Abstract:

Objective: The efficacy of bacteriological technology for pus specimens and pathological technology for tissue specimens in the diagnosis of osteoarticular tuberculosis was retrospectively analyzed. Methods: The 213 suspected osteoarticular tuberculosis patients hospitalized in Beijing Chest Hospital from January 2016 to December 2018 were selected as the research objects. Pus and tissue specimens specimens of them were submitted at the same site for test. Fresh pus specimens were tested with smear staining microscopic examination, GeneXpert MTB/RIF, FQ-PCR and BACTEC MGIT 960 liquid culture test; tissue specimens were embedded in paraffin and then subjected to acid-fast staining microscopic examination and FQ-PCR. Results: According to the composite reference standard (CRS), 186 patients were diagnosed as osteoarticular tuberculosis, of which 124 were confirmed tuberculosis cases, 23 were highly suspected tuberculosis cases, 39 were suspected tuberculosis cases, 27 patients were excluded from osteoarticular tuberculosis. Compare to CRS, the sensitivities of smear microscopy, MGIT 960 liquid culture, FQ-PCR, GeneXpert MTB/RIF for pus specimens, and acid-fast staining and FQ-PCR detection for tissue specimens were 28.7% (49/171), 49.0% (48/98), 58.1% (25/43), 87.5% (161/184), 48.6% (90/185) and 85.4% (146/171); the specificities were 100.0% (26/26), 11/11, 8/9, 96.2% (25/26), 96.3% (26/27) and 100.0% (27/27). Conclusion: GeneXpert MTB/RIF examination for pus specimens and FQ-PCR examination for tissue specimens had high sensitivity and short turn-around time, they could be used for early diagnosis of osteoarticular tuberculosis.

Key words: Tuberculosis,osteoarticular, Pathology, Bacteriological techniques, Diagnosis