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Vol. 16. Issue 3.
La Mucoviscidose
Pages 242-249 (May - June 2012)
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Vol. 16. Issue 3.
La Mucoviscidose
Pages 242-249 (May - June 2012)
Open Access
Effectiveness of the BDProbeTec ET system for detection of Mycobacterium tuberculosis complex in sputum and bronchoalveolar lavage specimens
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Hung-Chang Hunga,b,c, Chi-Ho Chanb,d, Shih-Ming Tsaoa,b,e,f, Shiuan-Chih Chena,b,g, Tzu-Chin Wua,b,e, Min-Chi Lua,b,f, Der-Jinn Wua,b,h, Shu-Ju Huanga,b,f, Yuan-Ti Leea,b,f,
Corresponding author
leey521@yahoo.com.tw

Corresponding author at: Division of Infectious Diseases, Department of Internal Medicine, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan.
a Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
b Faculty of Medicine, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
c Potz Hospital, Department of Health, Executive Yuan, Chiayi, Taiwan
d Department of Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan
e Division of Chest, Department of Internal Medicine, Chung Shan Medical University, Taichung, Taiwan
f Division of Infectious Diseases, Department of Internal Medicine, Chung Shan Medical University, Taichung, Taiwan
g Department of Family and Community Medicine, Chung Shan Medical University, Taichung, Taiwan
h Division of Cardiology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
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Abstract
Objective

The diagnostic efficacy of the BDProbeTEC ET Mycobacterium tuberculosis (MTB) complex direct detection assay (DTB) performed on bronchoalveolar lavage (BAL) specimens and sputum smears was compared with acid-fast bacilli (AFB) smear microscopy.

Method

AFB smear microscopy, DTB and culture results of 286 patients with pulmonary tuberculosis were retrospectively reviewed. A total of 120 patients provided expectorated sputum samples, and 166 patients provided BAL specimens. Culture results and clinical diagnosis were used as gold standards.

Results

The sensitivity and specificity of the DTB assay in detecting MTB in sputum specimens was significantly higher compared to AFB smear microscopy (83.7% and 82.4%, vs. 75.6%, and 41.2%, respectively). The sensitivity and specificity of the DTB assay in detecting MTB in sputum samples was 77.2% and 100% compared to clinical diagnosis, while AFB smear had a sensitivity and specificity of 70.3% and 26.3%, respectively. Compared to culture, DTB had a sensitivity and specificity of 82.8% and 93.2%, respectively, in detecting MTB from BAL specimens; AFB smear had a sensitivity and specificity of 41.9% and 87.7%, respectively. Compared to clinical diagnosis, DTB had a sensitivity and specificity of 67.2% and 100%, respectively, in detecting MTB from BAL specimens; AFB smear had a sensitivity and specificity of 34.8% and 79.5%, respectively.

Conclusions

The superior performance of the DTB assay relative to AFB smear microscopy makes it a valuable tool to enable early diagnosis of MTB, thereby improving patient care and reducing transmission.

