Correlation of microbiological yield with radiographic activity on chest computed tomography in cases of suspected pulmonary tuberculosis
Identifieur interne : 000729 ( Main/Exploration ); précédent : 000728; suivant : 000730Correlation of microbiological yield with radiographic activity on chest computed tomography in cases of suspected pulmonary tuberculosis
Auteurs : Yousang Ko [Corée du Sud] ; Ho Young Lee [Corée du Sud] ; Yong Bum Park [Corée du Sud] ; Su Jin Hong [Corée du Sud] ; Jeong Hwan Shin [Corée du Sud] ; Seok Jin Choi [Corée du Sud] ; Changhwan Kim [Corée du Sud] ; So Young Park [Corée du Sud] ; Jin Young Jeong [Corée du Sud]Source :
- PLoS ONE [ 1932-6203 ] ; 2018.
Abstract
Little is known about the correlation between microbiological yield and radiographic activity, on chest computed tomography (CT), in suspected pulmonary tuberculosis (PTB) cases, despite CT being widely used, clinically.
We used multicenter retrospective data, obtained from medical records, focusing on the diagnostic performance for definite PTB. We categorized patients into four groups, by radiographic activity: definitely active, probably active, indeterminate activity, and probably inactive.
Of the 650 patients included, 316 had culture-confirmed PTB; 190 (29.2%), 323 (49.7%), 70 (10.8%), and 67 (10.3%) were classified into the definitely active, probably active, indeterminate activity, and probably inactive groups, respectively. The corresponding observed culture rates for CT radiographic activity were 61.6%, 60.7%, 4.3% and 0%, respectively. When not only culture rates but TB-PCR and histological results were taken into consideration as definite PTB, it showed 66.6%, 67.2%, 14.3%, and 0% of each CT radiographic activity, respectively. Regarding the diagnostic performance for definite PTB, radiographic activity displayed high sensitivity (97.1%, 95% confidence interval (CI), 94.6–98.5) and negative predictive values (92.7%, 95% CI, 86.6–96.2), considered definitely and probably active PTB. Apart from PTB, other etiologies, according to radiographic activity, were predominantly respiratory infections such as bacterial pneumonia and non-tuberculous mycobacterial infection.
Radiographic activity showed good diagnostic performance, and can be used easily in clinical practice. However, clinicians should consider other possibilities, because radiologic images do not confirm microbiological PTB.
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DOI: 10.1371/journal.pone.0201748
PubMed: 30091997
PubMed Central: 6084932
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Ko</name><affiliation wicri:level="3"><nlm:aff id="aff001"><addr-line>Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea</addr-line></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Lung Research Institute of Hallym University College of Medicine, Chuncheon, Republic of Korea</addr-line></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Lung Research Institute of Hallym University College of Medicine, Chuncheon</wicri:regionArea><wicri:noRegion>Chuncheon</wicri:noRegion></affiliation></author><author><name sortKey="Lee, Ho Young" sort="Lee, Ho Young" uniqKey="Lee H" first="Ho Young" last="Lee">Ho Young Lee</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea</addr-line></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan</wicri:regionArea><wicri:noRegion>Busan</wicri:noRegion></affiliation></author><author><name sortKey="Park, Yong Bum" sort="Park, Yong Bum" uniqKey="Park Y" first="Yong Bum" last="Park">Yong Bum Park</name><affiliation wicri:level="3"><nlm:aff id="aff001"><addr-line>Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea</addr-line></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Lung Research Institute of Hallym University College of Medicine, Chuncheon, Republic of Korea</addr-line></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Lung Research Institute of Hallym University College of Medicine, Chuncheon</wicri:regionArea><wicri:noRegion>Chuncheon</wicri:noRegion></affiliation></author><author><name