Literature DB >> 20600294

Diagnostic usefulness of a T-cell-based assay for osteoarticular tuberculosis.

Oh-Hyun Cho1, Su-Jin Park, Ki-Ho Park, Yong Pil Chong, Heungsup Sung, Mi-Na Kim, Sang-Oh Lee, Sang-Ho Choi, Jun Hee Woo, Yang Soo Kim, Sung-Han Kim.   

Abstract

BACKGROUND: Although diagnosing osteoarticular tuberculosis (TB) remains a challenge, a recently developed Mycobacterium tuberculosis-specific ELISPOT assay for diagnosing TB infection has shown promising results. We performed a prospective, blinded, observational study to compare its diagnostic usefulness with those of conventional tests in patients with suspected osteoarticular TB.
METHODS: All patients presenting at a tertiary hospital between April 2008 and September 2009 with suspected osteoarticular TB were enrolled. In addition to conventional tests for TB, we used ELISPOT assays to measure the IFN-gamma response to ESAT-6 and CFP-10 in T-cells in samples of peripheral blood mononuclear cells (PBMC). Patients with suspected osteoarticular TB were classified by diagnostic category.
RESULTS: Of the 65 patients with suspected osteoarticular TB, 5 (8%) were excluded due to inconclusive diagnoses. Of the remaining 60 patients, 23 (38%) were classified as having confirmed TB, 3 (5%) as having probable TB, 2 (3%) as having possible TB, and 32 (53%) as not having active TB. Five (8%) patients with probable or possible TB were excluded from the final analysis. Of the 23 patients with confirmed osteoarticular TB, 15 (65%) had TB spondylitis, 4 (17%) had TB arthritis, 2 (9%) had prosthetic joint infection, and 2 (9%) had extra-spinal TB. The sensitivities of the tuberculin skin test (> or =10 mm) and the ELISPOT assay for active osteoarticular TB were 80% (95% confidence interval [CI], 58%-92%) and 100% (95% CI, 85%-100%) (P = 0.04), respectively and their specificities were 68% (95% CI, 51%-81%) and 58% (95% CI, 41%-74%) (P = 0.60), respectively.
CONCLUSION: A negative ELISPOT assay using PBMC may be a useful test for excluding a diagnosis of active osteoarticular TB. Copyright 2010 The British Infection Society. Published by Elsevier Ltd. All rights reserved.

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Year:  2010        PMID: 20600294     DOI: 10.1016/j.jinf.2010.06.015

Source DB:  PubMed          Journal:  J Infect        ISSN: 0163-4453            Impact factor:   6.072


  9 in total

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  9 in total

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