OBJECTIVETo explore the influences of intervention on the abilities of detecting pulmonary tuberculosis cases in general hospitals.

METHODSWe selected 6 general hospitals at 3 different levels (A, B, and C). The intervened group included hospitals A1, B1, and C1, and the non-intervened group included hospitals A2, B2, and C2. The results after intervention were compared.

RESULTSThe report rate of pulmonary tuberculosis, sputum positive rate of reported cases, and sputum check rate of reported cases were significantly higher in hospital A1 than grouping hospital A2 (P = 0.000, P = 0.045, and P = 0.017, respectively). The report rate and sputum examination rate of reported cases were significantly higher in hospital B1 than grouping hospital B2 (P = 0.000, P = 0.024, respectively). The report rate and sputum examination rate of reported cases were significantly lower in hospital C1 than grouping hospital C2 (P = 0.000, P = 0.001, respectively). In hospital A1, the report rate, sputum positive rate of reported cases, and sputum check rate of reported cases were not significantly different before and after intervention (P = 0.182, P = 0.116, and P = 0.583, respectively). In hospital B1, the report rate were significantly different before and after intervention (P = 0.004), while the sputum positive rate of reported cases and sputum check rate of reported cases were not significantly different (P = 0.909, P = 0.052, respectively). In hospital C1, the report rate was significantly higher after intervention (P = 0.025). In hospital C2, the sputum check rate significantly increased (P = 0.000).

CONCLUSIONSIntervention influences the hospitals abilities to detect pulmonary tuberculosis cases. However, more optimized and long-term intervention mechanism should be established to increase case detection rate of pulmonary tuberculosis.

Hospitals, General ; Humans ; Sputum ; microbiology ; Tuberculosis, Pulmonary ; diagnosis

Adult ; Diagnostic Errors ; Endophthalmitis ; diagnosis ; microbiology ; Female ; Humans ; Mycobacterium tuberculosis ; isolation & purification ; Tuberculosis, Pulmonary ; microbiology ; Uveitis ; diagnosis

Diagnostic Tests, Routine ; methods ; Humans ; Mycobacterium tuberculosis ; isolation & purification ; Sensitivity and Specificity ; Tuberculosis, Pulmonary ; diagnosis ; microbiology

No abstract available
Humans ; Papua New Guinea ; Preventive Health Services - organization & ; administration ; Sputum - microbiology ; Tuberculosis, Pulmonary - diagnosis ; Tuberculosis, Pulmonary - prevention & ; control

Mycobacterium lentiflavum has recently been described as an emerging human pathogen without regard to the immune status of the host. We herein report on M. lentiflavum isolated from a respiratory specimen of a patient. Although the organism described in this case seems to be a colonizer of a lung destroyed by tuberculosis, the current methods for species identification of nontuberculous mycobacteria have to be re-evaluated so as not to underestimate these organisms.
Aged ; Humans ; Male ; Mycobacterium/genetics/*isolation & purification ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary/diagnosis/*microbiology/radiography

OBJECTIVETo establish a laboratory method for detection of Mycobacterium tuberculosis in sputum based on variable number tandem repeat (VNTR).

METHODSMycobacterium tuberculosis was tested by VNTR and fluorescent quantitative reverse transcription polymerase chain reaction (FQ-PCR) in 130 sputum samples from patients with pulmonary tuberculosis and 200 specimens from patients with other lung diseases. According to the amplification conditions and clinical detection needs, MTUB21, MUTB04, QUB18, QUB26, QUB11b, MIRU31, MIRU10 and MIRU26 were selected as test targets. The results of VNTR and FQ-PCR were compared with Lowenstein-Jensen culture and clinical diagnosis, and analyzed by chi-square test.

