Use of conventional PCR and smear microscopy to diagnose pulmonary tuberculosis in the Amazonian rainforest area.
The diagnostic usefulness of Ziehl-Neelsen (ZN)-stained sputum smears combined with conventional polymerase chain reaction (ZN/PCR) to amplify IS6110 region DNA extracted from ZN slides was evaluated. The objective was to verify if this association could improve tuberculosis (TB) diagnosis in patients at remote sites. The study was carried out in 89 patients with culture-confirmed pulmonary TB as defined by the Brazilian Manual for TB Treatment. The participants were recruited in a reference unit for TB treatment in Rondônia, a state in the Amazonian area in northern Brazil. ZN, PCR, and culture performed in the sputum samples from these patients were analyzed in different combinations (i.e., ZN plus PCR and ZN plus culture). The prevalence rates of pulmonary TB in these patients were 32.6 and 28.1% considering culture and ZN/PCR, respectively. The sensitivity and specificity of ZN/PCR were 86 and 93%, respectively. ZN/PCR was able to detect more TB cases than ZN alone. This method could offer a new approach for accurate tuberculosis diagnosis, especially in remote regions of the world where culture is not available.
Universidade Luterana do Brasil, Canoas, RS, Brasil.
F
F
Carniel
Centro de Desenvolvimento Científico e Tecnológico, Fundação Estadual de Produção e Pesquisa em Saúde, Porto Alegre, RS, Brasil.
E R
ER
Dalla Costa
Universidade Luterana do Brasil, Canoas, RS, Brasil.
G
G
Lima-Bello
Universidade Luterana do Brasil, Canoas, RS, Brasil.
C
C
Martins
Universidade Luterana do Brasil, Canoas, RS, Brasil.
L C
LC
Scherer
Universidade Luterana do Brasil, Canoas, RS, Brasil.
M L
ML
Rossetti
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004269:DNA, Bacterial / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques; D009169:Mycobacterium tuberculosis / Q000235:genetics* / Q000254:growth & development; D016133:Polymerase Chain Reaction / Q000379:methods*; D015995:Prevalence; D065947:Rainforest; D012680:Sensitivity and Specificity; D013183:Sputum / Q000382:microbiology*; D013194:Staining and Labeling / Q000379:methods; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology; D055815:Young Adult
D004269:DNA, Bacterial