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題名 | Evaluation of an Automatic Polymerase Chain Reaction Assay for Identification of Mycobacterium Tuberculosis in Respiratory Specimens=以一種自動聚合酶連鎖反應分析鑑定呼吸道檢體中之結核菌之評估 |
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作者 | 詹一秀; 薛博仁; 鄧麗珍; 李麗娜; 楊泮池; 陸坤泰; Jan, I-shiow; Hsueh, Po-ren; Teng, Lee-jene; Lee, Li-na; Yang, Pan-chyr; Luh, Kwen-tay; |
期刊 | 臺灣醫學會雜誌 |
出版日期 | 19980300 |
卷期 | 97:3 1998.03[民87.03] |
頁次 | 頁204-209 |
分類號 | 414.83 |
語文 | eng |
關鍵詞 | 自動聚合酶連鎖反應; 呼吸道; 檢體; 結核菌; Mycobacterium tuberculosis; COBAS AMPLICOR MTB test; Respiratory specimens; |
英文摘要 | We evaluated the performance of an automatic polymerase chain reaction (PCR) detection system for identification of Mycobacterium tuberculosis in respiratory specimens. Six hundred and two respiratory specimens. including 557 sputa and 45 bronchial washing samples, were analyzed using the COBAS AMPLICOR Mycobacterium tuberculosis (MTB) test. The results were compared with those obtained from acid-fast microscopy, conventional culture, and clinical history. In cases of discrepancy between the results of the COBAS AMPLICOR MTB test and culture, the medical history of the patient was reviewed, the COBAS AMPLICOR MTB test was repeated, and the gene encoding M. tuberculosis superoxide dismutase was screened using PCR (SOD-PCR). Fourteen samples were excluded because the internal control test result was negative. Of 57 specimens that were culture positive for Mycobacterium species, 40 appeared to have growth of M. tuberculosis and 21 were smear positive for acid-fast bacteria. The sensitivity, specificity, and positive and negative predictive values for the COBAS AMPLICOR MTB test evaluated at our laboratory were 85.0% (34/40), 99.3% (544/548), 89.5% (34/38), and 98.9% (544/550), respectively. Three specimens that were culture positive for Al. tuberculosis but negative by COBAS AMPLICOR MTB test were positive when rechecked by both COBAS AMPLICORMTB test and SOD-PCR. Among the four specimens with positive reactions on both COBAS AMPLICOR MTB test and SOD-PCR that were culture negative, two were from patients who had been receiving antituberculosis treatment, one was from a patient who had been treated for tuberculosis for 1 year, and the other was from a patient who died of sepsis with adult respiratory distress syndrome In more than 70% of smear-negative and culture-positive specimens and 86.4% of smear-positive specimens, M. tuberculosis was identified by the COBAS AMPLICOR MTB test within 10 hours after receipt of the specimens. Our data show that the COBASAMPLICORMTB test provides rapid and accurate detection of M tuberculosis in respiratory specimens. |
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