EFFICACY OF GASTRIC LAVAGE SMEAR AND CULTURE EXAMINATION FOR THE DIAGNOSIS OF PULMONARY TUBERCULOSIS
Journal Name:
- İstanbul Tıp Fakültesi Dergisi
Keywords (Original Language):
| Author Name | University of Author |
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Abstract (2. Language):
Objective: Examining gastric lavage (GL) smear and culture for pulmonary tuberculosis, we assessed diagnostic
sensitivity of gastric lavage in patients who had sputum smear positivity or those who weren’t able to expectorate
enough sputum.
Materials and methods: GL was obtained from 29 patients who had two smear positivity or one smear positivity
with clinical and radiological evidence of pulmonary tuberculosis. Sampling of gastric lavage was examined
for acid fast bacilli (AFB) and cultured for M tuberculosis. All the same GL was obtained from 134 patients
who weren’t able to expectorate enough sputum. GL smear was also examined and cultured for M tuberculosis
in these patients.
Results: Probability of detecting acid fast bacilli (AFB) and growing M tuberculosis was found to increase so
far as radiologic extensivity is excessive (p=0.0001, r = -0.60). However there wasn’t a relation between whether
there is a cavity view on radiography or there is a detection of AFB (p=0.317, r=0.239). If sputum smear positivity
is accepted as gold standart in the diagnosis of pulmonary tuberculosis, sensitivity of gastric lavage smear examination
was found as 51.7% and sensitivity of culture was found as 62%. Total sensitivity of smear and culture examination
was found as 79%.
Without microbiological evidence of AFB in the sputum, if diagnosis of tuberculosis that was established by the
criteria of ‘from treatment to diagnosis’ in patients with suggestive of tuberculosis clinically and radiologically is accepted as gold standart, the sensitivity of gastric lavage smear examination was found as 23.8% and the sensitivity
of the culture was found as 42.5%. Total sensitivity of smear and culture examination was found as 47%.
Conclusion: Because of the definitive diagnosis of pulmonary tuberculosis relies on identifying or culturing Mycobacterium
tuberculosis from respiratory specimens, GL AFB examination importantly contributes to diagnose pulmonary
tuberculosis. Total sensitivity of GL smear and culture was found as 79% in patients with sputum smear
positive pulmonary tuberculosis and 47% in patients who weren’t able to expectorate enough sputum.
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Abstract (Original Language):
Amaç:Araflt›rmam›zda balgam yayma pozitif hastalar ile yeterli veya hiç balgam ç›karamayan akci¤er tüberkülozlu
hastalardan al›nan açl›k mide suyunun (AMS) tan›sal duyarl›l›¤›n› ortaya koymaya çal›flt›k.
Gereç ve yöntem: Balgam yaymada en az iki kez tüberküloz basili saptanan veya radyolojik ve klinik olarak akci¤
er tüberkülozu flüphesi olan ve bir kez yayma pozitifli¤i saptanan 29 akci¤er tüberkülozlu hastadan bir kez AMS
al›nd› ve asiderezistan basil (ARB) incelemesi yap›ld› ve kültüre ekildi. Yeterli veya hiç balgam ç›karamayan 134
hastadan bir kez AMS al›nd›. Bu hastalarda da ARB incelemesi yap›ld› ve kültüre ekildi.
Bulgular: Radyolojik yayg›nl›k artt›kça etkeni mikroskopik olarak gösterme ve/ veya kültürde üretme olas›l›¤› artmaktad›
r (p = 0,0001, r = -0,60). Ancak kavite olup olmamas› ile basil elde etme aras›nda bir iliflki saptanamam›flt›
r (p = 0,317, r = 0,239). Balgam yayma pozitifli¤i alt›n standart olarak al›nan hastalarda, bir kez al›nan AMS yayma
duyarl›l›¤› %51,7, kültür duyarl›l›¤› %62 ve toplam duyarl›l›k %79 olarak bulunmufltur.
Klinik ve radyolojik olarak akci¤er tüberkülozu flüpheli hastalarda ‘tedaviden tan›ya’ kriteri alt›n standart olarak
al›nd›¤›nda AMS yayma duyarl›l›¤› %23,8, kültür duyarl›l›¤› %42,5 ve toplam duyarl›l›k %47 olarak bulunmufltur.
Sonuç: Tüberkülozun kesin tan›s› bakteriyolojik olarak konuldu¤undan dolay› AMS tan›ya önemli oranda katk›
yapmaktad›r.Balgam yayma pozitif hastalarda AMS yayma + kültür duyarl›l›¤› %79 ve yeterli veya hiç balgam ç›-
karamayan hastalarda AMS yayma + kültür duyarl›l›¤› %47 olarak bulunmufltur.
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