Use of polymerase chain reaction for improved diagnosis of tuberculosis in children.
OBJECTIVE
To study the value of a rapid diagnostic method based on the amplification by polymerase chain reaction (PCR) of a fragment of the IS6110 insertion element for the detection of Mycobacterium tuberculosis in children.


METHODS
We tested 199 specimens obtained from 68 children referred for evaluation of suspected tuberculosis.


RESULTS
In 83.3% of children with active disease and 38.9% with tuberculous infection but no evidence of disease, at least one positive PCR result was observed. No child without tuberculosis had positive PCR results (100% specificity). The sensitivity of the PCR was increased by testing of multiple samples from the same child and use of Chelex particles (Bio-Rad Laboratories, Ivry, France) rather than guanidine isothiocyanate-silica particles for DNA extraction. Bronchoalveolar lavage samples were no more useful than gastric aspirates.


CONCLUSIONS
If appropriate laboratory methods are used, DNA amplification is a reliable method for the early diagnosis of tuberculosis in children and appears to be very helpful in clinical pediatric practice when the diagnosis of active tuberculosis is difficult or needs to be rapidly confirmed.
Delacourt
C
C
Service de Pneumo-Pédiatrie, Hôpital des Enfants Malades, Paris, France.
Poveda
J D
JD
Chureau
C
C
Beydon
N
N
Mahut
B
B
de Blic
J
J
Scheinmann
P
P
Garrigue
G
G
D000293:Adolescent; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D002411:Cation Exchange Resins; D002614:Chelating Agents; D002648:Child; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000032:analysis* / Q000235:genetics; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D005766:Gastrointestinal Contents / Q000382:microbiology; D005784:Gene Amplification; D006146:Guanidines; D015658:HIV Infections / Q000150:complications; D006801:Humans; D007223:Infant; D017879:Isothiocyanates; D008297:Male; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012117:Resins, Synthetic; D012680:Sensitivity and Specificity; D012822:Silicon Dioxide; D013997:Time Factors; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology
D002411:Cation Exchange Resins; D002614:Chelating Agents; D004269:DNA, Bacterial; D006146:Guanidines; D017879:Isothiocyanates; D012117:Resins, Synthetic; C054435:guanidine isothiocyanate; C024997:Chelex 100; D012822:Silicon Dioxide