Identification of the causative organism of tuberculous lymphadenitis in Ethiopia by PCR
Identification of the causative organism of tuberculous lymphadenitis in Ethiopia by PCR
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DOI：
10.1128/jcm.40.11.4230-4234.2002
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发表时间：
2002-11-01
影响因子：
9.4
通讯作者：
Harboe, M
中科院分区：
文献类型：
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作者：
Kidane, D;Olobo, JO;Harboe, M
摘要结核性淋巴结炎是一种常见的肺外结核病，有多种鉴别诊断。通过涂片显微镜或细针穿刺（FNA）标本培养来证实病原体往往是不成功的。通过PCR分析了埃塞俄比亚南部一家农村卫生中心就诊的40名患者的FNA样本，这些患者根据临床和细胞学标准被诊断为TBLN阳性。30例（75%）患有颈部淋巴结炎，其中27.5%（27.5%）为人类免疫缺陷病毒（HIV）阳性。最初使用三个引物组在属（抗原85复合物）、复合物（IS6110插入序列）和种（pncA基因和等位变异）水平上鉴定病原体。40例TBLN中，属和复合体PCR阳性35例（87.5%）。PCR检测169位等位基因变异，结核分枝杆菌阳性24例（68.6%），M.牛。这六个在使用JB21-JB22引物组的额外PCR测定中呈阳性，该引物组对M具有高度特异性。牛5株（14.1%）同时扩增M.结核和M.牛的等位基因特异性引物组。吡嗪酰胺（PZA）敏感和耐药M.在这五个病例中，由于在使用JB21-JB22引物组的测定中全部为阴性，因此指示了结核病。11例HIV阳性者中有3例出现此特征，29例HIV阴性者中有2例出现此特征（P <0.001）。结论：在埃塞俄比亚南部35例PCR阳性的TBLN病例中，29例（82.9%）由M。结核病6例（17.1%）;牛
yTuberculous lymphadenitis (TBLN) is a common form of extrapulmonary tuberculosis with multiple differential diagnoses. Demonstration of the etiologic agent by smear microscopy or culture of fine needle aspirate (FNA) specimens is often unsuccessful. FNA specimens from 40 patients presenting at a rural health center in South Ethiopia and diagnosed as positive for TBLN on the basis of clinical and cytological criteria were analyzed for mycobacterial DNA by PCR. Thirty (75%) had cervical lymphadenitis and It (27.5%) Acre seropositive for human immunodeficiency virus (HIV). Three primer sets were initially used to identify the causative agent at the genus (antigen 85 complex), complex (IS6110 insertion sequence), and species (pncA gene and allellic variation) levels. Among the forty TBLN cases, 35 (87.5%) were positive by PCR at the genus and complex levels. Based on PCR for detection of allelic variation at position 169, 24 (68.6%) of the 35 were positive for Mycobacterium tuberculosis and 6 (17.1%) were positive for M. bovis. These six were positive in additional PCR assays using the JB21-JB22 primer set, which is highly specific for M. bovis. Five (14.1%) showed amplification for both M. tuberculosis and M. bovis with the allele-specific primer set. Cooccurrence of pyrazinamide (PZA)-sensitive and -resistant M. tuberculosis in those five cases was indicated, since all were ;negative in assays with the JB21-JB22 primer set. This feature was seen in 3 of 11 HIV-positive and 2 of 29 HIV-negative individuals (P < 0.001). Conclusion: among 35 PCR-positive cases of TBLN from southern Ethiopia, 29 (82.9%) were caused by M. tuberculosis and six (17.1%) were caused by M. bovis.