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Evaluation of Roche Amplicor PCR assay for Mycobacterium avium complex in bronchial washing
H Matsumoto1, K Tsuyuguchi, K Suzuki
1Department of Infection and Inflammation, Chest Disease Research Institute, Kyoto University, Japan. matsumo@kuhp.kyoto-u.ac.jp
Setting:
A commercially available polymerase chain reaction (PCR) test (Roche AmplicorTM Mycobacterium avium and M. intracellulare assay-MAC-PCR) designed to detect M. avium complex (MAC) in bronchial washing was evaluated.
Design:
A total of 141 specimens from 127 patients with various pulmonary conditions were examined. Results were compared with acid-fast smears, cultures with Ogawa egg medium, as is still commonly used in Japan, and final diagnoses.
Results And Conclusions:
A total of 14 bronchial washing specimens yielded MAC. Six smear- and culture-positive specimens were all MAC-PCR positive. In eight smear-negative and culture-positive specimens, six were MAC-PCR positive. The overall sensitivity versus culture was 85.7% (12/14). However, sensitivity might be over-estimated, as there is a lower recovery rate of MAC with egg-based medium compared with liquid media. In 127 patients, 15 were identified as having pulmonary MAC disease, of whom 13 had positive MAC-PCR in bronchial washing. In the remaining 112 patients, MAC-PCR was negative, which suggests that positive MAC-PCR was not a contaminated result. However, in terms of sensitivity and speed, we were unable to show any additional clinical benefit for using MAC-PCR as opposed to liquid media, in which MAC can frequently be detected in 7 to 14 days.
