The diagnostic accuracy of tuberculosis real-time polymerase chain reaction analysis of computed tomography-guided bronchial wash samples

Abstract

We evaluated the diagnostic accuracy of real-time polymerase chain reaction (RT-PCR) analysis of bronchoscopic wash specimens obtained using computed tomography (CT) guidance for diagnosis of pulmonary tuberculosis (TB) patients who were unable to produce sputum samples or were sputum smear-negative. Data from patients who had lesions likely to be pulmonary TB on CT images were analyzed retrospectively. Twenty-seven patients (23.1%) were diagnosed with definite pulmonary TB, and 72 patients (61.5%) were classified as not having TB. The sensitivity, specificity, positive predictive value, and negative predictive value of RT-PCR were 0.78 (95% CI, 0.57-0.91), 0.93 (95% CI, 0.84-0.97), 0.81 (95% CI, 0.60-0.93), and 0.92 (95% CI, 0.82-0.97), respectively. We concluded that most of the sputum-smear negative TB cases could be diagnosed microbiologically or ruled out rapidly and accurately by RT-PCR analysis of bronchial wash fluid.