@article {SivokozovP3599, author = {Ilya Sivokozov and Olga Lovacheva}, title = {Efficacy of transbronchial biopsies in diagnostics of smear-negative pulmonary TB}, volume = {40}, number = {Suppl 56}, elocation-id = {P3599}, year = {2012}, publisher = {European Respiratory Society}, abstract = {Background. Around half of all cases of tuberculosis are smear-negative. In order to achieve the final diagnosis and to find a susceptibility profile of mycobacteria, bronchosopy is used.Aim. To investigate the effectiveness of bronchosopy in the diagnosis of smear-negative TB.Materials and methods. We analyzed 99 cases of smear-negative, therapy-naive patients with pulmonary TB without cavity according to chest CT. All of them undergo a bronchoscopy with bronchial swabs with/without brush-biopsy of targeted bronchus. We analyzed further dataset: results of cytological examination of brush-biopsy (acid-fast bacilli detection, components of specific granuloma, caseous necrosis) and results for all available material of luminescent microscopy, PCR, BACTEC MGIT 960, and classical Lowenstein-Jensen (LY)culture.Results. Brush-biopsy was performed in 81/99 pts (81.2\%), cytology revealed acid-fast bacilli in 14/81 (17,3\%), specific granuloma components were found in 12/81 (14.8\%), caseous necrosis was found in 15/81 (18.5\%). In summary, combining all three components, cytology revealed TB signs in 21/81 (25.9\%) with brush. Luminescent microscopy of all biopsy types was positive in 6/81 (9.9\%). PCR testing was positive in 60/99 pts (60.6\%), whereas microbiology was less effective - 15/99 (15.2\%) for LY culture, and 42/99 (42.4\%) for BACTEC. In summary, PCR and culture methods were strong enough to detect as much as 68/99 (68.7\%) of all smear-negative TB-cases. Combining the cytology, genetics and culture data, 71/99 (71.8\%) of cases were detected.Conclusion. Bronchoscopy with brush-biopsy with or without swabs is effective method of diagnostics for patients with smear-negative pulmonary TB.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/40/Suppl_56/P3599}, eprint = {https://erj.ersjournals.com/content/40/Suppl_56/P3599.full.pdf}, journal = {European Respiratory Journal} }