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Clinical Usefulness of Real-time PCR and Amplicor MTB PCRAssays for Diagnosis of Tuberculosis

김미경|이미애|정채림|서동춘
대한임상미생물학회 (Korean Society of Clinical Microbiology)|2008.04|Annals of Clinical Microbiology|제11권 제1호|pp. 29-33

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키워드

Mycobacterium tuberculosisNontuberculous mycobacterianonrespiratoryRealtime PCR

초록

배경: PCR 검사가 개발되어 전통적인 항산균 도말과 배양 검사보다 신속하고 예민하게 결핵을 진단할 수 있게 되었다. 본 연구에서는 결핵균(Mycobacterium tuberculosis)과 비결핵항산균(nontuberculous mycobacteria, NTM)을 감별할 수 있게 최근 개발된 AdvanSure TB/NTM PCR 키트(LG Life Science Diagnostic Division, Korea)를 이용한 real-time PCR과 Amplicor MTB PCR (Roche Molecular Systems, USA)의 결핵 진단을 위한 임상적 유용성을 비교하였다. 방법 : 총 213예(호흡기 148예, 비호흡기 65예)에서 real-time PCR, Amplicor MTB PCR, 항산균 도말 및 배양 검사를 함께 시행하였다. 임상소견을 검토하여 각 검사법간의 민감도와 특이도를 비교하였다. 결과 : 배양에서 NTM이 자란 6예 중 4예(67%)가 real-time PCR에서 검출되었다. Real-time PCR과 Amplicor MTB PCR의 일치율은 92% (191/207)였다. 전반적인 real-time PCR의 민감도와 특이도는 91%, 87%, Amplicor MTB PCR의 민감도와 특이도는 86%, 93%이었다. 비호흡기 검체에서 real-time PCR과 Amplicor MTB PCR의 민감도는 각각 67%, 60%였고 특이 도는 모두 100%였으며, 항산균 도말 및 배양의 민감도는 각각 13%, 40%였고, 특이도는 모두 100%이었다. 결론 : AdvanSure TB/NTM 키트를 이용한 real-time PCR과 Amplicor MTB PCR은 결핵균에 대한 민감도와 특이도는 비슷 하였으나 AdvanSure TB/NTM 키트는 NTM을 검출할 수 있었다. PCR은 전통적인 항산균 도말과 배양에 비해 결핵균 검출의 민감도가 우수하였다.

Abstract

Background: PCR assay has provided a mean of more rapid and sensitive detection of Mycobacterium tuberculosis (MTB) complex than conventional acidfast bacilli (AFB) smears and MTB cultures. Using the recently developed AdvanSure TB/NTM kit (LG Life Science Diagnostic Division, Korea), which could differentiate nontuberculous mycobacteria (NTM) from MTB, this study compared clinical usefulness of real- time PCR assay and Amplicor MTB PCR assay (Roche Molecular Systems, USA) for diagnosis of tuberculosis. Methods: A total of 213 specimens (148 respiratory and 65 nonrespiratory specimens) were tested by using real-time PCR, Amplicor MTB PCR, AFB smear, and MTB culture. The sensitivity and specificity of four methods were evaluated according to clinical diagnosis. Results: Of six NTM grown in culture, four (67%) were detected by real-time PCR. The overall agreement of real-time and Amplicor MTB PCR was 92% (191/207). The overall sensitivity and specificity were 91% and 87%, respectively, for real-time PCR, and 86% and 93% for Amplicor MTB PCR. In nonrespiratory specimens, the sensitivities of real-time PCR, Amplicor MTB PCR, AFB smear, and MTB culture were 67%, 60%, 13%, and 40%, respectively, and the specificity of the four methods were all 100%. Conclusion: For diagnosis of tuberculosis, the sensitivity and specificity of the real-time PCR assay using AdvanSure TB/NTM kit and Amplicor MTB PCR were similar, and the former could differentiate NTM from MTB. The PCR assay can be considered as a more sensitive technique for the detection of MTB than the conventional AFB smear and culture.

참고문헌 (24)

