한빛사논문
- 조회275
대림성모병원
Jung Seop Eom 1 2 3, Seyeon Park 4, Hyojin Jang 1, Saerom Kim 1, Wan Ho Yoo 1, Soo Han Kim 1, Jeongha Mok 1 2 3
1Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.
2Pusan National University School of Medicine, Busan, Republic of Korea.
3Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
4Department of Internal Medicine, Daerim St. Mary's Hospital, Seoul, Republic of Korea.
J. S. E. and S. P. contributed equally to this work as co–first authors.
Correspondence: J. Mok
Abstract
Background
This study was performed to evaluate the efficacy of using a thin bronchoscope for the diagnosis of pulmonary tuberculosis (PTB).
Methods
Between March 2019 and November 2021, we prospectively enrolled participants with suspected PTB whose sputum acid-fast bacilli (AFB) smear and tuberculosis (TB) polymerase chain reaction (PCR) tests were negative or who could not produce self-expectorated sputum. Participants were randomized to a control group (bronchial washing [BW] using a 5.9-mm conventional bronchoscope guided by chest computed tomography) or an investigational group (BW using a 4.0-mm thin bronchoscope under virtual bronchoscopic navigation guidance). The primary outcome was detection of TB in BW fluid, defined as a positive result in the Xpert MTB/RIF assay. The secondary outcomes included AFB smear and Mycobacterium tuberculosis culture positivity, time to treatment initiation, and bronchoscopy-related complications.
Results
In total, 85 participants were included in the final analysis (43 in the control group and 42 in the investigational group). Twenty-three and 29, respectively, were finally diagnosed with PTB. The TB detection rate in BW fluid was higher in the investigational group (72.4% vs 43.5%, P = .035). Mycobacterium tuberculosis culture positivity was also higher in the investigational group (79.3% vs 52.2%, P = .038). No participants required premature bronchoscopy termination because of complications. Of the participants with PTB, the time to treatment initiation was shorter in the investigational group (median, 2.0 days vs 4.0 days, P = .001).
Conclusions
BW using a thin bronchoscope increases the TB detection rate in patients with PTB compared to conventional bronchoscopy.
논문정보
- Research article
- 2022년 09월 (BRIC 등록일 2022-10-28)
- 국내 연구진
- 의약학 > 응용의학
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