title: [Bacteriological examination on needle biopsy specimens of cavity and tuberculoma after a short course chemotherapy in initially sputum positive pulmonary tuberculosis patients].
abstract: OBJECTIVE
  To evaluate the therapeutic effect of a short course chemotherapy on initially sputum positive cavitary pulmonary tuberculosis or tuberculoma by bacteriological examination of specimens through percutaneous lung biopsy after the chemotherapy.
  
  
  METHODS
  Eighty-three cases of initially sputum positive pulmonary tuberculosis with cavities or tuberculoma were included from Jan. 2002 and May. 2004. The patients finished a course of chemotherapy (2HREZ/4HR), and the sputum was converted to smear-negative and culture-negative, but cavities or tuberculoma remained on the chest X-ray. Lung specimens were obtained from the wall or content of the cavity or from the tuberculoma by CT-guided percutaneous lung biopsy for bacteriological examination within one month after the course.
  
  
  RESULTS
  All the needle biopsy specimens were smeared and cultured for Mycobacterium tuberculosis. Eight cases (8/83, 9.6%) showed positive results: 3 were smear-positive and culture-positive, and 5 smear-negative but culture-positive. Drug susceptibility test showed that 7 of them were drug-sensitive and the remaining 1 was resistant to rifampin and isoniazid. After follow-up of 24 months, 6 of them converted to sputum smear-positive.
  
  
  CONCLUSIONS
  Our study showed that 90.4% (75/83) of the tuberculosis cases achieved real bacteriological negative result on biopsies after a short course chemotherapy, and the bacteriological positive cases on biopsy experienced 75.0% (6/8) sputum bacteriological recurrence. The result suggests that the evaluation criteria with sputum on therapeutic effect of pulmonary tuberculosis needs to be reassessed.
authors.affiliation: Shanghai Public Health Center, Shanghai Public Health Center Affiliated to Fudan University, Shanghai 201508, China.
authors.forename: Shui-hua
authors.initials: SH
authors.lastname: Lu
authors.forename: Ting-ping
authors.initials: TP
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Lü
authors.forename: Rong-hui
authors.initials: RH
authors.lastname: Du
authors.forename: Han-xiang
authors.initials: HX
authors.lastname: Wang
authors.forename: Zi-ran
authors.initials: ZR
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D001431:Bacteriological Techniques; D001707:Biopsy, Needle; D005260:Female; D006801:Humans; D008168:Lung / Q000382:microbiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D013183:Sputum / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000382:microbiology*; D055815:Young Adult