C. Delacourt et al., USE OF POLYMERASE CHAIN-REACTION FOR IMPROVED DIAGNOSIS OF TUBERCULOSIS IN CHILDREN, The Journal of pediatrics, 126(5), 1995, pp. 703-709
Objective: To study the value of a rapid diagnostic method based on th
e amplification by polymerase chain reaction (PCR) of a fragment of th
e IS6110 insertion element for the detection of Mycobacterium tubercul
osis in children. Design: We tested 199 specimens obtained from 68 chi
ldren referred for evaluation of suspected tuberculosis. Results: In 8
3.3% of children with active disease and 38.9% with tuberculous infect
ion but no evidence of disease, at least one positive PCR result was o
bserved. No child without tuberculosis had positive PCR results (100%
specificity), The sensitivity of the PCR was increased by testing of m
ultiple samples from the same child and use of Chelex particles (Bio-R
ad Laboratories, Ivry, France) rather than guanidine isothiocyanate-si
lica particles for DNA extraction, Bronchoalveolar lavage samples were
no more useful than gastric aspirates. Conclusions: If appropriate la
boratory methods are used, DNA amplification is a reliable method for
the early diagnosis of tuberculosis in children and appears to be very
helpful in clinical pediatric practice when the diagnosis of active t
uberculosis is difficult or needs to be rapidly confirmed.