Application of molecular, microbiological, and immunological tests for the diagnosis of bone and joint tuberculosis

J Clin Lab Anal. 2018 Feb;32(2):e22260. doi: 10.1002/jcla.22260. Epub 2017 May 22.

Abstract

Background: To evaluate the application of interferon gamma release assay (IGRA), rifampicin resistant real-time fluorescence quantitative PCR technique Xpert Mycobacterium tuberculosis/rifampicin (Xpert MTB/RIF), and the levels of TNF-α and TGF-β in the diagnosis of bone and joint tuberculosis.

Methods: Eighty-six patients with bone and joint tuberculosis, diagnosed by pathology or microbiology, were examined by Xpert MTB/RIF and IGRA (T-SPOT. TB) for Mycobacterium tuberculosis infection, and the TNF-α and TGF-β levels of the patients were measured.

Results: The sensitivity of IGRA in diagnosing bone and joint tuberculosis was 81.4%; Xpert MTB/RIF's sensitivity was 70.9%. The combined sensitivity of the two methods was 91.9%. The combined detection sensitivity of the two methods was higher than individual IGRA or Xpert MTB/RIF detection sensitivity. The TNF-α and TGF-β levels in bone and joint tuberculosis patients were higher than those in the control group.

Conclusion: Xpert MTB/RIF, IGRA, TNF-α, and TGF-βs expression have value in the rapid diagnosis of bone and joint tuberculosis, and the sensitivity and accuracy of bone and joint tuberculosis diagnosis by combining them can improve it.

Keywords: TGF-β; TNF-α; Xpert; bone and joint tuberculosis; γ-interferon.

MeSH terms

  • Adult
  • Female
  • Humans
  • Interferon-gamma Release Tests
  • Male
  • Middle Aged
  • Molecular Typing / methods*
  • Molecular Typing / statistics & numerical data*
  • Mycobacterium tuberculosis / genetics*
  • Mycobacterium tuberculosis / immunology*
  • Polymerase Chain Reaction
  • Sensitivity and Specificity
  • Transforming Growth Factor beta / analysis
  • Transforming Growth Factor beta / metabolism
  • Tuberculosis, Osteoarticular / diagnosis*
  • Tumor Necrosis Factor-alpha / analysis
  • Tumor Necrosis Factor-alpha / metabolism

Substances

  • Transforming Growth Factor beta
  • Tumor Necrosis Factor-alpha