  1. Diagnostic Standards and Classification of Tuberculosis in Adults and Children, "This official statement of the American Thoracic Society and the Centers for Disease Control and Prevention was adopted by the ATS Board of Directors, July 1999. This statement was endorsed by the Council of the Infectious Disease Society of America, September 1999", Am J Respir Crit Care Med, 161, pp.1376~1395 (2000)
  2. Lew WJ, "Tuberculosis situation in Korea", Tuberc Respir Dis, 46, pp.301~310 (1999)
  3. Lee JY, "Recovery rate and characteristics of nontuberculous mycobacterial isolates in a university hospital in Korea", Tuberc Respir Dis, 58, pp.385~391 (2005)
  4. Koh WJ, "Recovery rate of nontuberculous mycobacteria from acid-fast-bacilli smear-positive sputum specimens", Tuberc Respir Dis, 54, pp.22~32 (2003)
  5. Scientific committee in Korean academy of tuberculosis and respiratory disease, "National survey of mycobacterial diseases other than tuberculosis in Korea", Tuberc Respir Dis, 42, pp.277~294 (1995)
  6. Cho SN, "Tuberculosis: diagnostics", Tuberculosis, 87, pp.S14~17 (2007)
  7. 조상래, "Current Issues on Molecular and Immunological Diagnosis of Tuberculosis", Yonsei Medical Journal, 48(3), pp.347~359 (2007), 연세대학교의과대학
  8. Woods GL, "Molecular techniques in mycobacterial detection", Arch Pathol Lab Med, 125, pp.122~126 (2001)
  9. 이재승, "객담 항산균 도말 양성 환자에서 비결핵항산균 과의 감별을 위한 결핵균 중합효소연쇄반응 검사의 유용성", 결핵 및 호흡기질환, 58(5), pp.452~458 (2005), 대한결핵및호흡기학회
  10. Yu CM, "Usefulness of PCR test for M. tuberculosis for the differentiation of pulmonary tuberculosis and nontuberculous mycobacterial lung disease in patients with smear-positive sputum", Tuberc Respir Dis, 57, pp.528~534 (2004)
  11. Centers for Disease Control and Prevention (CDC), "Update: Nucleic acid amplification tests for tuberculosis", MMWR Morb Mortal Wkly Rep, 49, pp.593~594 (2000)
  12. Michos AG, "Detection of Mycobacterium tuberculosis DNA in respiratory and nonrespiratory specimens by the Amplicor MTB PCR", Diagn Microbiol Infect Dis, 54, pp.121~126 (2006)
  13. 최우순, "신선조직 검체에서 결핵균 검출을 위한 자동화 중합효소연쇄반응 검사의 유용성", 결핵 및 호흡기질환, 61(1), pp.54~59 (2006), 대한결핵및호흡기학회
  14. Shah S, "Rapid diagnosis of tuberculosis in various biopsy and body fluid specimens by the AMPLICOR Mycobacterium tuberculosis polymerase chain reaction test", Chest, 113, pp.1190~1194 (1998)
  15. Tortoli E, "Multicenter evaluation of two commercial amplification kits (Amplicor, Roche and LCx, Abbott) for direct detection of Mycobacterium tuberculosis in pulmonary and extrapulmonary specimens", Diagn Microbiol Infect Dis, 33, pp.173~179 (1999)
  16. Scarparo C, "Comparison of enhanced Mycobacterium tuberculosis amplified direct test with COBAS AMPLICOR Mycobacterium tuberculosis assay for direct detection of Mycobacterium tuberculosis complex in respiratory and extrapulmonary specimens", J Clin Microbiol, 38, pp.1559~1562 (2000)
  17. Levidiotou S, "Four-year experience of use of the Cobas Amplicor system for rapid detection of Mycobacterium tuberculosis complex in respiratory and nonrespiratory specimens in Greece", Eur J Clin Microbiol Infect Dis, 22, pp.349~356 (2003)
  18. Rajalahti I, "Detection of Mycobacterium tuberculosis complex in sputum specimens by the automated Roche Cobas Amplicor Mycobacterium Tuberculosis Test", J Clin Microbiol, 36, pp.975~978 (1998)
  19. Brown TJ, "Evaluation of three commercial detection systems for Mycobacterium tuberculosis where clinical diagnosis is difficult", Clin Pathol, 52, pp.193~197 (1999)
  20. D'Amato RF, "Application of the Roche Amplicor Mycobacterium tuberculosis (PCR) test to specimens other than respiratory secretions", Diagn Microbiol Infect Dis, 24, pp.15~7 (1996)
  21. Reischl U, "Clinical evaluation of the automated COBAS AMPLICOR MTB assay for testing respiratory and nonrespiratory specimens", J Clin Microbiol, 36, pp.2853~2860 (1998)
  22. Lee MH, "Evaluation of Amplicor PCR kit for direct detection of Mycobacterium tuberculosis from sputum specimens", Korean J Lab Med, 16, pp.364~372 (1996)
  23. Lee J, "Clinical utility of bronchial washing PCR for IS6110 and Amplicor for the rapid diagnosis of active pulmonary tuberculosis in smear negative patients", Tuberc Respir Dis, 50, pp.213~221 (2001)
  24. Piersimoni C, "Relevance of commercial amplification methods for direct detection of Mycobacterium tuberculosis complex in clinical samples", J Clin Microbiol, 41, pp.5355~5365 (2003)

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