Usefulness of multiplex PCR in the diagnosis of genital tuberculosis in females with infertility.
The purpose of this investigation was to evaluate the usefulness of multiplex polymerase chain reaction (m-PCR) in detecting uterine tuberculosis in women with infertility. In a prospective study, endometrial curetting from 620 females with infertility were investigated using laparoscopy, hysteroscopy, histopathology, smear microscopy, mycobacterial culture in BACTEC MGIT™ 960, and in-house m-PCR. The mean age of the women was 29.75 ± 4.66 years. The majority (596) sought medical attention for infertility; of them, 455 (76.34 %) presented with primary and 141 (23.65 %) with secondary infertility. A total of 158 (25.48 %) women were diagnosed as having uterine tuberculosis by at least one of the diagnostic methods. Among them, laparoscopy was positive in 46 (29.11 %), hysteroscopy in 77 (48.73 %), histopathology in only 8 (5.06 %), smear for acid fast bacilli in 4 (2.53 %), and liquid culture in 24 (15.18 %) patients. The in-house m-PCR was positive in 135 (85.44 %) women. Of these, 129 (95.55 %) samples were positive for Mycobacterium tuberculosis, while 6 (4.44 %) were positive for non-tuberculous mycobacterial DNA. Of the 129 M. tuberculosis PCR-positive women, 112 received anti-tubercular treatment and 23 of these conceived and fell pregnant after the completion of treatment. For the diagnosis of uterine tuberculosis, m-PCR was found to be the most efficient diagnostic tool compared to the other methods.
Clinical Microbiology Division, Department of Laboratory Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi 110 029, India.
M M
MM
Sankar
P
P
Kumar
A
A
Munawwar
M
M
Kumar
J
J
Singh
A
A
Singh
D
D
Parashar
N
N
Malhotra
S
S
Duttagupta
S
S
Singh
D000328:Adult; D001431:Bacteriological Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007246:Infertility / Q000209:etiology*; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D060885:Multiplex Polymerase Chain Reaction / Q000379:methods*; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification*; D009170:Nontuberculous Mycobacteria / Q000235:genetics / Q000302:isolation & purification*; D011446:Prospective Studies; D014384:Tuberculosis, Female Genital / Q000175:diagnosis*; D055815:Young Adult