RAPID DIAGNOSIS OF MYCOBACTERIUM-TUBERCULOSIS BACTEREMIA BY PCR

A method based on DNA amplification and hybridization has been used fo r the rapid detection of Mycobacterium tuberculosis in blood samples f rom 38 hospitalized patients (15 human immunodeficiency virus [HIV] po sitive and 23 HIV negative) in whom localized or disseminated forms of tuberculosis were suspected. In 32 of these patients, the diagnosis o f tuberculosis was eventually confirmed by conventional bacteriologica l or histological procedures, M. tuberculosis DNA was detected with th e PCR technique in the peripheral blood mononuclear cells from 9 of 11 (82%) HIV-infected patients and in 7 of 21 (33%) HIV-negative patient s (P < 0.01), while M. tuberculosis blood cultures were positive in 1 of 8 (12.5%) and 1 of 18 (5.5%) patients, respectively. PCR was positi ve in all cases with disseminated disease in both HIV-negative and HIV -positive patients and also in the HIV-positive patients with extrapul monary tuberculosis. Seven samples from patients with documented illne ss other than tuberculosis and 12 specimens from healthy volunteers, i ncluding seven volunteers with a recent positive purified protein deri vative test, were used as controls and had a negative PCR. These resul ts suggest that detection of M. tuberculosis DNA in peripheral blood m ononuclear cells may be a useful tool for rapid diagnosis of dissemina ted and extrapulmonary forms of tuberculosis, especially in an HIV-pos itive population.