Keywords:
Bronchoalveolar lavage
Mycobacterium tuberculosis
Acid-fast bacilli staining
Molecular diagnosis
BDProbeTEC ET system
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References
[1.]
World Health Organization. Tuberculosis. 2005. [cited 12 Abr 2011]. Available from: http://www.who.int/tb/publications/global_report/2009/update/a-1_full.pdf.
[2.]
Department of Health, Executive Yuan, Taiwan. Health Statistics in Taiwan. 2006. [cited 21 May 2011]. Available from: http://www.dohv.tw/EN2006/DM/DM2_p01.aspx?class_ no=390&now_fod_list_no=9377≤vel_no=2docno=67745.
[3.]
Bureau for Chronic Disease Control.
Tuberculosis Annual Report (Taiwan) 2001.
Taipei, Bureau for Chronic Disease Control, (2002),
[4.]
S.H. Tseng, D.D. Jiang, H.S. Hoi, S.L. Yang, K.P. Hwang.
Impact of HAART therapy on co-infection of tuberculosis and HIV cases for 9 years in Taiwan.
Am J Trop Med Hyg, 80 (2009), pp. 675-677
[5.]
J.P. Chern, D.R. Chen, T.H. Wen.
Delayed treatment of diagnosed pulmonary tuberculosis in Taiwan.
BMC Public Health, 8 (2008), pp. 236
[6.]
H.P. Lin, C.Y. Deng, P. Chou.
Diagnosis and treatment delay among pulmonary tuberculosis patients identified using the Taiwan reporting enquiry system, 2002–2006.
BMC Public Health, 9 (2009), pp. 55
[7.]
J. Glassroth.
Clinical considerations in designing trials of vaccines for tuberculosis.
Clin Infect Dis., 30 (2000), pp. S229-S232
[8.]
A Clinician's guide to tuberculosis, 1st,
[9.]
T.S. Huang, W.K. Huang, S.S. Lee, H.Z. Tu, S.H. Chang, Y.C. Liu.
Rapid detection of pulmonary tuberculosis using the BDProbeTEC ET Mycobacterium tuberculosis complex direct detection assay (DTB).
Diagn Microbiol Infect Dis, 46 (2003), pp. 29-33
[10.]
D. Watrelot-Virieux, E. Drevon-Gaillot, Y. Toussaint, P. Belli.
Comparison of three diagnostic detection methods for tuberculosis in French cattle.
J Vet Med B Infect Dis Vet Public Health, 53 (2006), pp. 321-325
[11.]
Y.M.K. Kobashi, M. Fukuda, K. Yoshida, M. Oka.
The usefulness of bronchoscopy for the diagnosis of pulmonary tuberculosis.
J Bronchol, 14 (2007), pp. 4
[12.]
A. Tamura, M. Shimada, Y. Matsui, et al.
The value of fiberoptic bronchoscopy in culture-positive pulmonary tuberculosis patients whose pre-bronchoscopic sputum specimens were negative both for smear and PCR analyses.
Intern Med., 49 (2010), pp. 95-102
[13.]
J.S. Bergmann, G.L. Woods.
Clinical evaluation of the BDProbeTec strand displacement amplification assay for rapid diagnosis of tuberculosis.
J Clin Microbiol, 36 (1998), pp. 2766-2768
[14.]
J.S. Bergmann, W.E. Keating, G.L. Woods.
Clinical evaluation of the BDProbeTec ET system for rapid detection of Mycobacterium tuberculosis.
J Clin Microbiol, 38 (2000), pp. 863-865
[15.]
I.S. Johansen, V.O. Thomsen, A. Johansen, P. Andersen, B. Lundgren.
Evaluation of a new commercial assay for diagnosis of pulmonary and nonpulmonary tuberculosis.
Eur J Clin Microbiol Infect Dis, 21 (2002), pp. 455-460
[16.]
C.E. O'Sullivan, D.R. Miller, P.S. Schneider, G.D. Roberts.
Evaluation of Gen-Probe amplified mycobacterium tuberculosis direct test by using respiratory and nonrespiratory specimens in a tertiary care center laboratory.
J Clin Microbiol, 40 (2002), pp. 1723-1727
[17.]
C. Piersimoni, C. Scarparo, P. Piccoli, et al.
Performance assessment of two commercial amplification assays for direct detection of Mycobacterium tuberculosis complex from respiratory and extrapulmonary specimens.
J Clin Microbiol, 40 (2002), pp. 4138-4142
[18.]
J.Y. Wang, L.N. Lee, C.S. Chou, et al.
Performance assessment of a nested-PCR assay (the RAPID BAP-MTB) and the BD ProbeTec ET system for detection of Mycobacterium tuberculosis in clinical specimens.
J Clin Microbiol, 42 (2004), pp. 4599-4603
[19.]
G. Mazzarelli, L. Rindi, P. Piccoli, C. Scarparo, C. Garzelli, E. Tortoli.
Evaluation of the BDProbeTec ET system for direct detection of Mycobacterium tuberculosis in pulmonary and extrapulmonary samples: a multicenter study.
J Clin Microbiol, 41 (2003), pp. 1779-1782
[20.]
J.Y. Wang, L.N. Lee, H.L. Hsu, P.R. Hsueh, K.T. Luh.
Performance assessment of the DR, MTBC Screen assay and the BD ProbeTec ET system for direct detection of Mycobacterium tuberculosis in respiratory specimens.
J Clin Microbiol, 44 (2006), pp. 716-719
[21.]
Taiwan Guidelines for TB Diagnosis and Treatment.
Department of Health ROC.
