Analysis of Patients with Positive Acid-fast Bacilli Culture and Negative T-SPOT.TB Results / 대한진단검사의학회지
The Korean Journal of Laboratory Medicine
; : 414-419, 2010.
Article
em Ko
| WPRIM
| ID: wpr-77833
Biblioteca responsável:
WPRO
ABSTRACT
BACKGROUND: T-SPOT.TB is a sensitive test that detects interferon-gamma producing T-cells in tuberculosis patients following stimulation with tuberculosis-specific antigens. Our study was aimed to investigate the possible causes of false negative results of the test by analyzing the patients with positive acid-fast bacilli (AFB) culture and negative T-SPOT.TB results. METHODS: We investigated 138 patients with positive AFB culture results reported between January 2009 and April 2010. Medical records of these patients were reviewed for the results of T-SPOT.TB test, AFB culture, PCR for Mycobacterium tuberculosis (TB-PCR), chest X-ray, drug treatment, etc. Diagnosis of tuberculosis was confirmed by positive TB-PCR or identification of Mycobacterium tuberculosis (MTB). Sensitivity of T-SPOT.TB test was calculated and the possible causes of AFB culture positive and T-SPOT.TB negative results were analyzed. RESULTS: T-SPOT.TB test was performed in 63 of the 138 patients with AFB culture positive results. Fifty-six (88.9%) were positive and 7 patients (11.1%) were negative on T-SPOT.TB test. Of these 7 negative cases, 4 were confirmed as nontuberculous mycobacteria (NTM), 2 were suspected as NTM and diagnosis could not be confirmed in 1. Six of these 7 patients were over 70 yr old and 6 patients had lymphocytopenia. T-SPOT.TB negative results were not observed in any of the 44 patients confirmed to have active tuberculosis (sensitivity 100%). CONCLUSIONS: Our results suggest that T-SPOT.TB test is very sensitive for diagnosing active tuberculosis. NTM may be the main cause of AFB culture positive and T-SPOT.TB negative results, but MTB infection in immunocompromised patients also has to be considered.
Palavras-chave
Texto completo:
1
Índice:
WPRIM
Assunto principal:
Kit de Reagentes para Diagnóstico
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Bacillus
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Tuberculose
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Reação em Cadeia da Polimerase
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Sensibilidade e Especificidade
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Contagem de Linfócitos
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Meios de Cultura
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Linfopenia
Tipo de estudo:
Diagnostic_studies
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Prognostic_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
Idioma:
Ko
Revista:
The Korean Journal of Laboratory Medicine
Ano de publicação:
2010
Tipo de documento:
Article