Clinical,radiological and molecular diagnosis correlation in serum samples from patients with osteoarticular tuberculosis

查看全文 作　　者：Guadalupe Garcia-[1]Elorriaga;Olga Martinez-[2]Elizondo;Guillermo del Rey-[3]Pineda;Cesar Gonzalez-[1]Bonilla 机构地区：[1]Unidad de Investigacion Medica en Inmunologia e Infectologia,Hospital de Infectologia,Centro Medico Nacional La Raza(CMNR).Instituto Mexicano del Seguro Social(IMSS),Mexico City.Mexico(Medical Research Unit in Immunology and Infectious Disease,Hospital for Infectious Disease,'La Raza'National Medical Center(CMNR).Mexican Social Security Institute(IMSS),Mexico City,Mexico);[2]Hospital de Ortopedia 'Dr.Victorio de la Fuente Narvaez',Instituto Mexicano del Seguro Social(IMSS),Mexico City,Mexico(Orthopedics Hospital ' Dr.Victorio de la Fuente Narvaez',Mexican Social Security Institute(IMSS),Mexico City,Mexico);[3]Banco Central de Sangre,CMNR,IMSS,and Departamento de Infectologia,Hospital Infantil de Mexico Federico Gomez.Secretaria de Salud(SSA),Mexico City,Mexico(Central Blood Bank,CMNR.IMSS and Department of Infectious Disease 'Federico Comez' Children's Hospital.Health Ministry (SSA),Mexico City,Mexico) 出　　处：《Asian Pacific Journal of Tropical Biomedicine》索引2014年第4卷第7期,共5页 基　　金：supported by FIS,IMSS(Grant No.2009-785-011) 摘　　要：Objective:To assess the role of polymerase chain reaction(PCR)in serum sauples,in the diagnosis of osteoarticular tuberculosis(OTB)in a setting where only clinical and imaging diagnoses determine the treatment.Methods:A total of 44 consecutive serum specimens were collected from clinically suspected OTB patients,based on clinical and radiological[X-ray or magnetic resonance imagng/computecl tomography]features.They were scrcened by in-house nested PCR.In addition,a few specimens were examined by Gram stain,acid-fast bacilli stain,histand routine bacterial culture.A total of 39 specimens were collected from patients suffering from other bone diseases of nontuberculous origin and included as negative controls.Results:of the 44 clinically suspected OTB patients,in-house nested PCR was positive in 40(91%)cases;PCR was negative in 38(97%)negative controls.Sensitivity and specificity of our in—house nested PCR was 90.3%and 97.4%,respectively.The PCR report was available within 48 h.It was possible to standardize serum PCR technique and in positive cases,a good n was observed in terms of an adequate treatment response.Conclusions:Nested PCR in serum samples is a rapid,highly sensitive and specific modality for OTB detection,PCR should be performed in addition to clinical evaluation,imaging studies,acidfast bacilli staining,culture and histopathology diagnosis,if possible. 关 键 词：Osteoarticular TUBERCULOSIS Molecular diagnosis Nested POLYMERASE CHAIN reaction Sensitivity SPECIFICITY