Diagnostic Value of PCR compared to Urine Culture for Urinary Tuberculosis in Adult Women: An Evidence-Based Case Report

Background: genitourinary tuberculosis (GUTB) refers to a Mycobacterium tuberculosis infection of the urinary tract with clinical manifestation masquerading as various urological diagnostic entities. With an incidence rate of 192-232 per 100,000 individuals, current diagnoses have fallen short in c...

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Main Authors: Indra Wicaksono, Harrina Erlianti Rahardjo
Format: Article
Language:English
Published: Interna Publishing 2021-03-01
Series:Acta Medica Indonesiana
Subjects:
Online Access:https://www.actamedindones.org/index.php/ijim/article/view/1446
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author Indra Wicaksono
Harrina Erlianti Rahardjo
author_facet Indra Wicaksono
Harrina Erlianti Rahardjo
author_sort Indra Wicaksono
collection DOAJ
description Background: genitourinary tuberculosis (GUTB) refers to a Mycobacterium tuberculosis infection of the urinary tract with clinical manifestation masquerading as various urological diagnostic entities. With an incidence rate of 192-232 per 100,000 individuals, current diagnoses have fallen short in comparison to the total incidence. Combined with an atypical and non-specific manifestation, a high false negative rate of acid-fast bacilli (AFB) staining, and long AFB culture duration has made diagnosis difficult. We aim to gather current available evidence regarding the diagnostic performance of polymerase chain reaction (PCR) in the diagnosis of GUTB. Methods: a literature search was conducted in four different, well-known databases using a predetermined PICO, keywords, and Boolean operators. All included articles will be subjected to rigorous appraisal according the University of Oxford’s Centre for Evidence-Based Medicine (CEBM) Diagnostic Variability Criteria. Review and meta-analysis will be subjected to the QFAITH appraisal checklist to assess its quality. Results: out of a total of 243 initial search results, 11 relevant studies were determined after title and abstract screening. Additionally, nine articles were excluded based on the predetermined criteria. Two fully appraised articles were included in the study: one systematic review article, revealing a heterogenous (I2 = unstated; p = unstated) result of sensitivity mean above 85% and specificity above 75%; and one cross-sectional diagnostic study that reported the use of two different PCR primers: IS6110-PCR and 16SrRNA-PCR primer with a sensitivity of 95.99% and 87.05% and specificity of 98.11% and 98.9%, respectively. Conclusion: current limited evidence showed that PCR could not be solely used for the diagnosis of GUTB, but its use is recommended to guide patient treatment and monitoring. 
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spelling doaj-art-6afdb93ffbb64dcf9026e6cf2bd2cd202025-08-20T03:51:44ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322021-03-01531Diagnostic Value of PCR compared to Urine Culture for Urinary Tuberculosis in Adult Women: An Evidence-Based Case ReportIndra Wicaksono0Harrina Erlianti Rahardjo1Department of Urology, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDepartment of Urology - Cipto Mangunkusumo General Referral Hospital, Universitas Indonesia Background: genitourinary tuberculosis (GUTB) refers to a Mycobacterium tuberculosis infection of the urinary tract with clinical manifestation masquerading as various urological diagnostic entities. With an incidence rate of 192-232 per 100,000 individuals, current diagnoses have fallen short in comparison to the total incidence. Combined with an atypical and non-specific manifestation, a high false negative rate of acid-fast bacilli (AFB) staining, and long AFB culture duration has made diagnosis difficult. We aim to gather current available evidence regarding the diagnostic performance of polymerase chain reaction (PCR) in the diagnosis of GUTB. Methods: a literature search was conducted in four different, well-known databases using a predetermined PICO, keywords, and Boolean operators. All included articles will be subjected to rigorous appraisal according the University of Oxford’s Centre for Evidence-Based Medicine (CEBM) Diagnostic Variability Criteria. Review and meta-analysis will be subjected to the QFAITH appraisal checklist to assess its quality. Results: out of a total of 243 initial search results, 11 relevant studies were determined after title and abstract screening. Additionally, nine articles were excluded based on the predetermined criteria. Two fully appraised articles were included in the study: one systematic review article, revealing a heterogenous (I2 = unstated; p = unstated) result of sensitivity mean above 85% and specificity above 75%; and one cross-sectional diagnostic study that reported the use of two different PCR primers: IS6110-PCR and 16SrRNA-PCR primer with a sensitivity of 95.99% and 87.05% and specificity of 98.11% and 98.9%, respectively. Conclusion: current limited evidence showed that PCR could not be solely used for the diagnosis of GUTB, but its use is recommended to guide patient treatment and monitoring.  https://www.actamedindones.org/index.php/ijim/article/view/1446genitourinary tuberculosisdiagnosispolymerase chain reactionacid-fast bacilliurine culture
spellingShingle Indra Wicaksono
Harrina Erlianti Rahardjo
Diagnostic Value of PCR compared to Urine Culture for Urinary Tuberculosis in Adult Women: An Evidence-Based Case Report
Acta Medica Indonesiana
genitourinary tuberculosis
diagnosis
polymerase chain reaction
acid-fast bacilli
urine culture
title Diagnostic Value of PCR compared to Urine Culture for Urinary Tuberculosis in Adult Women: An Evidence-Based Case Report
title_full Diagnostic Value of PCR compared to Urine Culture for Urinary Tuberculosis in Adult Women: An Evidence-Based Case Report
title_fullStr Diagnostic Value of PCR compared to Urine Culture for Urinary Tuberculosis in Adult Women: An Evidence-Based Case Report
title_full_unstemmed Diagnostic Value of PCR compared to Urine Culture for Urinary Tuberculosis in Adult Women: An Evidence-Based Case Report
title_short Diagnostic Value of PCR compared to Urine Culture for Urinary Tuberculosis in Adult Women: An Evidence-Based Case Report
title_sort diagnostic value of pcr compared to urine culture for urinary tuberculosis in adult women an evidence based case report
topic genitourinary tuberculosis
diagnosis
polymerase chain reaction
acid-fast bacilli
urine culture
url https://www.actamedindones.org/index.php/ijim/article/view/1446
work_keys_str_mv AT indrawicaksono diagnosticvalueofpcrcomparedtourinecultureforurinarytuberculosisinadultwomenanevidencebasedcasereport
AT harrinaerliantirahardjo diagnosticvalueofpcrcomparedtourinecultureforurinarytuberculosisinadultwomenanevidencebasedcasereport