[Bacteriological examination on needle biopsy specimens of cavity and tuberculoma after a short course chemotherapy in initially sputum positive pulmonary tuberculosis patients].
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.
Lu
Shui-hua
SH
Shanghai Public Health Center, Shanghai Public Health Center Affiliated to Fudan University, Shanghai 201508, China.
Wang
Ting-ping
TP
Lü
Wei
W
Du
Rong-hui
RH
Wang
Han-xiang
HX
Wang
Zi-ran
ZR
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