Journal Article

Improved Detection of <i>Mycobacterium tuberculosis</i> in Peruvian Children by Use of a Heminested IS6110 Polymerase Chain Reaction Assay

Sonia H. Montenegro, Robert H. Gilman, Patricia Sheen, Rosa Cama, Lucy Caviedes, Terryl Hopper, Richard Chambers and Richard A. Oberhelman

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 36, issue 1, pages 16-23
Published in print January 2003 | ISSN: 1058-4838
Published online January 2003 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/344900
Improved Detection of Mycobacterium tuberculosis in Peruvian Children by Use of a Heminested IS6110 Polymerase Chain Reaction Assay

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A novel heminested IS6110 polymerase chain reaction (PCR) assay was evaluated as a tool for diagnosing tuberculosis in 222 children. In an analysis of 392 specimens (gastric aspirates, nasopharyngeal aspirates, and sputum samples), results of PCR were compared with those of 3 culture methods, acid-fast bacillus (AFB) staining, and clinical assessment by the Stegen-Toledo score. The sensitivity of PCR (67%) was comparable to that of the 3-culture method (71%) and was significantly higher than that of Löwenstein-Jensen culture (54%) or AFB stain (42%) for children with highly probable tuberculosis. PCR detection rates for culture-positive specimens were 100% for smear-positive samples and 76.7% for smear-negative samples. The specificity of PCR was 100% in control children. Compared with culture, PCR demonstrated a sensitivity of 90.4%, a positive predictive value of 89%, a specificity of 94%, and a negative predictive value of 95% (κ =.85). With clinical assessment as the standard, PCR had a sensitivity of 71%, a positive predictive value of 92%, a specificity of 95%, and a negative predictive value of 79% (κ =.67). PCR is a rapid and sensitive method for the early diagnosis of pediatric tuberculosis.

Journal Article.  4735 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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