Modified TB rapid test by proteinase K for rapid diagnosis of pleural tuberculosis

APMIS. 2016 Mar;124(3):201-7. doi: 10.1111/apm.12490. Epub 2015 Dec 23.

Abstract

The diagnosis of pleural tuberculosis continues to be a challenge due to the low sensitivity of traditional diagnostic methods. Better and more rapid tests are needed for diagnosis of pleural TB. In this study, pleural fluids were tested with rapid test to determine Mycobacterium tuberculosis (MTB antigen). Affinity chromatography was used to purify specific polyclonal antibodies against MTB antigen. Pleural samples after decontamination were treated with proteinase K. Rapid test for pleural fluids was prepared by specific antibody. Rapid test was performed on 85 pleural fluid patients. The patients had a mean age of 46.55 ± 15.96 years and 38 were men. The performance of rapid test, using proteinase K, was found to be the most impressive: sensitivity 93%, specificity 94%, PPV 90%, and NPV 96% compared with adenosine deaminase test (ADA), PCR, smear, and culture. The present study did demonstrate that modified TB rapid test can substantially improve the diagnosis of extrapulmonary TB.

Keywords: TB rapid test; adenosine deaminase test; pleural tuberculosis; proteinase K.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenosine Deaminase / metabolism
  • Adult
  • Aged
  • Antigens, Bacterial / metabolism
  • Endopeptidase K / metabolism*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis / isolation & purification
  • Mycobacterium tuberculosis / metabolism
  • Pleura / microbiology
  • Polymerase Chain Reaction
  • Sensitivity and Specificity
  • Tuberculosis, Pleural / diagnosis*
  • Young Adult

Substances

  • Antigens, Bacterial
  • Endopeptidase K
  • Adenosine Deaminase