Objective:To assess the role of polymerase chain reaction(PCR)in serum sauples,in the diagnosis of osteoarticular tuberculosis(OTB)in a setting where only clinical and imaging diagnoses determine the treatment.Methods...Objective:To assess the role of polymerase chain reaction(PCR)in serum sauples,in the diagnosis of osteoarticular tuberculosis(OTB)in a setting where only clinical and imaging diagnoses determine the treatment.Methods:A total of 44 consecutive serum specimens were collected from clinically suspected OTB patients,based on clinical and radiological[X-ray or magnetic resonance imagng/computecl tomography]features.They were scrcened by in-house nested PCR.In addition,a few specimens were examined by Gram stain,acid-fast bacilli stain,histand routine bacterial culture.A total of 39 specimens were collected from patients suffering from other bone diseases of nontuberculous origin and included as negative controls.Results:of the 44 clinically suspected OTB patients,in-house nested PCR was positive in 40(91%)cases;PCR was negative in 38(97%)negative controls.Sensitivity and specificity of our in—house nested PCR was 90.3%and 97.4%,respectively.The PCR report was available within 48 h.It was possible to standardize serum PCR technique and in positive cases,a good n was observed in terms of an adequate treatment response.Conclusions:Nested PCR in serum samples is a rapid,highly sensitive and specific modality for OTB detection,PCR should be performed in addition to clinical evaluation,imaging studies,acidfast bacilli staining,culture and histopathology diagnosis,if possible.展开更多
【正】Objective:To assess the usefulness of IGRA test(QuantiFERON<sup>?</sup> -Cell mediated immune) compared with the tuberculin skin test.Methods:A cross-sectional study was carried out in Mexico,25 infe...【正】Objective:To assess the usefulness of IGRA test(QuantiFERON<sup>?</sup> -Cell mediated immune) compared with the tuberculin skin test.Methods:A cross-sectional study was carried out in Mexico,25 infected patients with HIV-AIDS and the suspicion or with latent tuberculous infection （LTBI） who were】18 years of age and without treatment for tuberculosis（TB）,were enrolled in the study.Results:Median cluster of differentiation（CD4） count was 364 cells/μL and median HIV viral load was 50 copies/mL.Overall,20 patients（80%） had at least one positive diagnostic test for LTBI:four（16%） had a positive tuberculin skin test and 19（76%）,a positive QuantiFERON <sup>?</sup> -tuberculosis.Conclusions:No agreement is found between the two diagnostic tests:k = -0.004,95%confidence interval（-0.2219,0.2210）.Additional longitudinal studies among HIV-infected populations with high prevalence of TB are needed to further assess the usefulness of IGRAs in this patient population.展开更多
文摘Objective:To assess the role of polymerase chain reaction(PCR)in serum sauples,in the diagnosis of osteoarticular tuberculosis(OTB)in a setting where only clinical and imaging diagnoses determine the treatment.Methods:A total of 44 consecutive serum specimens were collected from clinically suspected OTB patients,based on clinical and radiological[X-ray or magnetic resonance imagng/computecl tomography]features.They were scrcened by in-house nested PCR.In addition,a few specimens were examined by Gram stain,acid-fast bacilli stain,histand routine bacterial culture.A total of 39 specimens were collected from patients suffering from other bone diseases of nontuberculous origin and included as negative controls.Results:of the 44 clinically suspected OTB patients,in-house nested PCR was positive in 40(91%)cases;PCR was negative in 38(97%)negative controls.Sensitivity and specificity of our in—house nested PCR was 90.3%and 97.4%,respectively.The PCR report was available within 48 h.It was possible to standardize serum PCR technique and in positive cases,a good n was observed in terms of an adequate treatment response.Conclusions:Nested PCR in serum samples is a rapid,highly sensitive and specific modality for OTB detection,PCR should be performed in addition to clinical evaluation,imaging studies,acidfast bacilli staining,culture and histopathology diagnosis,if possible.
文摘【正】Objective:To assess the usefulness of IGRA test(QuantiFERON<sup>?</sup> -Cell mediated immune) compared with the tuberculin skin test.Methods:A cross-sectional study was carried out in Mexico,25 infected patients with HIV-AIDS and the suspicion or with latent tuberculous infection （LTBI） who were】18 years of age and without treatment for tuberculosis（TB）,were enrolled in the study.Results:Median cluster of differentiation（CD4） count was 364 cells/μL and median HIV viral load was 50 copies/mL.Overall,20 patients（80%） had at least one positive diagnostic test for LTBI:four（16%） had a positive tuberculin skin test and 19（76%）,a positive QuantiFERON <sup>?</sup> -tuberculosis.Conclusions:No agreement is found between the two diagnostic tests:k = -0.004,95%confidence interval（-0.2219,0.2210）.Additional longitudinal studies among HIV-infected populations with high prevalence of TB are needed to further assess the usefulness of IGRAs in this patient population.
