Improved detection of Mycobacterium tuberculosis 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, Richard A. Oberhelman

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)16-23
Number of pages8
JournalClinical Infectious Diseases
Volume36
Issue number1
DOIs
StatePublished - Jan 1 2003

Fingerprint

Mycobacterium tuberculosis
Polymerase Chain Reaction
Tuberculosis
Bacillus
Acids
Sputum
Early Diagnosis
Stomach
Coloring Agents
Pediatrics
Staining and Labeling

ASJC Scopus subject areas

  • Immunology

Cite this

Improved detection of Mycobacterium tuberculosis in Peruvian children by use of a heminested IS6110 polymerase chain reaction assay. / Montenegro, Sonia H.; Gilman, Robert H; Sheen, Patricia; Cama, Rosa; Caviedes, Lucy; Hopper, Terryl; Chambers, Richard; Oberhelman, Richard A.

In: Clinical Infectious Diseases, Vol. 36, No. 1, 01.01.2003, p. 16-23.

Research output: Contribution to journalArticle

Montenegro, Sonia H. ; Gilman, Robert H ; Sheen, Patricia ; Cama, Rosa ; Caviedes, Lucy ; Hopper, Terryl ; Chambers, Richard ; Oberhelman, Richard A. / Improved detection of Mycobacterium tuberculosis in Peruvian children by use of a heminested IS6110 polymerase chain reaction assay. In: Clinical Infectious Diseases. 2003 ; Vol. 36, No. 1. pp. 16-23.
@article{7349ca4e8d91435d8ee887b5ef850709,
title = "Improved detection of Mycobacterium tuberculosis in Peruvian children by use of a heminested IS6110 polymerase chain reaction assay",
abstract = "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 L{\"o}wenstein-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.",
author = "Montenegro, {Sonia H.} and Gilman, {Robert H} and Patricia Sheen and Rosa Cama and Lucy Caviedes and Terryl Hopper and Richard Chambers and Oberhelman, {Richard A.}",
year = "2003",
month = "1",
day = "1",
doi = "10.1086/344900",
language = "English (US)",
volume = "36",
pages = "16--23",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "1",

}

TY - JOUR

T1 - Improved detection of Mycobacterium tuberculosis in Peruvian children by use of a heminested IS6110 polymerase chain reaction assay

AU - Montenegro, Sonia H.

AU - Gilman, Robert H

AU - Sheen, Patricia

AU - Cama, Rosa

AU - Caviedes, Lucy

AU - Hopper, Terryl

AU - Chambers, Richard

AU - Oberhelman, Richard A.

PY - 2003/1/1

Y1 - 2003/1/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=0037236899&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037236899&partnerID=8YFLogxK

U2 - 10.1086/344900

DO - 10.1086/344900

M3 - Article

C2 - 12491196

AN - SCOPUS:0037236899

VL - 36

SP - 16

EP - 23

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 1

ER -