Yield of smear, culture and amplification tests from repeated sputum induction for the diagnosis of pulmonary tuberculosis.

  • 1 September 2001
    • journal article
    • clinical trial
    • Vol. 5  (9) , 855-60
Abstract
To assess the yield of repeated sputum induction for the diagnosis of active tuberculosis in patients who do not produce spontaneous sputum, or with smear-negative spontaneous samples. Induced sputum was examined with fluorescent microscopy, two amplification methods (PCR Amplicor MTB, and MTD2), and cultured for mycobacteria using liquid (Bactec 12B) and Lowenstein-Jensen media. Bronchoscopy and collection of other specimens were performed at the discretion of the treating physician. A total of 1115 sputum inductions performed in 500 patients without adverse events yielded an adequate specimen in 1113 (99.8%), and microbiological confirmation in 43 of 44 (98%) culture-positive active TB cases. Yield increased with repeated sputum induction. The cumulative yield for acid-fast bacilli smear and mycobacterial culture was 64% and 70% respectively for one, 81% and 91% for two, 91% and 99% for three, and 98% and 100% for four induced samples. Yield of PCR also increased with the greater number of induced samples tested. Repeated sputum induction could considerably improve diagnostic accuracy for pulmonary TB.

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