The performance of an in-house nested-PCR technique for pleural tuberculosis diagnoses

• Published in: Revista da Sociedade Brasileira de Medicina Tropical
• Main Authors: Lilian Maria Lapa Montenegro, Bruno Cesar da Silva, Juliana Figueiredo da Costa Lima, Heidi Lacerda Alves da Cruz, Rosana de Albuquerque Montenegro, Fernando Luiz Cavalcanti Lundgren, Alfredo Pereira Leite de Albuquerque Filho, Haiana Charifker Schindler
• Format: Article in Journal/Newspaper
• Language: English
• Published: Sociedade Brasileira de Medicina Tropical (SBMT) 2013
• Subjects: Pleural tuberculosis; Extrapulmonary tuberculosis; Nested PCR diagnosis; Mycobacterium tuberculosis; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.1590/0037-8682-0127-2013; https://doaj.org/article/23606202d3244292b15761c1cb6a3807

Introduction This study evaluated the performance of an in-house nested-PCR system for the detection of the Mycobacterium tuberculosis complex in pleural fluid, blood and urine samples from pleural effusion tuberculosis patients by health services physicians in Pernambuco, Brazil. Methods A prospective double-blind study with 37 hospitalized patients of both sexes, aged over 15, was used to investigate the diagnosis of pleural effusion. The criteria used to define the cases included the demonstration of bacillus in biological samples by smear or culture or by a granulomatous finding in the histopathological examination, associated with an evident response to specific treatments to each clinical situation. Pleural fluid, blood and urine samples were collected and subjected to routine tests and the nested PCR technique to assess for M. tuberculosis amplification. Results In total, 37 pleural effusion patients took part in the study, of whom 19 (51.3%) had tubercular etiologies and 18 (48.7%) had etiologies from other causes. When the pleural fluid, blood and/or urine sample in-house nested-PCR sensitivities were evaluated simultaneously, the results were positive regardless of the biological specimen (the sensitivity was 84.2%); however, when the blood and/or urine samples were analyzed together, the sensitivity was 72.2%. When the pleural fluid samples were evaluated alone, the sensitivity was only 33.3%. Conclusions The performance of the diagnostic pleural tuberculosis nested-PCR was directly related to the diversity of the samples collected from the same patient. Additionally, this study may identify a need to prioritize non-invasive blood and urine collection for this diagnosis.