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

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OBJECTIVES: 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.

METHODS: Induced sputum was examined with fluorescent microscopy, two amplification methods (PCR Amplicor MTB, and MTD2), and cultured for mycobacteria using liquid (Bactec 12B) and Löwenstein-Jensen media. Bronchoscopy and collection of other specimens were performed at the discretion of the treating physician.

RESULTS: 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.

CONCLUSIONS: Repeated sputum induction could considerably improve diagnostic accuracy for pulmonary TB.

Keywords: bacteriology; diagnosis; pulmonary tuberculosis; sputum induction; tuberculosis disease

Document Type: Regular Paper

Affiliations: 1: Montreal Chest Institute, McGill University, Montreal, Canada and Respiratory Epidemiology Unit, McGill University, Montreal, Canada 2: Montreal Chest Institute, McGill University, Montreal, Canada 3: Hopital Maisonneuve Rosemont, University of Montreal, Montreal, Canada 4: Department of Microbiology, Royal Victoria Hospital, McGill University, Montreal, Canada

Publication date: September 1, 2001

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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