Test with recombinant tuberculosis allergen (Diaskintest®) in the diagnosis of pulmonary tuberculosis in pulmonological practice

Abstract

Differential diagnosis of pulmonary tuberculosis and community-acquired pneumonia remains an urgent problem in primary health care despite the improvement of radiological and laboratory diagnostic methods.The aimof study was to evaluate the possibility of using a skin test with recombinant tuberculosis allergen (Diaskintest®, Generium, Russia) for the differential diagnosis of pulmonary tuberculosis and pneumonia.Methods.119 cases of pulmonary tuberculosis first detected in the pulmonology department during differential diagnosis were analyzed. The diagnosis was verified by a liquid media culture in the BACTEC MGIT 960 system (BD, USA). All patients with suspected tuberculosis had a skin test with recombinant tuberculosis allergen upon admission. Statistical analysis was carried out using the statistical software package IBM SPSS Statistics 22.0. The differences were considered statistically significant atp< 0.05.Results.Most patients were of working age and had aggravating social risk factors 49 (41.2%), HIV-infection 75 (63.0%), drug addiction 44 (36.9%), or viral hepatitis C 33 (24.2%). As for the clinical forms, infiltrative and disseminated tuberculosis prevailed. Evaluation of the results of the «fast» methods of the diagnostic minimum showed that a positive result of the test with Diaskintest®was almost three times more likely than the positive result of bacterioscopy of a sputum smear with Ziehl–Neelsen staining.Mycobacterium tuberculosisDNA was detected in sputum using the GeneXpert MTB/RIF cartridge technology in 92.6% patients with a positive result of Diaskintest®skin test and a negative sputum bacterioscopy analysis.Conclusion.Is advisable to use Diaskintest®skin test in patients of a pulmonological hospital in the early stages and confirm the positive result with GeneXpert MTB/RIF to reduce the time for diagnosing tuberculosis and the patient’s bed-days in a non-specialized medical institution.