RESULTSWith the results of L-J culture as the standard, the sensitivity and specificity of VNTR were 93.1% (108/116) and 97.7% (209/214), and those of FQ-PCR were 94.0% (109/116) and 96.7% (207/214), respectively; no significant difference was observed between two groups (χ2=0.352, P=0.569). Using the clinical diagnosis as the standard, the sensitivity and specificity of VNTR were 86.9% (113/130) and 100% (200/200), and those of FQ-PCR were 87.7% (114/130) and 99.0% (198/200), respectively; the difference was not statistically significant (χ2=0.030, P=0.862). In 113 VNTR positive samples, the molecular codes differed from each other in 98.2% samples (111/113); only 2 samples had identical code (5-4-6-8-5-5-3-8).

CONCLUSIONThe study suggests that VNTR provides a promising method for diagnosis of clinical tuberculosis.

Humans ; Minisatellite Repeats ; Mycobacterium tuberculosis ; isolation & purification ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Sputum ; microbiology ; Tuberculosis, Pulmonary ; diagnosis

PURPOSE: Many medical centers routinely culture bronchoscopy samples for Mycobacterium tuberculosis, even when tuberculosis is not strongly suspected. The value of this practice, however, is controversial. We evaluated the role of that procedure in the diagnosis of pulmonary tuberculosis in an intermediate tuberculosis-burden country. PATIENTS AND METHODS: A prospective, observational study was conducted in a tertiary referral center and included 733 consecutive patients who underwent bronchoscopy examination. RESULTS: M. tuberculosis was isolated in 47 patients (6.4%). According to radiographic features, the rate of positive culture for M. tuberculosis was relatively high in patients with atelectasis (5/33, 15.2%) and those with pulmonary infiltrations of suspicious infections (26/183, 14.2%). M. tuberculosis was isolated even in patients with pulmonary masses (9/266, 3.4%) and those with pulmonary nodules (5/175, 2.9%). In 16/47 (34.0%) patients with positive cultures for M. tuberculosis, active pulmonary tuberculosis was not suspected at the time of bronchoscopy. CONCLUSION: These results suggest that routinely culturing for M. tuberculosis during bronchoscopy is still useful in the diagnosis of pulmonary tuberculosis in an intermediate tuberculosis-burden country.
Adult ; Aged ; Bacteriological Techniques/methods ; Bronchoscopy ; Female ; Humans ; Lung/microbiology/pathology ; Lung Neoplasms/microbiology ; Male ; Middle Aged ; Mycobacterium tuberculosis/growth & development/*isolation & purification ; Prospective Studies ; Pulmonary Atelectasis/microbiology ; Reproducibility of Results ; Sensitivity and Specificity ; Tuberculosis, Pulmonary/*diagnosis/microbiology

BACKGROUND: Although there are many methods including AFB smear and culture, and the analysis of pleural fluid in the etiological diagnosis of pleural effusion, it is sometimes difficult to confirm a diagnosis especially in cases of incomplete pleural biopsies. Moreover, the high incidence of tuberculous pleuritis in young people caused confusion in the differential diagnosis of pleural effusion in Korea. The pathognomonic finding of tuberculous pleuritis in pleural biopsy is chronic granulomatous pleuritis (CGP) with caseous necrosis. But a biopsy does not always provide a definitive diagnosis, which shows in only 60~70% of all biopsies, because of either limitations in blind biopsies or inadequate specimens. An adequate biopsy also gives only limited information, such as chronic or nonspecific pleuritis. METHODS: We compared the clinical diagnosis, pathologic findings and detection of mycobacterial DNA using nested PCR of pleural biopsy tissues. We carried out the nested PCR for IS6110 insertion sequence of Mycobacterium tuberculosis using outer primer IS-1/IS-2 (5'-AGGCGTTGGTTCGCGAGGG-3' /5'-TGATGACGCCCTCGTTGCC-3') and inner primer IS-3/IS-4 (5'-CCAACCCGCTCGGTCTCAA-3' /5'-ACCGATGGACTGGTCACCC-3') in 52 pleural biopsy tissues which were pathologically diagnosed as tuberculous pleuritis, malignant pleuritis or non-specific pleuritis. RESULTS: Five (71.4%) of 7 cases clinically and pathologically confirmed tuberculous pleuritis diagnosed as chronic granulomatous pleuritis (CGP) with caseous necrosis revealed positive in nested PCR for M. tuberculosis. Seven (36.8%) of 19 cases diagnosed as CGP without caseous necrosis were positive. However, only 3 (25%) of 12 cases diagnosed as non-specific chronic pleuritis were positive by PCR for M. tuberculosis. Neither congestive heart failure nor malignancies with pleurisy showed a positive reaction. CONCLUSION: In this study, pathologic findings were significantly associated with the detection rate of mycobacterial DNA. And, even in patients with nonspecific or chronic inflammatory pleuritis, mycobacterial DNA could be detected by using nested PCR in pleural biopsy tissue with good specificity. Detection of mycobacterial DNA in pleural tissue might provide additional information for etiological diagnosis in patients with pleural effusion.
Biopsy ; Comparative Study ; DNA, Bacterial/*isolation & purification ; Human ; Lung/microbiology/*pathology ; Mycobacterium tuberculosis/*genetics/isolation & purification ; *Polymerase Chain Reaction ; Support, Non-U.S. Gov't ; Tuberculosis, Pulmonary/*diagnosis/genetics/microbiology

