Comparison of Different Diagnostic Techniques for the Identification of Pulmonary Tuberculosis and Using Serum Tnf-? Levels as a Biomarker for Evaluating the Severity of Tuberculosis
Keywords:Pulmonary tuberculosis, MDR-TB, TNF-alpha, GeneXpert MTB\RIF, BACTEC MGIT960.
Background and Objective: Pulmonary tuberculosis(PTB) is a serious disease that mainly affects the
lungs. The aim of this study was a Comparison between conventional, and molecular methods to diagnose
M.tuberculosis complex (MTBC) and using serum TNF-? levels as a biomarker for evaluating the severity of
the disease. Methodology: The study analyzed 586 sputa collected from suspected pulmonary tuberculosis
patients (217 female and 369 male) their ages ranged from 16 to 66 years for mycobacteriological study,
while the immuno-study included 85 blood samples that collected from eighty patients and five healthy
persons (45 male,40 female) their ages (18-66) years. We tested all sputum samples by AFB direct stain and
GX methods, while we cultured sputum restrictively for Patients who have two different outcomes by AFB
direct stain and GX methods. TNF-? levels have been measured by sandwich ELISA in patients and healthy
persons. Results: Our result showed detection of (135\586) patients infected with M.tuberculosis complex
(MTBC) and (1\586) patient infected with non-mycobacterium tuberculosis(NMT) by AFB direct stain and
GX methods comparing with culture method as a gold standard. Sensitivity and specificity for AFB direct
stain and GX techniques for diagnosis PTB were (15.0% and 100% ) and (95.0% and 66.7% ) respectively.
On the other side, TNF-? levels were elevated in inpatient groups compared with healthy persons. The mean
of TNF-? levels measured in multidrug resistance tuberculosis (MDR-TB) patients was higher than in other
cases. Conclusion: Our findings demonstrate that the sensitivity of the GX technique is higher compared
to other techniques, and serum TNF-? levels can be used as a biomarker for evaluating the severity of
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