Sensitivity of PCR targeting Mycobacterium ulcerans by use of fine-needle aspirates for diagnosis of Buruli ulcer.
In a previous study, we reported that the sensitivity of PCR targeting the IS2404 insertion sequence of Mycobacterium ulcerans was 98% when it was applied to 4-mm punch biopsy samples of Buruli lesions. Fine-needle aspiration (FNA) is a less traumatic sampling technique for nonulcerated lesions, and we have studied the sensitivity of PCR using FNA samples. Fine-needle aspirates were taken with a 21-gauge needle from 43 patients diagnosed clinically with M. ulcerans disease. Four-millimeter punch biopsies were obtained for microscopy, culture, and PCR targeting the IS2404 insertion sequence. The sensitivity of PCR using samples obtained by FNA was 86% (95% confidence interval [95% CI], 72 to 94%) compared with that for PCR using punch biopsy samples. In this study, the sensitivities of culture and microscopy for punch biopsy samples were 44% (95% CI, 29 to 60%) and 26% (95% CI, 14 to 41%), respectively. This demonstrates that PCR on an FNA sample is a viable minimally invasive technique to diagnose M. ulcerans lesions.
Phillips
R O
RO
Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Sarfo
F S
FS
Osei-Sarpong
F
F
Boateng
A
A
Tetteh
I
I
Lartey
A
A
Adentwe
E
E
Opare
W
W
Asiedu
K B
KB
Wansbrough-Jones
M
M
D000293:Adolescent; D000328:Adult; D044963:Biopsy, Fine-Needle; D054312:Buruli Ulcer / Q000175:diagnosis*; D002648:Child; D004251:DNA Transposable Elements; D004269:DNA, Bacterial / Q000235:genetics; D005260:Female; D006801:Humans; D008297:Male; D019911:Mycobacterium ulcerans / Q000235:genetics* / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity; D055815:Young Adult
D004251:DNA Transposable Elements; D004269:DNA, Bacterial