Polymerase Chain Reaction of Pleural Biopsy Is a Rapid and Sensitive Method for the Diagnosis of Tuberculous Pleural Effusion

Hasaneen, Nadia A.; Zaki, Magdi E. A.; Shalaby, Hala M.; El-Morsi, Ahmad S.

doi:10.1378/chest.124.6.2105

Cited by 57 publications

(42 citation statements)

References 25 publications

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“…An Egyptian study recommended PCR of pleural biopsy specimens as a rapid diagnostic test, finding that PCR when applied to pleural biopsy specimens in tuberculous pleurisy reached a sensitivity of 90%, specificity of 100% and a negative predictive value of 86.6%. In this study the diagnostic accuracy of PCR was similar to that to culture of closed needle biopsy samples [46].…”

Section: The Role Of Pcr In the Diagnosis Of Tuberculous Pleural Diseasesupporting

confidence: 69%

Pleural tuberculosis

Chakrabarti

Davies

2016

Monaldi Arch Chest Dis

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Pleural effusions in tuberculosis are commonly seen in young adults as an immunological phenomenon occurring soon after primary infection. However, the epidemiology and demographics of tuberculous pleurisy are changing due to the impact of HIV co-infection and the increasing number of pleural effusions seen as part of re-activation disease. Pleural biopsy for histology and culture is the mainstay of diagnosis with closed needle biopsy adequate in the majority of cases. Techniques such as PCR of biopsy specimens and the role of pleural fluid ADA are still being evaluated as a diagnostic aid. Tuberculous empyema is less commonly seen in the western world and the diagnostic yield from pleural fluid here is greater than in “primary” effusions. Treatment with appropriate antituberculous chemotherapy is generally successful though there is currently insufficient evidence to recommend the routine use of corticosteroids in this condition.

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Section: The Role Of Pcr In the Diagnosis Of Tuberculous Pleural Diseasesupporting

confidence: 69%

Pleural tuberculosis

Chakrabarti

Davies

2016

Monaldi Arch Chest Dis

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“…Among the patients enrolled in the study 28(46.6%) were males and 32 (54.4%) were females, those results agree with similar reports noting a higher female to male ration (Fader et al, 2010;Noertjojo et al, 2002;Forssbohm et al, 2008) with an age range 25-80 years with the mean + SD 49.23+12.6, these results were confirming those of previous studies reporting approximately similar means of ages for patients presenting with pleural effusion (Hasaneen et al, 2003).…”

Section: Resultssupporting

confidence: 91%

Rapid Detection of Mycobacteria using automated Detection/ Incubation System in Exudative Pleural Effusion in Alexandria Main University Hospital

Shaaban¹,

Hanafi²

2017

Int.J.Curr.Microbiol.App.Sci

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“…A recent study showed the high sensitivity of over 97% and specificity of the Xpert assay for pulmonary specimens (2). Numerous studies have assessed the yield of PCR techniques for the diagnosis of extrapulmonary tuberculosis (3,10,13). Nevertheless, this is the first study to verify the usefulness of application of the Xpert assay to the rapid diagnosis of extrapulmonary tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

Rapid Molecular Detection of Extrapulmonary Tuberculosis by the Automated GeneXpert MTB/RIF System

et al. 2011

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Twenty (3.8%) of the 521 specimens gave no interpretable result. Whereas the sensitivity of the Xpert assay with tissue specimens was 69.0% (20 out of 29 culture-positive cases detected), 100% sensitivity was found with the urine and stool specimens. The combined sensitivity and specificity of the Xpert assay were calculated to be 77.3% and 98.2%, respectively.With an estimated 9 million new cases and 2 million deaths every year, tuberculosis (TB) remains a leading public health problem worldwide (6). In the majority of cases, the disease affects the lungs, but there are also not negligible numbers of cases (about 15%) with extrapulmonary involvement in lowincidence countries. There are even higher rates in high-incidence countries. HIV-coinfected TB patients often develop extrapulmonary involvement and may progress rapidly unless the infection is diagnosed and they are treated appropriately (8).Extrapulmonary infection with members of the Mycobacterium tuberculosis complex (MTBC) remains a diagnosis that is often difficult to establish, since the number of bacteria in extrapulmonary specimens is often lower than the number in pulmonary specimens. Furthermore, collection of extrapulmonary material often requires invasive procedures, and it is not easy to obtain additional samples. In recent times, attention has been devoted to new nucleic acid amplification diagnostic technologies, owing to their rapidity, sensitivity, and specificity.One of the latest systems, the GeneXpert MTB/RIF (Xpert) assay, was evaluated only recently in a large study with pulmonary specimens. The Xpert assay uses heminested real-time PCR to amplify an M. tuberculosis-specific sequence of the rpoB gene. To determine rifampin (RMP) resistance, the rifampin resistance-determining region of the rpoB gene is probed with molecular beacons (7). The assay can be carried out in a nearly fully automated manner, including bacterial lysis, nucleic acid extraction and amplification, and amplicon detection. The test runs on the GeneXpert platform (Cepheid, Sunnyvale, CA) using a disposable plastic cartridge with all required reagents (16).It could be shown that the Xpert assay detected pulmonary TB in all TB patients, including over 90% of smear-negative patients, with a high sensitivity of over 97% (2). The purpose of this study was to test the efficiency and reliability of the Xpert system for the detection of M. tuberculosis bacteria in extrapulmonary specimens and to compare it to conventional culture methods. MATERIALS AND METHODSSpecimens. All nonrespiratory specimens that were submitted to the German National Reference Laboratory for Mycobacteria (NRL) from May 2009 to August 2010 were included in the study. The specimens originated from patients with suspected M. tuberculosis or nontuberculous mycobacterial (NTM) infection on the basis of clinical criteria or to rule out these infections. Consecutive specimens were used, and specimens were not selected by the use of special criteria. In total, 521 specimens were tested. These comprised 91 urin...

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Polymerase Chain Reaction of Pleural Biopsy Is a Rapid and Sensitive Method for the Diagnosis of Tuberculous Pleural Effusion

Cited by 57 publications

References 25 publications

Pleural tuberculosis

Pleural tuberculosis

Rapid Detection of Mycobacteria using automated Detection/ Incubation System in Exudative Pleural Effusion in Alexandria Main University Hospital

Rapid Molecular Detection of Extrapulmonary Tuberculosis by the Automated GeneXpert MTB/RIF System

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