The performances of the BDProbeTec ET (Becton Dickinson) and COBAS AMPLICOR MTB (Roche) were retrospectively evaluated for detecting Mycobacterium tuberculosis complex in various respiratory specimens. The BACTEC and MGIT liquid culture system (Becton Dickinson) was used as a reference method. A total of 824 respiratory specimens, comprised of sputa, bronchoalveolar lavage fluid, and bronchial and tracheal aspirates from 580 patients, were evaluated. Out of 824 clinical specimens, 109 specimens from 43 patients were culture positive for M. tuberculosis. Of these 109 specimens, 67 were smear positive, 85 were positive by the COBAS AMPLICOR MTB test, and 94 were positive by the BDProbeTec ET. Of the 715 culture-negative specimens, 17 were positive by the auramine staining, 11 were positive by the COBAS AMPLICOR MTB test, and 12 were positive by the BDProbeTec ET. After discrepancy analysis and review of the patients' clinical data, 130 specimens from 50 patients were considered "true-positive" specimens. This resulted in the following sensitivities: microscopy, 61.5%; COBAS AMPLICOR MTB test, 78.0%; and BDProbeTec ET, 86.2%. The specificities of each system, based on the clinical diagnosis, were 99.7% for microscopy, 99.9% for the COBAS AMPLICOR MTB test, and 99.9% for the BDProbeTec ET. The data presented represent a considerable number of specimens evaluated with a considerable number of culture-and auramine-positive and culturepositive and auramine-negative results and therefore give a realistic view of how the data should be interpreted in a daily routine situation. Specifically, the data with regard to the culture-positive and auramine-negative specimens are useful, because in a routine situation, auramine-negative specimens are sometimes accepted, on clinical indications, to be analyzed by an amplification method.In contrast to general expectations, the incidence of mycobacterial disease has significantly increased worldwide since 1990 (7). The technical developments in diagnosing infections caused by Mycobacterium tuberculosis have increased similarly, an important change being the replacement of traditional solid culture media by liquid media and the introduction of molecular amplification techniques, such as PCR, has decreased the turnaround time even further (1, 22). Many commercial assays are now available; for instance, the COBAS AMPLICOR MTB system (Roche, Basel, Switzerland) uses PCR (4, 27), while the BDProbeTec ET system (14) from Becton Dickinson (Sparks, Md.) uses the "strand displacement amplification" technique for detecting M. tuberculosis (3,5,6,8,11,23,24,26).Amplification techniques have a good sensitivity for smearpositive specimens; however, for smear-negative samples, the reported sensitivity varies considerably (16,17,18,21).The objective of the present study was to compare the sensitivities and specificities of the BDProbeTec ET and the COBAS AMPLICOR MTB properly by evaluating the assays with the same set of processed specimens. Secondly, as the smear-negative specimens influence the ...