The Detection of Mycobacterium Tuberculosis in Bone Marrow Aspirate Using the Polymerase Chain Reaction

Setting: Tygerberg Hospital, South Africa.

Objective: Bone marrow aspirate and biopsy were obtained from 37 patients who were in-patients at the Tygerberg hospital. The specificity and sensitivity of the polymerase chain reaction (PCR) in the detection of Mycobacterium tuberculosis in bone marrow aspirate was evaluated.

Design: The PCR was compared to standard culture as well as to clinical and bone marrow biopsy data in 24 patients with suspected tuberculosis (TB).

Results: 12 of the 24 patients eventually had definite or probable TB and in these 12 patients the detection incidence was 42% for PCR and 25% for culture.

Conclusion: This study confirms that it is possible to use PCR to detect M. tuberculosis in bone marrow aspirate material and that this technique is more sensitive than culture methods. The PCR technique has the added advantage of being a rapid test yielding results within 2 days of sampling. Overall sensitivity for the detection of M. tuberculosis in bone marrow aspirate may be improved to 58% [corrected] by using both culture and PCR techniques.