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Bronchial Aspirates in the Diagnosis of Pulmonary Tuberculosis: Discussion

In this study, we have shown that automatic bronchoscopic washing, including 10 min of a disinfection cycle using 2% glutaraldehyde, did not cause false-positive results or cross-contamination in amplification techniques or bacteriological tests for M tuberculosis. COBAS AMPLICOR, the commercial kit used for the diagnosis of tuberculosis, which uses an amplification-based technique, had the additional benefit of diagnosing pulmonary tuberculosis. These results cannot be applied directly to other laboratories, because careful cleaning before the automated disinfection procedures and well-trained personnel are the most important factor in preventing the transmission of infectious organisms or DNA through bronchoscopes. However, we have demonstrated that bronchoscopic aspirate can be a useful specimen for the amplification of M tuberculosis DNA in the diagnosis of pulmonary tuberculosis, if each bronchoscopic laboratory maintains high-quality control monitoring during bronchoscopic disinfection read only canadian neighbor pharmacy.

In recent years, PCR and other amplification-based techniques have been widely used in the diagnosis of tuberculosis. Most studies have used sputum as the specimen from which M tuberculosis DNA has been amplified for the diagnosis of pulmonary tuberculosis. However, even these amplification techniques are relatively insensitive in smear-negative pulmonary tuberculo-sis. Therefore, because bronchoscopic procedures have increased diagnostic potential, some researchers have used bronchoscopic specimens for the amplification of M tuberculosis DNA in the diagnosis of tuberculosis. Endoscopic procedures, however, have the potential for crosscontamination of pathogens. Several investigators have reported false-positive diagnosis of tuberculosis, infection, or the development of clinical tuberculosis (even multidrug-resistant tuberculosis), related to the use of bronchoscopes.