Nucleic acid amplification test and bronchoscopy improve the diagnostic accuracy of smear-negative tuberculosis

P. C. Chou, Chun Hua Wang, C. D. Huang, Y. L. Lo, K. Y. Lee, C. T. Yu, S. M. Lin, H. C. Lin, H. P. Kuo

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9 Citations (Scopus)


OBJECTIVE: To determine whether the nucleic acid amplification (NAA) test on specimens collected by bronchoscopy improves the diagnostic accuracy of pulmonary tuberculosis (PTB) in sputum-negative patients. DESIGN: Bronchoscopy was performed among smear-negative PTB suspects to collect respiratory specimens to assess the efficacy and accuracy of the Amplified Mycobacterium Tuberculosis Direct (AMTD) test in the diagnosis of PTB. RESULTS: In 105 PTB suspects, 80 were finally excluded, of whom two were false-AMTD-positive. PTB (n = 25) was diagnosed in 10 patients culture-positive for Mycobacterium tuberculosis (7/105 bronchial wash/ bronchoalveolar lavage [BW/BAL] specimens, 6/315 expectorated sputum specimens [2 positive in 2 patients; 1 positive in 2 patients], and one with both), and in 15 patients with improvement after anti-tuberculosis treatment. Among the 25 PTB patients, 20 were AMTD- positive, of whom four were culture-positive. Three AMTD-negative patients were culture-positive. The sensitivity and specificity of AMTD were respectively 80.0% and 97.5%. The diagnostic yield was higher in respiratory specimens obtained at bronchoscopy and measured by AMTD than in conventional sputum or BW/BAL culture. CONCLUSION: NAA testing on specimens collected using bronchoscopy provides a highly efficient and reliable approach in the diagnosis of PTB in smear-negative PTB suspects.

Original languageEnglish
Pages (from-to)1674-1679
Number of pages6
JournalInternational Journal of Tuberculosis and Lung Disease
Issue number12
Publication statusPublished - Dec 1 2012
Externally publishedYes


  • Bronchoscopy
  • Nucleic acid amplification test
  • Pulmonary tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases


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