title: Clinical value of whole-blood interferon-gamma assay in patients with suspected pulmonary tuberculosis and AFB smear- and polymerase chain reaction-negative bronchial aspirates.
abstract: Combining a polymerase chain reaction (PCR) test with bronchoscopy is frequently performed to allow a rapid diagnosis of smear-negative pulmonary tuberculosis (PTB). However, limited data are available concerning clinical judgment in patients with suspected PTB and AFB smear- and PCR-negative bronchial aspirates (BA). The present study evaluated the usefulness of whole-blood QuantiFERON-TB Gold In-Tube (QFT) testing in these patients. Of 166 patients with suspected PTB who had undergone bronchoscopy because of smear-negative sputum or inadequate sputum production, 93 (56%) were diagnosed with culture-positive PTB. Seventy-four patients were either AFB smear- or PCR-positive. In the 75 patients whose BA AFB smear and PCR results were both negative, 19 were finally diagnosed with PTB by culture. The QFT test had a negative predictive value of 91% for PTB. The QFT test may be useful for excluding PTB in patients with suspected PTB whose BA AFB smear and PCR results are both negative.
authors.affiliation: Department of Internal Medicine, Kyungpook National University, School of Medicine, Daegu, Republic of Korea.
authors.forename: Jaehee
authors.initials: J
authors.lastname: Lee
authors.forename: Shin Yup
authors.initials: SY
authors.lastname: Lee
authors.forename: Seung Soo
authors.initials: SS
authors.lastname: Yoo
authors.forename: Seung Ick
authors.initials: SI
authors.lastname: Cha
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Won
authors.forename: Jae Yong
authors.initials: JY
authors.lastname: Park
authors.forename: Won-Kil
authors.initials: WK
authors.lastname: Lee
authors.forename: Chang Ho
authors.initials: CH
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001431:Bacteriological Techniques / Q000379:methods*; D001769:Blood / Q000276:immunology*; D001980:Bronchi / Q000382:microbiology; D005122:Exudates and Transudates / Q000382:microbiology; D005260:Female; D006801:Humans; D059425:Interferon-gamma Release Tests / Q000379:methods*; D008297:Male; D008853:Microscopy / Q000379:methods; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013183:Sputum / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis*; D055815:Young Adult