Does multiplex Polymerase Chain Reaction increase the diagnostic percentage in osteoarticular tuberculosis? A prospective evaluation of 80 cases

• Published in: International orthopaedics 2012-02, Vol.36 (2), p.255-259
• Main Authors: Sharma, Kusum, Sharma, Aman, Sharma, Shiv Kumar, Sen, Ramesh Kumar, Dhillon, Mandeep Singh, Sharma, Meera
• Format: Article
• Language: English
• Subjects: DNA, Bacterial - isolation & purification; Gene Targeting - methods; Humans; Medicine; Medicine & Public Health; Mycobacterium tuberculosis - genetics; Mycobacterium tuberculosis - isolation & purification; Original Paper; Orthopedics; Polymerase Chain Reaction - methods; Sensitivity and Specificity; Tuberculosis, Osteoarticular - diagnosis
• ISSN: 0341-2695; 1432-5195
• DOI: 10.1007/s00264-011-1241-7

Purpose Multiplex Polymerase Chain Reaction (MPCR) is a technique in which two or more gene targets are amplified in a single reaction. This has increased sensitivity of diagnosis as a single gene target may be absent in some Mycobacterium tuberculosis strains. Methods MPCR using two target genes specific for Mycobacterium tuberculosis , that is, IS6110 and MPB 64, ZN staining and Mycobacterial culture were performed on synovial fluid/pus samples of 80 (three confirmed, 77 suspected) patients of osteoarticular tuberculosis and 25 non tuberculosis patients. Results MPCR had a sensitivity of 100% in confirmed cases and 81.8% in clinically suspected cases. AFB was positive in one patient and Mycobacterial culture was positive in three patients. MPCR also had 100% specificity; MPB64 was positive in five patients in which IS6110 was negative whereas IS6110 was positive in two patients in which MPB64 was negative. Conclusions MPCR is a sensitive and specific method for diagnosis of paucibacilliary conditions such as osteoarticular tuberculosis.