Tuberc Respir Dis.
1998 Jun;45(3):519-528. 10.4046/trd.1998.45.3.519.
The Clinical Utility of Polymerase Chain Reaction in the Bronchoalveolar Lavage Fluid for the Detection of Mycobacteria
- Affiliations
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- 1Department of Internal Medicine, College of Medicine, Hallym University, Chuncheon, Korea.
- 2Department of Clinical Pathology, College of Medicine, Hallym University, Chuncheon, Korea.
- KMID: 1969827
- DOI: http://doi.org/10.4046/trd.1998.45.3.519
Abstract
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BACKGROUND: Diagnosis of pulmonary tuberculosis is not easy when the sputum smear for Mycobacterium tuberculosis(M. Tb) is negative. We evaluated the clinical utility of polymerase chain reaction(PCR) for detecting M. Tb in bronchoalveolar lavage(BAL) samples.
METHODS
We recruited 84 patients whose sputum smear for M. Th were negative or not available due to no production of sputum. We performed bronchoalveolar lavage for acid-fast stain, culture of mycobacteria, and PCR assay of BAL fluid. We analyzed the results of microbiologic examination.
RESULTS
The sensitivity of BAL fluid smear, culture, and PCR were 20%, 38%, and 40%, respectively. The specificity of BAL fluid PCR was 95%. The positive predictive value of PCR was 89%. The smear of BAL fluid was positive in 17%. The PCR of BAL fluid was the only diagnostic test in 17%. Therefore, the BAL fluid analysis including smear and PCR was diagnostic in 34% within 24 hours. The BAL fluid analysis including smear, PCR, and culture was diagnostic in 55% within 2 month.
CONCLUSION
The BAL fluid PCR was valuable method in the diagnosis of pulmonary tuberculosis in patients whose sputa were not available or reveal negative smear.
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