Centers for Disease Control, (2008),
[22.]
E. Hidaka, T. Honda, I. Ueno, Y. Yamasaki, K. Kubo, T. Katsuyama.
Sensitive identification of mycobacterial species using PCR-RFLP on bronchial washings.
Am J Respir Crit Care Med, 161 (2000), pp. 930-934
[23.]
C.C. Boehme, P. Nabeta, D. Hillemann, et al.
Rapid molecular detection of tuberculosis and rifampin resistance.
N Engl J Med, 363 (2010), pp. 1005-1015
[24.]
A.K. Croker, D. Goodale, J. Chu, et al.
High aldehyde dehydrogenase and expression of cancer stem cell markers selects for breast cancer cells with enhanced malignant and metastatic ability.
J Cell Mol Med, 13 (2009), pp. 2236-2252
[25.]
P.R. Hsueh, Y.C. Liu, J. So, C.Y. Liu, P.C. Yang, K.T. Luh.
Mycobacterium tuberculosis in Taiwan.
J Infect, 52 (2006), pp. 77-85
[26.]
Y. Iinuma, K. Senda, N. Fujihara, et al.
Comparison of the BDProbeTec ET system with the Cobas Amplicor PCR for direct detection of Mycobacterium tuberculosis in respiratory samples.
Eur J Clin Microbiol Infect Dis, 22 (2003), pp. 368-371
[27.]
Clinical microbiology procedures handbook,
[28.]
K.L. Kaul.
Molecular detection of Mycobacterium tuberculosis: impact on patient care.
Clin Chem, 47 (2001), pp. 1553-1558
[29.]
P.T. Kent, G.P. Kubica.
Public health mycobacteriology: a guide for the level III laboratory.
Department of Health and Human Services, Center for Disease Control, (1985),
[30.]
Mycobacterium, 7th rev.,
[31.]
G.E. Pfyffer, P. Funke-Kissling, E. Rundler, R. Weber.
Performance characteristics of the BDProbeTec system for direct detection of Mycobacterium tuberculosis complex in respiratory specimens.
J Clin Microbiol, 37 (1999), pp. 137-140
[32.]
M.A. Behr, S.A. Warren, H. Salamon, et al.
Transmission of Mycobacterium tuberculosis from patients smear-negative for acid-fast bacilli.
Lancet, 353 (1999), pp. 444-449
[33.]
Update: nucleic acid amplification tests for tuberculosis. MMWR Morb Mortal Wkly Rep.: Centers for Disease Control and Prevention; 2008. pp. 593–4.
[34.]
H.S. Chan, A.J. Sun, G.B. Hoheisel.
Bronchoscopic aspiration and bronchoalveolar lavage in the diagnosis of sputum smear-negative pulmonary tuberculosis.
Lung, 168 (1990), pp. 215-220
[35.]
O.D. Schoch, P. Rieder, C. Tueller, et al.
Diagnostic yield of sputum, induced sputum, and bronchoscopy after radiologic tuberculosis screening.
Am J Respir Crit Care Med, 175 (2007), pp. 80-86
[36.]
M. Brown, H. Varia, P. Bassett, R.N. Davidson, R. Wall, G. Pasvol.
Prospective study of sputum induction, gastric washing, and bronchoalveolar lavage for the diagnosis of pulmonary tuberculosis in patients who are unable to expectorate.
Clin Infect Dis, 44 (2007), pp. 1415-1420
[37.]
A. Mohan, S.K. Sharma.
Fibreoptic bronchoscopy in the diagnosis of sputum smear-negative pulmonary tuberculosis: current status.
Indian J Chest Dis Allied Sci, 50 (2008), pp. 67-78
[38.]
C.K. Liam, Y.C. Chen, S.F. Yap, P. Srinivas, P.J. Poi.
Detection of Mycobacterium tuberculosis in bronchoalveolar lavage from patients with sputum smear-negative pulmonary tuberculosis using a polymerase chain reaction assay.
Respirology, 3 (1998), pp. 125-129
[39.]
I. Jesús de la Calle, M.A. Jesús de la Calle, M. Rodríguez-Iglesias.
Evaluation of the BDProbeTec ET system as screening tool in the direct detection of Mycobacterium tuberculosis complex in respiratory specimens.
Diagn Microbiol Infect Dis, 47 (2003), pp. 573-578
[40.]
A.O. Kehinde, A. Baba, R.A. Bakare, O.M. Ige, C.F. Gbadeyanka, A.O. Salako.
Risk factors for pulmonary tuberculosis among health-care workers in Ibadan.
Nigeria. Afr J Med Med Sci, 39 (2010), pp. 105-112
[41.]
S. Baboolal, D. Ramoutar, P.E. Akpaka.
Comparison of the QuantiFERON(R)-TB Gold assay and tuberculin skin test to detect latent tuberculosis infection among target groups in Trinidad & Tobago.
Rev Panam Salud Publica, 28 (2010), pp. 36-42
[42.]
S. Deuffic-Burban, K. Atsou, N. Viget, H. Melliez, E. Bouvet, Y. Yazdanpanah.
Cost-effectiveness of QuantiFERON-TB test vs. tuberculin skin test in the diagnosis of latent tuberculosis infection.
Int J Tuberc Lung Dis, 14 (2010), pp. 471-481
[43.]
D. Helb, M. Jones, E. Story, et al.
Rapid detection of Mycobacterium tuberculosis and rifampin resistance by use of on-demand, near-patient technology.
J Clin Microbiol, 48 (2010), pp. 229-237
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