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Diagnosis of Tuberculous Pleural Effusion by Microbiologicall, Histopathological and Polymerase Chain Reaction : Comparative Study

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Polymerase Chain Reaction (PCR) is a common method of creating copies of creating copies of specific fragments of DNA PCR rapidly amplifies a single DNA molecule into many billions of molecules and can be detected with visualization. Diagnostic of pleural effusion caused by Mycobacterium tuberculosis is still a clinical prili were oblem especially of low sensitivity in conventional methods. To evaluate PCR technique based on IS6110 sequence detection of M tuberculosis in pleural fluid. A total of 66 pleural fluid samples of highly suspected pleurisy tuberculosis outpatient and inpatient of Persahabatan Hospital, Jakarta. Diagnosis made based on microscopy, microbiology and histopathology finding. Each sample was examined microscopic examination with auramin and Ziehl-Neelsen stain, culture in solid and liquid media, pleural biopsy for histopathologic examination, PCR with E1 and E2 primer. Gold standard criteria for pleurisy tuberculosis were positive if one or more extors ofilli were influenced facamination positive (microscopic, culture, histopatologic). DNA was extracted with Boom method. Primer E1 and E2 were used and amplified to 123 bp of IS6110. Sample was exclude if culture growth MOTT were exclude. PCR was a rapid diagnostic test and can detect DNA of M. Tuberculosis in pleural fluid specimen with sensitivity 54,35%, Specificity 93,75%, positive predicted value 96,15%, negative predicted value 41,67%, false positive 1 (1,61%), false negative 21 (33,87%) (x2=11,278, p=0,001). Sensitivity of direct stain AFB, culture and pleural biopsy were 12,77%, 23,40%, 96,55% and the specificity were 100%, 100%, 45,45% respectively. M. Tuberculosis and MOTT (M.fortuitum, M.terrae, M.avium complex) (6.67%) were etiology of pleural tuberculosis. Quality control of laboratory, primer used, contaminant and dead bacilli were influenced factors of PCR result. PCR has higher diagnostic value of pleurisy tuberculosis compared with AFB microscopy, culture but lower than pleural biopsy, however it should be carefully implemented with patient’s clinical condition

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Detail Information

Series Title

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Call Number

Jurnal Respirologi Indonesia, 28(4):197-205

Publisher

Jakarta : Perhimpunan Dokter Kesehatan Kerja Indonesia., 2008

Collation

9p.

Language

English

ISBN/ISSN

0853-7704

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Edition

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Subject(s)

polymerase chain reaction
diagnosis
TUBERCULOSIS, PLEURAL

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