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Bronchial Aspirates in the Diagnosis of Pulmonary Tuberculosis: Conclusion

Our results are comparable with the results of other studies performed on sputum specimens, which showed about 50% sensitivity of DAT in AFB smear-negative patients. Further study is needed to compare the diagnostic efficacy of DATs between sputum and bronchial aspirates, and BAL fluid specimens.
In contrast to a previous study that used restriction fragment-length polymorphism (RFLP) analysis to identify contamination arising via bronchoscopy, we performed outward PCR analysis because the amount of DNA was too small to do RFLP analysis, Although we could not perform outward PCR analysis in all consecutively positive cases, because of PCR failure in some specimens, we could exclude the possibility of contamination through the bronchoscope washer in the most suspicious case. As others suggested, it could be used as a rapid and simple method for typing isolates of M tuberculosis, especially in cases where the amount of DNA was not enough to do RFLP analysis as in this case.
In conclusion, amplification-based techniques can be used for the diagnosis of pulmonary tuberculosis in bronchial aspirate specimens without the increased risk of cross-contamination, if adequate cleaning and disinfection procedures are adopted. To perform diagnostic tests using amplification techniques, each bronchoscopic laboratory should monitor cleaning and disinfection procedures continuously, until generalized guidelines for the use of amplification techniques in bronchoscopic specimens have been formulated.