RT Journal Article
SR Electronic
T1 Rapid diagnosis of pulmonary tuberculosis by an enzyme-linked immunospot assay using induced sputum cells
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P4442
VO 42
IS Suppl 57
A1 Doosoo Jeon
A1 Seung Eun Lee
A1 Woo Hyun Cho
A1 Yun Seong Kim
A1 Eun-Soon Son
A1 Min-Sun Hong
A1 Seok-Yong Eum
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P4442.abstract
AB BackgroundThe purpose of this study was to evaluate the diagnostic utility and predictors for determinate results of an enzyme-linked immunospot assay using induced sputum cells (IS ELISPOT) for a rapid diagnosis of pulmonary tuberculosis (TB).MethodsSubjects suspected of pulmonary TB who had either sputum acid fast bacilli smear-negative or not producing sputum spontaneously were prospectively enrolled in the study. ELISPOT assay was performed using cells from induced sputum.ResultsA total of 43 subjects, including 25 with TB (TB group) and 18 with non-TB disease (non-TB group) were enrolled in the study. Results of IS ELISPOT were determinate in only 17/43 (39%) subjects, but all of determinate results were consistent with the final diagnosis. Of the 43 sputum samples, 11 (26%) were inadequate to perform IS ELISPOT. Of 32 adequate sputum samples, the proportion of determinate results was significantly higher in the TB group (75%, 15/20) than in the non-TB group (17%, 2/12) (p = 0.002). Smear positivity and extent of chest radiograph were not predictors for determinate results in the TB group. Sensitivity of IS ELISPOT (75%, 9/12) was higher than that of TB-PCR (25%, 3/12) in smear-negative TB.ConclusionIS ELISPOT, in its current format, is not clinically useful because of the high proportion of inconclusive results. However, in the TB group, IS ELISPOT showed relatively high diagnostic value and accuracy regardless of smear positivity. IS ELISPOT may provide additional diagnostic yield for microbiological tools in the rapid diagnosis of smear-negative TB.