rapid diagnosis of tuberculosis and resistance in suspicious clinical samples.

Anahtar Kelimeler

• Mycobacterium tuberculosis
• Polymerase chain reaction
• Rapid diagnosis
• Rapid resistance test

Laboratuvarımızda Konvansi̇yonel ve Moleküler Yöntemlerle Tüberküloz Tanısı: 4 Yıllık Bir Değerlendirme

Öz

Amaç: Bu çalışmanın amacı, tüberküloz tanısında direkt mikroskopi, kültür ve Polimeraz Zincir Reaksiyonu (PCR) yöntemlerini karşılaştırmak ve son 4 yılın antibiyotik direnç profilini konvansiyonel ve moleküler yöntemlerle karşılaştırmalı olarak sunmaktır. Gereç ve Yöntemler: Tüm örneklere Ehrlich-Ziehl-Neelsen (EZN) boyama, Mycobacterium kültürü ve PCR testleri yapıldı. EZN boyama ile aside dirençli basil (ARB) saptanan örneklere direkt hızlı direnç testi yapıldı. Bulgular: Çalışmaya 968 örnek dahil edildi. Bunların 81’inde (%8) kültür, 78’inde (%8) PCR ve 39’unda (%46) EZN pozitif bulundu. Hem solunum hem de diğer örneklerde aynı gün yapılan PCR kültür ile çok iyi uyum gösterirken, EZN boyaması orta düzeyde uyum gösterdi. Hızlı direnç testinin kültürde saptanmayan rifampisin direncini saptadığı, INH durumunda ise kültür antibiyogramı ile hızlı direnç testinin tam uyumlu olduğu görülmüştür. Hızlı direnç testinin EZN boyaması pozitif olan her hastaya uygulanması, direncin çok erken tespit edilmesini sağlamıştır. Sonuç: Şüpheli klinik örneklerde tüberküloz ve direncin hızlı tanısında PCR testlerinin yararlı olduğu sonucuna varılmıştır.

Anahtar Kelimeler

• Mycobacterium tuberculosis
• Polimeraz zincir reaksiyon
• Hızlı teşhis
• Hızlı direnç testi

Kaynakça

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