NILAI DIAGNOSTIK PEMERIKSAAN REAKSI RANTAI POLIMEREASE PADA TUBERKULOSIS PARU SPUTUM BASIL TAHAN ASAM NEGATIF

(I Wayan Agus Putra*, EddySurjanto*, Suradi* dan Tjandra Yoga Aditama**)

* Departemen Pulmonologi dan Ilmu Kedokteran Respirasi FK UNS – RSUD Dr. Moewardi Surakarta

** Departemen Pulomonologi dan Ilmu Kedokteran Respirasi FKUI – SMF – Paru, RS Paru Persahabatan, Jakarta

ABSTRACT

Tuberculosis (TB) remains an important health problem in Indonesia. Diagnosis of pulmonary tuberculosis requires sputum examination and isolation of M. Tuberculosis from a culture specimen. The limitation of acid-fast bacilli (AFB) microscopic has relatively low sensitivity and solid media culture of M. tuberculosis required for long time (4-6 weeks) in identifying M. tuberculosis. Approximately 30-60% of pulmonary tuberculosis recorded negatif AFB. Thus patients with negative AFB were usually clinical and unspecified radiological. Polymerase Chain Reaction (PCR) method amplifying DNA or RNA in vitro were the method used as detection, identification and sensitivity test of Mycobacterium tuberculosis.

The aim of this study was to determine the validity of PCR for the diagnosis of pulmonary tuberculosis that than solid media Kudoh. A cross sectional study was conducted in Moewardi General Hospital Surakarta. Seventy four patients of pulmonary TB with negative AFB were reqruited in this study. All sputum specimens were examinded on the solid media (Kudoh) and PCR method. All patients were given antituberculosis drug. Respond of the therapy would be analysed in the following 2 months.

We got 26 patients positive culture media solid Kudoh and 61 patients positive PCR from the sample of 74 specimens with pulmonary tuberculosis negative AFB. The sensitivity and specificity of PCR on the solid media Kudoh were 96% and 25%. PCR on clinical responds were 84.7% and 100%.

The conclusion of this study were the sensitivity of PCR method for the diagnosis of pulmonary tuberculosis negative AFB relatively high (96%) but not specificity (25%).


Key words: negative AFB microscopic, solid media culture, PCR, diagnostic value.
index penelitian dosen