Identification of HIV patients with active pulmonary tuberculosis using urine based polymerase chain reaction assay
Identification of HIV patients with active pulmonary tuberculosis using urine based polymerase chain reaction assay
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DOI：
10.1136/thx.54.2.145
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发表时间：
1999-02-01
期刊：
影响因子：
10
通讯作者：
Fadda, G
中科院分区：
文献类型：
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作者：
Aceti, A;Zanetti, S;Fadda, G
背景-尽管结核病在HIV感染患者中的传播增加，但诊断仍很难确定。传统的微生物方法缺乏令人满意的灵敏度。我们已经开发了一种高灵敏度和特异性的巢式聚合酶链反应（PCR），能够检测尿液标本中的结核分枝杆菌DNA，并使用该试验来检查来自HIV患者的尿液标本与活动性肺tuberculosis。艾滋病合并非结核分枝杆菌感染10例（通过血培养记录），53名艾滋病患者没有分枝杆菌疾病的证据，和80名健康受试者采用PCR、抗酸染色（AFS）和培养法对25例对纯化蛋白衍生物皮试阳性的患者进行结核分枝杆菌检测。PCR检测全部为阳性，培养检测2例为阳性，AFS检测均为阴性。在非结核分枝杆菌感染患者的尿液标本中未观察到反应性。53例无分枝杆菌感染的AIDS患者中，1例尿PCR阳性。结论尿结核分枝杆菌巢式PCR检测可作为HIV感染者合并肺结核的一种有效检测方法。
Background-Despite the increased dissemination of tuberculosis among HIV infected patients, the diagnosis is difficult to establish. Traditional microbiological methods lack satisfactory sensitivity. We have developed a highly sensitive and specific nested polymerase chain reaction (PCR) capable of detecting Mycobacterium tuberculosis DNA in urine specimens and have used this test to examine urine specimens from HIV patients with active pulmonary tuberculosis.Methods-Urine specimens from 13 HIV infected patients with microbiologically proven active pulmonary tuberculosis, 10 AIDS patients with non-tuberculous mycobacterial infection (documented by blood culture), 53 AIDS patients with no evidence of mycobacterial disease, and 80 healthy subjects (25 with positive skin test to purified protein derivative) were tested for M tuberculosis using PCR, acid fast staining (AFS), and culture.Results-Of the urine specimens from patients with active tuberculosis, all tested positive by PCR, two by culture, and none by AFS. No reactivity was observed in urine specimens from patients with non-tuberculous mycobacterial infection. Of the 53 AIDS patients without mycobacterial infection, one had a positive urine PCR. Normal subjects were all negative.Conclusions-Urine based nested PCR for M tuberculosis may be a useful test for identifying HIV patients with pulmonary tuberculosis.