著者

伊藤 邦彦 吉山 崇 中園 智昭 尾形 英雄 和田 雅子 水谷 清二

出版者

THE JAPANESE SOCIETY FOR TB AND NTM

雑誌

結核 (ISSN:00229776)

巻号頁・発行日

vol.75, no.12, pp.691-697, 2000-12-15 (Released:2011-05-24)

参考文献数

19

被引用文献数

1

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Study objectives: To assess the usefulness of commercial kits of nucleic acid amplifica tion test (NAAT) for diagnosis of smear negative (SN) pulmonary tuberculosis.Design and patients: Retrospective study of patients who were diagnosed as, or sus pected of pulmonary tuberculosis during 3 years from January 1996 to December 1998 in Fukuiuii Hospital which has 100 beds for tuberculosis patients.Measurements and Results: 145 smear-negative culture-positive pulmonary tuberculosis patients are entered to our analysis. The DNA-based amplification test kit (Amplicor Mycobacterium tuberculosis Test (AMPL), Roche Diagnostic Systems, Basel, Switzerland) detected 39.2% (20/51, 95% confidence interval (CI): 25.8-52.6%) of smear-nega tive culture-positive (SNCP) pulmonary tuberculosis cases. The RNA-based amplification test kit (Gen-Probe Amplified Mycobacterium tuberculosis Direct Test (AMTDT), Gen-Probe Inc., San Diego, Calif., USA) detected 40.5% (15/37, 95% CI: 24.7-56.3%) of SNCP pulmonay tuberculosis cases. For both NAATs (AMPL and AMTDT), between two groups with and without the NAAT at diagnosis of SNCP pulmonary tuberculosis, there was statistical difference in culture-positive rate (proportion of positivity in sputum culture tests at diagnosis), but no statistical difference in maximum number of colony of Mycobacterium tuberculosis (MTB). When stratified for the culture-positive rate, adjusted sensitivity for SNCP patients was 44.2% (AMPL) and 40.4% (AMTDT) respec tively. On the other hand, among 245 patients with sputum AMPL positive results during the 3 years, 8 were smear-negative culture-negative (SNCN), only one out of these 8 cases was judged as true active tuberculosis without treatment. Among 89 patients with sputum AMTDT positive results, 7 were SNCN, and 3 out of them were judged as true active tuberculosis without treatment.Conclusion: Usefulness of commercial NAAT kits (AMPL and AMTDT) to diagnosis SN pulmonary tuberculosis is limited in the point of sensitivity.