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Vol. 221. Núm. 3.
Páginas 139-144 (Marzo 2021)
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Vol. 221. Núm. 3.
Páginas 139-144 (Marzo 2021)
ORIGINAL
DOI: 10.1016/j.rce.2020.04.010
FluoroType® MTB en líquido pleural para el diagnóstico de tuberculosis
FluoroType® MTB in pleural fluid for diagnosing tuberculosis
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S. Bielsaa, A. Bernetb, C. Civita, C. Acostaa, A. Manonellesb, J.M. Porcela,
Autor para correspondencia
jporcelp@yahoo.es

Autor para correspondencia.
a Unidad de Medicina Pleural, Servicio de Medicina Interna, Hospital Universitario Arnau de Vilanova, Instituto de Investigación Biomédica de Lleida, IRBLleida, Lérida, España
b Servicio de Microbiología, Hospital Universitario Arnau de Vilanova, Instituto de Investigación Biomédica de Lleida, IRBLleida, Lérida, España
Información del artículo
Resumen
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Estadísticas
Figuras (1)
Tablas (4)
Tabla 1. Características de la población
Tabla 2. Características bioquímicas del líquido pleural en la población de estudio
Tabla 3. Medidas de eficacia de las técnicas microbiológicas sobre líquido pleural y esputo para diagnosticar tuberculosis pleural
Tabla 4. Complementariedad de FluoroType MTB® con otros datos microbiológicos en pacientes con tuberculosis pleurala
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Resumen
Objetivos

This work aims to investigate the diagnostic accuracy of a nucleic acid amplification test (FluoroType MTB®) in pleural fluid (PF) and sputum to diagnose tuberculous pleural effusion (TPE). We also analyzed the increase in diagnostic accuracy of a second FluoroType MTB® test on a second thoracentesis sample when the first was negative.

Métodos

We conducted a prospective single-center study that included 207 patients with pleural effusion (31 tuberculous and 176 due to other causes). Of the 31 cases of TPE, 21 (68%) were confirmed histologically or microbiologically; the other cases were considered probable.

Resultados

The operational characteristics of FluoroType MTB® in PF for identifying tuberculosis were a sensitivity of 13%, a specificity of 99%, a positive likelihood ratio of 11, and a negative likelihood ratio of 0.9. The diagnostic efficacy data for sputum samples were 21%, 91%, 2.4, and 0.9, respectively. PF and sputum cultures in solid and liquid media had greater sensitivity (36% and 31%, respectively). A second FluoroType MTB® test in PF was negative for 24 patients who had TPE and for whom the first FluoroType MTB® test was also negative. Only two (6.5%) patients with TPE had a confirmed diagnosis based exclusively on the positive results of the FluoroType MTB® in PF.

Conclusión

Due to its low sensitivity, the FluoroType MTB® test in PF has a limited role in diagnosing tuberculous pleurisy.

Palabras clave:
FluoroType MTB
Tuberculosis pleural
Derrame pleural
Abstract
Objectives

This work aims to investigate the diagnostic accuracy of a nucleic acid amplification test (FluoroType MTB®) in pleural fluid (PF) and sputum to diagnose tuberculous pleural effusion (TPE). We also analyzed the increase in diagnostic accuracy of a second FluoroType MTB® test on a second thoracentesis sample when the first was negative.

Methods

We conducted a prospective single-center study that included 207 patients with pleural effusion (31 tuberculous and 176 due to other causes). Of the 31 cases of TPE, 21 (68%) were confirmed histologically or microbiologically; the other cases were considered probable.

Results

The operational characteristics of FluoroType MTB® in PF for identifying tuberculosis were a sensitivity of 13%, a specificity of 99%, a positive likelihood ratio of 11, and a negative likelihood ratio of 0.9. The diagnostic efficacy data for sputum samples were 21%, 91%, 2.4, and 0.9, respectively. PF and sputum cultures in solid and liquid media had greater sensitivity (36% and 31%, respectively). A second FluoroType MTB® test in PF was negative for 24 patients who had TPE and for whom the first FluoroType MTB® test was also negative. Only two (6.5%) patients with TPE had a confirmed diagnosis based exclusively on the positive results of the FluoroType MTB® in PF.

Conclusion

Due to its low sensitivity, the FluoroType MTB® test in PF has a limited role in diagnosing tuberculous pleurisy.

Keywords:
FluoroType MTB
Pleural tuberculosis
Pleural effusion

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