الفهرس 
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Abstract
TB is aglobal health proplem, which remasins one of the deadliest
diseases in yhe world, the world health organization in 2002, estimated
that more than 8 million new cases occur and approximately 3 million
person die from this diseas yearly.
Because of the shortin comings of the traditional methods for
diagnosing TB. There was an ergent need for rapid, sensitive and specific
diagnostic test.
In this study, we try to evaluate the role of BACTEC as a
diagnostic culture that needs all these requirements for diagnosis
of pulmonary TB.
This study included 50 subjects (45 males & 5 females)
The mean age of PTB patients was (34.66+12.6 years), 37/50 (74%) were
current smokers while 30/50(60%) were diabetic. All of PTB patients’
experienced cough, 49/50(98%) had phlegm, 39/50(78%) had Toxic
manifestation, 30/50(60%) had exertional dysnea, 29/50(58%) had
hemoptysis and 35/50(70%) had Chest pain.
The following items were performed to all subjects:
-A full medical history taking.
-Full Clinical Examination: - General & Local.
-Radiological Examination:-
Plain chest X- Ray: -
Posteroanterior and lateral films were done for every patient.
SUMMARY
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- Mycobacteriological investigations:-
a- sputum ZN smear
b- Sputum LJ culture
c- Sputum BACTEC culture
d-BAL ZN smear for the 8th sputum smear negative group
patients
e- BAL BACTEC culture for the 8th sputum smear negative group
patients
f- BAL LJ culture for the 8th sputum smear negative group
patients
-Routine Investigations:-
Compelete Blood Picture (CBC), Erythrocyte sedimentation rate
(ESR), Fasting and 2 hours postprandial blood sugar, Liver function tests,
and Kidney function tests.
-Tuberculin skin test
- Fiberoptic broncoscopy and BAL for the 8 th sputum smear
Negative group patients
Tuberculin skin test was reactive in 47/50(94%) of PTB group. The
current sensitivity, specificity, PPV, NPV, and accuracy of TST were
40%, 100%, 100%, 60% and 60% respectively. Sputum specimens
received from PTB cases were subjected to direct smear microscopy by
Ziehl-Neelsen (ZN) staining method revealed positive smear in
25/50(50%) cases, according to the size of the inoculums the positivity of
the sputum ranged from +1 AFB /100 oil immersion field in 8/25(32%)
SUMMARY
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,+2 in 10/25(40%) and +3 in 7/25( 28%). The current sensitivity,
specificity, PPV, and NPV of Ziehl-Neelsen (ZN) staining method were
50%, 85%, 89%, and 42% respectively. Sputum Specimens inoculated
into the L-J as well as BACTEC media revealed growth in 28/50 (56%)
and 34/50(65%) of PTB group respectively. The current sensitivity,
specificity, PPV, and NPV of L-J media were 75%, 93%, 93%, and 75%
respectively. While that of BACTEC media were87.5%, 95%, 98%, and
84% respectively. BAL Specimens were subjected to direct smear
microscopy by Ziehl-Neelsen (ZN) staining method as well as inoculated
into the LJ and BACTEC media revealed positive smear
in3/8(37.5%)and growth in 5/8 (62.5%) and 8/8(100%) of PTB group
respectively.