Avtor/Urednik		Žolnir-Dovč, Manca; Triller, Nadja; Eržen, Damijan; Kajba, Stanislav
Naslov		Mycobacterium tuberculosis v invazivno odvzetih kužninah
Prevedeni naslov		Mycobacterium tuberculosis in specimens obtained by invasive techniques
Tip		članek
Vir		Endoskopska revija
Vol. in št.		Letnik 3, št. 7
Leto izdaje		1998
Obseg		str. 163-8
Jezik		slo
Abstrakt		Rapid diagnosis is a very important measure in preventing the transmission of every infective disease including tuberculosis. The results of a three year routine nucleic acid amplification testing of bronchial aspirates are presented in the first part, and the results are compared with standard bacteriological methods (microscopic examination and isolation of mycobacteria by culture), as well as with the final diagnosis. The sensitivity of acid-fast microscopy from bronchial aspirate in comparison with culture is considered to be 22,94%, and the specificity 100%. The sensitivity of amplification test compared with culture is 80,73% and the specificity is 98,60%. The sensitivity of amplification test decreased to 49,76% when this method was compared with the final diagnosis while the specificity increased to 99,5%. The results of all three bacterilogic diagnostic methods performed on five different bronchoscopic specimens and the specimen from percutaneous needle aspirate are analysed in the second part. Final diagnosis of tuberculosis was established in 135 patients. Bronchial aspirate was positive in 70 patients (51,85%), transbronchial lung biopsy in 11 patients (13,10%), bronchial biopsy in 8 patients (47,06%), brush washing in 2 patients (33,33%), bronchoscopic needle aspirate in 4 patients (28,56%), and percutaneous needle aspirate in 7 patients (41,18%). At least one bronchoscopy specimen was positive for mycobacteria in 19 patients (14,07%) while all other specimens were bacteriologically negative. Percutaneous needle aspirate was positive in 3 patients (2,22%) while all other specimens were bacteriologically negative. Both facts confirme teh need for invasively obtaine specimens from patients with possible tuberculosis, but only in selected patients.
Izvleček		Hitra diagnostika je zelo pomemben ukrep pri zmanjševanju širjenja vsake nalezljive bolezni, tudi tuberkuloze. V prvem delu prispevka avtorji prikazujejo rezultate triletnega rutinskega testiranja izbirkov bronha s testi pomnoževanja nukleinskih kislin (TPNK) in jih primerjajo s klasičnimi bakteriološkimi metodami (mikroskopskim pregledom in osamitvijo mikobakterij), in tudi s končno diagnozo. Navajajo, da je bila občutljivost mikroskopskega razmaza iz izpirkov bronha v primerjavi z osamitvijo mikobakterij 22,94%, specifičnost pa 100%. občutljivost TPNK v primerjavi z osamitvijo je znašala 80,73% in specifičnost 98,60%. občutljivost TPNK se je znižala na 49,76%, ko smo TPNK primerjali s končno diagnozo, medtem ko se je specifičnost zvišala na zvišala na 99,50%. V drugem delu avtorji analizirajo rezultate vseh treh bakterioloških metod pri odkrivanju bacilov tuberkuloze v petih različnih bronhoskopskih kužninah inv pljučnem punktatu. Od 135 bolnikov s končno diagnozo tuberkuloza je bil izpirek bronha pozitiven pri 70 bronhoskopiranih bolnikih (51,85%), košček pljuč pri 11 (13,10%), košček bronha pri 8 (47,06%), izpirek krtače pri 2 (33,33%), bronhoskopski igelni aspirat pri 4 (28,57%) in pljučni punktat pri 7 bolnikih (41,18%). Pri19 bronhoskopiranih bolnikih (14,07%) je bila bakteriološko pozitivna vsaj ena od bronhoskopskih kužnin, medtem ko so bile vse ostale kužnine pri istih osebah bakteriološko negativne. Podobno je bil v 3 primerih (2,22%) z bakteriološkim metodami pozitiven pljučni punktat kot edina pozitivnakužnina pri treh bolnikih. oboje potrjuje upravičenost invazivno odvzetih kužnin za potrjevanje tuberkuloze, vendar samo pri prej strogo "presejanih" bolnika s sumom na tuberkulozo.
Deskriptorji		TUBERCULOSIS, PULMONARY MYCOBACTERIUM TUBERCULOSIS BRONCHOSCOPY BRONCHOALVEOLAR LAVAGE FLUID POLYMERASE CHAIN REACTION DNA, BACTERIAL