sortKey="Hong, Su Jin" sort="Hong, Su Jin" uniqKey="Hong S" first="Su Jin" last="Hong">Su Jin Hong</name><affiliation wicri:level="1"><nlm:aff id="aff004"><addr-line>Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea</addr-line></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri</wicri:regionArea><wicri:noRegion>Guri</wicri:noRegion></affiliation></author><author><name sortKey="Shin, Jeong Hwan" sort="Shin, Jeong Hwan" uniqKey="Shin J" first="Jeong Hwan" last="Shin">Jeong Hwan Shin</name><affiliation wicri:level="1"><nlm:aff id="aff005"><addr-line>Department Laboratory Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea</addr-line></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Department Laboratory Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan</wicri:regionArea><wicri:noRegion>Busan</wicri:noRegion></affiliation></author><author><name sortKey="Choi, Seok Jin" sort="Choi, Seok Jin" uniqKey="Choi S" first="Seok Jin" last="Choi">Seok Jin Choi</name><affiliation wicri:level="1"><nlm:aff id="aff006"><addr-line>Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea</addr-line></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan</wicri:regionArea><wicri:noRegion>Busan</wicri:noRegion></affiliation></author><author><name sortKey="Kim, Changhwan" sort="Kim, Changhwan" uniqKey="Kim C" first="Changhwan" last="Kim">Changhwan Kim</name><affiliation wicri:level="1"><nlm:aff id="aff007"><addr-line>Department of Internal Medicine, Jeju National University Hospital, Jeju, Republic of Korea</addr-line></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Department of Internal Medicine, Jeju National University Hospital, Jeju</wicri:regionArea><wicri:noRegion>Jeju</wicri:noRegion></affiliation></author><author><name sortKey="Park, So Young" sort="Park, So Young" uniqKey="Park S" first="So Young" last="Park">So Young Park</name><affiliation wicri:level="1"><nlm:aff id="aff008"><addr-line>Department of Pulmonary and Critical Care Medicine, Chung Nam National University Medical Center, Daejeon, Republic of Korea</addr-line></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Department of Pulmonary and Critical Care Medicine, Chung Nam National University Medical Center, Daejeon</wicri:regionArea><wicri:noRegion>Daejeon</wicri:noRegion></affiliation></author><author><name sortKey="Jeong, Jin Young" sort="Jeong, Jin Young" uniqKey="Jeong J" first="Jin Young" last="Jeong">Jin Young Jeong</name><affiliation wicri:level="1"><nlm:aff id="aff009"><addr-line>Hallym Research Institute of Clinical Epidemiology, Chuncheon, Republic of Korea</addr-line></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Hallym Research Institute of Clinical Epidemiology, Chuncheon</wicri:regionArea><wicri:noRegion>Chuncheon</wicri:noRegion></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2018">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Background</title><p>Little is known about the correlation between microbiological yield and radiographic activity, on chest computed tomography (CT), in suspected pulmonary tuberculosis (PTB) cases, despite CT being widely used, clinically.</p></sec><sec id="sec002"><title>Methods</title><p>We used multicenter retrospective data, obtained from medical records, focusing on the diagnostic performance for definite PTB. We categorized patients into four groups, by radiographic activity: definitely active, probably active, indeterminate activity, and probably inactive.