Browsing by Author "Sumi, S."

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    Diagnostic approaches in patients with tuberculous pleural effusion
    (DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE, 2007)
    The conventional bacteriologic methods used for diagnosing pleural tuberculosis are less sensitive and time consuming. The objective of this study was to develop nonbacteriologic methods and to assess their potential utilities for the rapid diagnosis, especially in smear/culture-negative patients. One hundred forty patients with pleural effusion were investigated for tuberculous etiology by bacteriologic methods. Mycobacterium tuberculosis in the pleural fluid specimens was isolated in I I patients. To establish a tuberculous etiology in the remaining 129 patients, we performed the following assays: a) estimation of tuberculosis-associated glycolipid antigen (TBGL) by a modified indirect enzyme-linked inummosorbent assay (ELISA), b) an immunocytochemical method for the demonstration of TBGL antigen in the Cytospin smears, and c) detection of mycobacterial DNA by polymerase chain reaction (PCR). Estimation of TBGL antigen by ELISA showed 100% specificity and overall 85.5% sensitivity. Immunocytochemistry could be applied only in those samples with adequate number of macrophages. PCR carried sensitivity and specificity of 87% and 93%, respectively. Estimation of TBGL antigen in pleural fluid specimens by ELISA has a definite role in establishing tuberculous etiology, particularly in those patients in whom bacteriologic methods did not demonstrate M. tuberculosis and also in those in whom a distinction between tuberculous and nontuberculous etiology was not possible based on the clinical and radiologic features of the thorax. (c) 2007 Elsevier Inc. All rights reserved.
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    Diagnostic Significance of Humoral Immune Responses to Recombinant Antigens of Mycobacterium tuberculosis in Patients with Pleural Tuberculosis
    (JOURNAL OF CLINICAL LABORATORY ANALYSIS, 2010)
    Mycobacterium tuberculosis bacilli are seldom demonstrated in tuberculous pleural effusion (TPE) by conventional bacteriological methods. In this study, an indirect enzyme-linked immunosorbent assay (ELISA) was developed to detect IgG against four mycobacterial recombinant antigens (ESAT-6, PlcA, HspX and Tb8.4) in 69 pleural fluids of patients with TPE and 71 patients with malignant pleural effusion. To increase the sensitivity of the assay, a multi-antigen cocktail containing all the above antigens were also used. IgG positivity in ELISA for PlcA, HspX, Tb8.4, ESAT-6 antigens and multi-antigen complex were 49.3, 60.8, 49.3, 53.6 and 75.4% respectively. Each one of the above four antigens and their multi-antigen cocktail were highly specific in distinguishing tuberculous and malignant pleural effusion. This new generation immunoassay will serve as a useful marker for the diagnosis of pleural tuberculosis patients in whom M. tuberculosis bacilli were not demonstrated by bacteriological methods. J. Clin. Lab. Anal. 24:283-288, 2010. (C) 2010 Wiley-Liss, Inc.