The Diagnostic Value of the Thermostatic Amplification of Ribonucleic Acid in Bronchoalveolar Lavage Fluid in Smear-Negative Pulmonary Tuberculosis

Abstract

ObjectiveThis study aimed to determine the value of the simultaneous amplification and testing for Mycobacterium tuberculosis in bronchoalveolar lavage fluid (BALF) in the diagnosis of smear-negative pulmonary tuberculosis (PTB).MethodsA total of 316 patients were selected, of which 197 had smear-negative PTB (observation group), and 119 did not have TB (control group). Bronchoscopy was performed in both groups, and BALF samples were collected for acid-fast bacilli smears, simultaneous amplification/testing for TB (SAT-TB), and BACTEC MGIT 960 cultures. The sensitivity, specificity, positive predictive, and negative predictive values of SAT-TB in BALF for the diagnosis of negative TB were calculated.ResultsThe sensitivity of SAT-TB detection was 45.18%, which was significantly higher than smears and slightly lower than cultures. The specificity of SAT-TB was 99.16%, which differed slightly from the other two methods. The positive predictive value was 98.89%, which was not significantly different from the other two methods. The negative predictive value of SAT-TB was 58.91%, which was higher than smears and slightly lower than cultures.ConclusionThe very high specificity and negative prediction of SAT-TB in BALF means that the method has great application value for the rapid diagnosis of smear-negative PTB.

Evaluation of nucleotide MALDI-TOF MS on bronchoalveolar lavage fluid for pulmonary Tuberculosis: experience from a tertiary hospital in southwestern China

“…BALF is the most common used respiratory sample type for the diagnosis of PTB besides sputum, which is also preferred by clinicians due to its closer proximity to the lesion. Multiple studies have reported the capability of different molecular tests to diagnose PTB in BALFs, such as Xpert MTB/RIF assay, SAT-TB, LAMP, next-generation metagenome sequencing, nanopore sequencing, etc., with sensitivities raging from 45.18-94.4% [21][22][23][24][25][26] . The comparatively lower results of the Xpert MTB/RIF assay in our study than those previously studies may be related to several factors, including study site, sample source, and the operator, suggesting that we need to improve the level of testing within our hospital.…”

Evaluation of Nanopore Sequencing for Diagnosing Pulmonary Tuberculosis Using Negative Smear Clinical Specimens

“…8 Consequently, relying solely on MTB culture technique for diagnosing smear-negative PTB may have limited efficacy. 9 The development of molecular diagnostic techniques in recent years has led to significant advancements in the rapid diagnosis of infectious diseases, including TB. 10,11 Xpert MTB/RIF is the most widely used molecular test for rapid diagnosis of TB recommended by the World Health Organization, also in China.…”

Retrospective analysis of the clinical utility of multi-cytokine profiles in smear-negative pulmonary tuberculosis

“… 1 , 2 Smear-negative pulmonary tuberculosis is defined by the absence of detectable bacteria in sputum smears, despite clinical and radiological indications of pulmonary TB. 3 The limited bacterial presence in SNPT complicates diagnosis using conventional techniques, resulting in delays in treatment initiation and heightened risk of disease transmission. 4 Given these challenges, the investigation of alternative diagnostic biomarkers is crucial in addressing the diagnostic limitations associated with SNPT.…”