Molecular Detection of Mycobacterium tuberculosis: Impact on Patient Care

摘要: Background: Nucleic acid amplification technologies such as PCR are revolutionizing the detection of infectious pathogens tuberculosis (TB). Amplification technology offers potential for diagnosis TB in a few hours with high degree sensitivity and specificity. However, molecular assays neither replace nor reduce need conventional smear culture, speciation, antibiotic assays. Methods: We undertook prospective studies sputum samples to assess performance two PCR-based well impact more rapid availability test results on patient care. Results: The both in-house Amplicor was 100% smear-positive sputa. For smear-negative sputa (two collected during first 24 h hospitalization), 85% our assay 74% Roche assay. Approximately 10% smear- culture-negative yielded positive results; however, than one-half these were assays, suggesting presence DNA or organisms. Several came from patients whose other grew Mycobacterium same admission, others who had previously treated TB. Overall, specificities 86% 93%, respectively. Conclusions: Molecular slow-growing M. have improve clinical care through dramatic reduction time required may provide substantial savings overall cost compared smear, speciation alone, despite fact that must still be performed nontuberculous mycobacteria full assessment sensitivity.