title: Rapid Detection of Cell-Free Mycobacterium tuberculosis DNA in Tuberculous Pleural Effusion.
abstract: Tuberculous pleurisy is one of the most common types of extrapulmonary tuberculosis, but its diagnosis remains difficult. In this study, we report for the first time on the detection of cell-freeMycobacterium tuberculosisDNA in pleural effusion and an evaluation of a newly developed molecular assay for the detection of cell-freeMycobacterium tuberculosisDNA. A total of 78 patients with pleural effusion, 60 patients with tuberculous pleurisy, and 18 patients with alternative diseases were included in this study. Mycobacterial culture, the Xpert MTB/RIF assay, the adenosine deaminase assay, the T-SPOT.TB assay, and the cell-freeMycobacterium tuberculosisDNA assay were performed on all the pleural effusion samples. The cell-freeMycobacterium tuberculosisDNA assay and adenosine deaminase assay showed significantly higher sensitivities of 75.0% and 68.3%, respectively, than mycobacterial culture and the Xpert MTB/RIF assay, which had sensitivities of 26.7% and 20.0%, respectively (P< 0.01). All four of these tests showed good specificities: 88.9% for the adenosine deaminase assay and 100% for the remaining three assays. The T-SPOT.TB assay with pleural effusion showed the highest sensitivity of 95.0% but the lowest specificity of 38.9%. The cell-freeMycobacterium tuberculosisDNA assay detected as few as 1.25 copies of IS6110per ml of pleural effusion and showed good accordance of the results between repeated tests (r= 0.978,P= 2.84 × 10-10). These data suggest that the cell-freeMycobacterium tuberculosisDNA assay is a rapid and accurate molecular test which provides direct evidence ofMycobacterium tuberculosisetiology.
authors.affiliation: Department of Pathology, Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, Beijing, China cheny0448@163.com chenxy1998@hotmail.com.
authors.forename: Nanying
authors.initials: N
authors.lastname: Che
authors.affiliation: Department of Tuberculosis, Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, Beijing, China.
authors.forename: Xinting
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of Pathology, Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, Beijing, China.
authors.forename: Zichen
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Pathology, Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, Beijing, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Li
authors.affiliation: Department of Tuberculosis, Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, Beijing, China cheny0448@163.com chenxy1998@hotmail.com.
authors.forename: Xiaoyou
authors.identifier: 0000-0003-4179-1737
authors.initials: X
authors.lastname: Chen
mesh_terms: D000243:Adenosine Deaminase / Q000032:analysis; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004269:DNA, Bacterial / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000235:genetics*; D010996:Pleural Effusion / Q000235:genetics* / Q000382:microbiology; D011446:Prospective Studies; D014396:Tuberculosis, Pleural / Q000175:diagnosis* / Q000382:microbiology; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial; D000243:Adenosine Deaminase
keywords: Mycobacterium tuberculosis; cell-free DNA; pleural effusion