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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Sensitivity of PCR targeting the IS2404 insertion sequence of Mycobacterium ulcerans in an assay using punch biopsy specimens for diagnosis of buruli ulcer
Journal of Clinical Microbiology, Volume 43, No. 8, Year 2005
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Description
Punch biopsy specimens from Mycobacterium ulcerans disease lesions were used to compare the sensitivities and specificities of direct smear, culture, PCR, and histopathology in making a diagnosis of M. ulcerans disease in a field setting. PCR for the insertion element IS2404 was modified to include uracil-N-glycosylase and deoxyuridine triphosphate instead of deoxythymidine triphosphate to reduce the risk of cross contamination. The "gold standard" for confirmation of clinically diagnosed Buruli ulcer was a definite histological diagnosis, a positive culture for M. ulcerans, or a smear positive for acid-fast bacilli (AFB), together with a possible histological diagnosis. For 70 clinically diagnosed cases of M. ulcerans disease, the modified PCR was 98% sensitive and gave a rapid result. The sensitivities of microscopy, culture, and histology were 42%, 49%, and 82%, respectively. The use of a 4-mm punch biopsy specimen was preferred to a 6-mm punch biopsy specimen since the wound was less likely to bleed and to need stitching. Given adequate technical expertise and the use of controls, the PCR was viable in a teaching hospital setting in Ghana; and in routine practice, we would recommend the use of Ziehl-Neelsen staining of biopsy specimens to detect AFB, followed by PCR, in AFB-negative cases only, in order to minimize costs. Histology and culture remain important as quality control tests, particularly in studies of treatment efficacy. Copyright © 2005, American Society for Microbiology. All Rights Reserved.
Authors & Co-Authors
Phillips, Richard Odame
Ghana, Kumasi
Komfo Anokye Teaching Hospital
United Kingdom, London
St George’s, University of London
Horsfield, Catherine J.
United Kingdom, London
King's College London
Kuijper, S.
Netherlands, Amsterdam
Royal Tropical Institute - Kit
Lartey, A.
Ghana, Kumasi
Komfo Anokye Teaching Hospital
Tetteh, I.
Ghana, Kumasi
Komfo Anokye Teaching Hospital
Etuaful, Samuel N.
Ghana
St. Martin's Catholic Hospital
Nyamekye, B.
Ghana, Kumasi
Nkawie Government Hospital
Awuah, Peter C.
Ghana, Kumasi
Nkawie Government Hospital
Nyarko, Kofi Mensah
Ghana, Tepa
Tepa Government Hospital
Osei-Sarpong, F.
Ghana, Tepa
Tepa Government Hospital
Lucas, Sebastian B.
United Kingdom, London
King's College London
Kolk, Arend H.J.
Netherlands, Amsterdam
Royal Tropical Institute - Kit
Wansbrough-Jones, Mark H.
United Kingdom, London
St George’s, University of London
Statistics
Citations: 95
Authors: 13
Affiliations: 7
Identifiers
Doi:
10.1128/JCM.43.8.3650-3656.2005
ISSN:
00951137
Research Areas
Health System And Policy
Study Locations
Ghana