We report a case of a 70-year-old woman who presented with mild exertional dyspnea and cough. Fiberoptic bronchoscopic findings revealed an endobronchial polypoid lesion with stenotic bronchus. The lesion was very similar to endobronchial tuberculosis. Histologic examination of the biopsy specimen demonstrated Actinomyces infection. There was a clinical response to intravenous penicillin therapy. Primary endobronchial actinomycosis must be considered in the differential diagnosis of an endobronchial lesion, especially endobronchial tuberculosis in Korea.
Actinomycosis/pathology* ; Actinomycosis/microbiology ; Actinomycosis/diagnosis ; Aged ; Bronchial Diseases/pathology* ; Bronchial Diseases/microbiology ; Bronchial Diseases/diagnosis ; Case Report ; Diagnosis, Differential ; Female ; Human ; Tomography, X-Ray Computed/methods ; Tuberculosis, Pulmonary/pathology* ; Tuberculosis, Pulmonary/diagnosis

OBJECTIVETo investigate the feasibility of real-time fluorescent quantitative (qPCR) assay in detecting mycobacterium tuberculosis complex (MTB) in paraffin embedded tissues for diagnostic purpose.

METHODSUsing qPCR assay, 1000 consecutive formalin-fixed and paraffin embedded (FFPE) tissues (from 2011 to 2012) suspected of MTB infection were tested by amplifying the MTB specific insertion sequence 6110 (IS6110). The specificity of the PCR product was confirmed by Sanger sequencing as compared with the MTB genomic DNA of the IS6110 sequence. Tissues with Ziehl-Neelsen acid-fast staining were used as control.

RESULTSIn the 1000 samples, 513 were positive for mycobacterium by Ziehl-Neelsen acid-fast staining (detection rate 51.3%); whereas 546 were MTB positive by qPCR assay (detection rate 54.6%). Concordance rate for both assays was 73.1%. The diagnosis rate increased by 14.4% by combinination of Ziehl-Neelsen acid-fast staining and qPCR results. More interestingly, by analyzing the Ziehl-Neelsen acid-fast staining and qPCR results three cases of M.leprae infection and four cases of non-tuberculous Mycobacterium (NTM) infection were identified.

CONCLUSIONSqPCR detection of MTB in FFPE tissue is more sensitive than Ziehl-Neelsen acid-fast staining assay. Combination of these two assays can increase the detection rate and also identify some rare cases of NTM infection.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; DNA, Bacterial ; genetics ; Female ; Humans ; Male ; Middle Aged ; Mycobacterium tuberculosis ; genetics ; isolation & purification ; Paraffin Embedding ; Real-Time Polymerase Chain Reaction ; Sequence Analysis, DNA ; Staining and Labeling ; methods ; Tuberculosis ; diagnosis ; microbiology ; Tuberculosis, Gastrointestinal ; diagnosis ; microbiology ; Tuberculosis, Lymph Node ; diagnosis ; microbiology ; Tuberculosis, Pulmonary ; diagnosis ; microbiology ; Young Adult