</p></sec><sec id="sec003"><title>Results</title><p>Of the 650 patients included, 316 had culture-confirmed PTB; 190 (29.2%), 323 (49.7%), 70 (10.8%), and 67 (10.3%) were classified into the definitely active, probably active, indeterminate activity, and probably inactive groups, respectively. The corresponding observed culture rates for CT radiographic activity were 61.6%, 60.7%, 4.3% and 0%, respectively. When not only culture rates but TB-PCR and histological results were taken into consideration as definite PTB, it showed 66.6%, 67.2%, 14.3%, and 0% of each CT radiographic activity, respectively. Regarding the diagnostic performance for definite PTB, radiographic activity displayed high sensitivity (97.1%, 95% confidence interval (CI), 94.6–98.5) and negative predictive values (92.7%, 95% CI, 86.6–96.2), considered definitely and probably active PTB. Apart from PTB, other etiologies, according to radiographic activity, were predominantly respiratory infections such as bacterial pneumonia and non-tuberculous mycobacterial infection.</p></sec><sec id="sec004"><title>Conclusions</title><p>Radiographic activity showed good diagnostic performance, and can be used easily in clinical practice. However, clinicians should consider other possibilities, because radiologic images do not confirm microbiological PTB.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Ryu, Yj" uniqKey="Ryu Y">YJ Ryu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lerner, Bh" uniqKey="Lerner B">BH Lerner</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koppaka, R" uniqKey="Koppaka R">R Koppaka</name></author><author><name sortKey="B, N" uniqKey="B N">N B</name></author><author><name sortKey="Frieden, T" uniqKey="Frieden T">T Frieden</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pinto, Lm" uniqKey="Pinto L">LM Pinto</name></author><author><name sortKey="Dheda, K" uniqKey="Dheda K">K Dheda</name></author><author><name sortKey="Theron, G" uniqKey="Theron G">G Theron</name></author><author><name sortKey="Allwood, B" uniqKey="Allwood B">B 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Y">YK Kim</name></author><author><name sortKey="Hahn, S" uniqKey="Hahn S">S Hahn</name></author><author><name sortKey="Uh, Y" uniqKey="Uh Y">Y Uh</name></author><author><name sortKey="Im, Dj" uniqKey="Im D">DJ Im</name></author><author><name sortKey="Lim, Yl" uniqKey="Lim Y">YL Lim</name></author><author><name sortKey="Choi, Hk" uniqKey="Choi H">HK Choi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Shimon, G" uniqKey="Shimon G">G Shimon</name></author><author><name sortKey="Yonit, Ww" uniqKey="Yonit W">WW Yonit</name></author><author><name sortKey="Gabriel, I" uniqKey="Gabriel I">I Gabriel</name></author><author><name sortKey="Naama, Br" uniqKey="Naama B">BR Naama</name></author><author><name sortKey="Nissim, A" uniqKey="Nissim A">A Nissim</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Corée du Sud</li></country><region><li>Région capitale de Séoul</li></region><settlement><li>Séoul</li></settlement></list><tree><country name="Corée du Sud"><region name="Région capitale de Séoul"><name sortKey="Ko, Yousang" sort="Ko, Yousang" uniqKey="Ko Y" first="Yousang" last="Ko">Yousang Ko</name></region><name sortKey="Choi, Seok Jin" sort="Choi, Seok Jin" uniqKey="Choi S" first="Seok Jin" last="Choi">Seok Jin Choi</name><name sortKey="Hong, Su Jin" sort="Hong, Su Jin" uniqKey="Hong S" first="Su Jin" last="Hong">Su Jin Hong</name><name sortKey="Jeong, Jin Young" sort="Jeong, Jin Young" uniqKey="Jeong J" first="Jin Young" last="Jeong">Jin Young Jeong</name><name sortKey="Kim, Changhwan" sort="Kim, Changhwan" uniqKey="Kim C" first="Changhwan" last="Kim">Changhwan Kim</name><name sortKey="Ko, Yousang" sort="Ko, Yousang" uniqKey="Ko Y" first="Yousang" last="Ko">Yousang Ko</name><name sortKey="Lee, Ho Young" sort="Lee, Ho Young" uniqKey="Lee H" first="Ho Young" last="Lee">Ho Young Lee</name><name sortKey="Park, So Young" sort="Park, So Young" uniqKey="Park S" first="So Young" last="Park">So Young Park</name><name sortKey="Park, Yong Bum" sort="Park, Yong Bum" uniqKey="Park Y" first="Yong Bum" last="Park">Yong Bum Park</name><name sortKey="Park, Yong Bum" sort="Park, Yong Bum" uniqKey="Park Y" first="Yong Bum" last="Park">Yong Bum Park</name><name sortKey="Shin, Jeong Hwan" sort="Shin, Jeong Hwan" uniqKey="Shin J" first="Jeong Hwan" last="Shin">Jeong Hwan Shin</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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