Improved diagnostic value of PCR in the diagnosis of female genital tuberculosis leading to infertility.
Histopathological and mycobacteriological examinations have limited utility in the diagnosis of genital tuberculosis. In this double-blind study, 61 samples, consisting of endometrial aspirates (EAs), endometrial biopsies (EBs) and fluid from the pouch of Douglas (POD), from 25 women suffering from infertility were investigated for the presence of the mpt64 gene of Mycobacterium tuberculosis by PCR and correlated with laparoscopic findings. PCR demonstrated M. tuberculosis DNA in 14 out of 25 patients (56.0 %), compared to one smear with acid-fast bacilli (1.6 %) and two culture-positive samples (3.2 %). The presence of M. tuberculosis DNA was observed in 53.3 % of EBs, 47.6 % of EAs and 16.0 % of POD fluid samples. All patients with laparoscopy suggestive of tuberculosis, 60 % of those with a probable diagnosis and 33 % of those with incidental findings were positive by PCR. However, one EA sample from an infertile patient with normal laparoscopy was also positive. Multiple sampling from different sites and amplification of the mpt64 gene segment by PCR offered increased sensitivity in determining tuberculous aetiology in female infertility.
Bhanu
N Vijaya
NV
Departments of Microbiology1 and Gynaecology2, All India Institute of Medical Sciences, New Delhi, India 3Molecular Medicine Branch, NIDDK, National Institutes of Health, Bethesda, MD 20892, USA.
Singh
Urvashi B
UB
Departments of Microbiology1 and Gynaecology2, All India Institute of Medical Sciences, New Delhi, India 3Molecular Medicine Branch, NIDDK, National Institutes of Health, Bethesda, MD 20892, USA.
Chakraborty
Milan
M
Departments of Microbiology1 and Gynaecology2, All India Institute of Medical Sciences, New Delhi, India 3Molecular Medicine Branch, NIDDK, National Institutes of Health, Bethesda, MD 20892, USA.
Suresh
Naga
N
Departments of Microbiology1 and Gynaecology2, All India Institute of Medical Sciences, New Delhi, India 3Molecular Medicine Branch, NIDDK, National Institutes of Health, Bethesda, MD 20892, USA.
Arora
Jyoti
J
Departments of Microbiology1 and Gynaecology2, All India Institute of Medical Sciences, New Delhi, India 3Molecular Medicine Branch, NIDDK, National Institutes of Health, Bethesda, MD 20892, USA.
Rana
Tanu
T
Departments of Microbiology1 and Gynaecology2, All India Institute of Medical Sciences, New Delhi, India 3Molecular Medicine Branch, NIDDK, National Institutes of Health, Bethesda, MD 20892, USA.
Takkar
D
D
Departments of Microbiology1 and Gynaecology2, All India Institute of Medical Sciences, New Delhi, India 3Molecular Medicine Branch, NIDDK, National Institutes of Health, Bethesda, MD 20892, USA.
Seth
Pradeep
P
Departments of Microbiology1 and Gynaecology2, All India Institute of Medical Sciences, New Delhi, India 3Molecular Medicine Branch, NIDDK, National Institutes of Health, Bethesda, MD 20892, USA.
D000328:Adult; D000942:Antigens, Bacterial / Q000235:genetics*; D001426:Bacterial Proteins / Q000235:genetics*; D004269:DNA, Bacterial / Q000032:analysis / Q000235:genetics; D004311:Double-Blind Method; D004312:Douglas' Pouch / Q000382:microbiology; D004717:Endometrium / Q000382:microbiology; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology*; D010535:Laparoscopy; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity; D014384:Tuberculosis, Female Genital / Q000150:complications / Q000175:diagnosis* / Q000473:pathology
D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D004269:DNA, Bacterial; C080865:MPB64 protein, Mycobacterium