{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T02:02:06Z","timestamp":1791338526026,"version":"4.3.1"},"reference-count":35,"publisher":"Microbiology Society","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,7,1]]},"abstract":"<jats:p>The laboratory diagnosis of pulmonary tuberculosis mainly relies on the detection of <jats:italic>Mycobacterium tuberculosis<\/jats:italic> complex (MTC) organisms in the sputum. In patients who do not give sputum, alternative respiratory tract specimens can be obtained only by invasive procedures. Based on the known survival of MTC organisms in the gastric fluid, we hypothesized that swallowed MTC organisms would be detectable in stool samples. We compared the presence of MTC organisms in respiratory tract specimens and stool specimens collected in parallel from the same patients. MTC was detected in cultures grown on egg-based medium after appropriate decontamination, by microscopic examination after Ziehl\u2013Neelsen staining and by real-time PCR detection of IS<jats:italic>6110<\/jats:italic> using internal controls. A case of pulmonary tuberculosis was defined by the presence of (i) clinical and radiological signs and symptoms suggestive of pulmonary tuberculosis, and (ii) culture of MTC organisms from at least one respiratory tract specimen or (iii) the presence of acid-fast bacilli in the sputum that were subsequently identified as MTC organisms by real-time PCR. The observation of 134 patients suspected to be suffering pulmonary tuberculosis led to the identification of 24 cases and 110 non-infected control patients. Cases and controls did not significantly differ with respect to sex but cases were significantly younger than controls. The sensitivity\/specificity was 37.5\u200a%\/100\u200a% for the microscopic examination of stools, 54.2\u200a%\/100\u200a% for culturing and 100\u200a%\/97.3\u200a% for real-time PCR. The positive predicted value was 100\u200a%, 100\u200a% and 88.9\u200a%, respectively, and the negative predicted value was 88\u200a%, 90.9\u200a% and 100\u200a%, respectively. In four patients, a stool specimen initially yielded the correct diagnosis of pulmonary tuberculosis before evaluation of the respiratory tract specimen confirmed the diagnosis. These data indicate that stools could be used in conjunction with sputum testing or as an alternative specimen upon which to base the diagnosis of pulmonary tuberculosis by molecular identification of acid-fast bacilli and culture. This non-invasive alternative procedure is of particular interest for patients who cannot expectorate.<\/jats:p>","DOI":"10.1099\/mic.0.026484-0","type":"journal-article","created":{"date-parts":[[2009,6,25]],"date-time":"2009-06-25T20:22:24Z","timestamp":1245961344000},"page":"2384-2389","source":"Crossref","is-referenced-by-count":92,"title":["Detection of Mycobacterium tuberculosis complex organisms in the stools of patients with pulmonary tuberculosis"],"prefix":"10.1099","volume":"155","author":[{"given":"Amel","family":"El Kh\u00e9chine","sequence":"first","affiliation":[{"name":"URMITE CNRS-IRD, UMR 6236, Facult\u00e9 de M\u00e9decine, IFR48, Universit\u00e9 de la M\u00e9diterran\u00e9e et P\u00f4le de Maladies Infectieuses, Assistance Publique-H\u00f4pitaux de Marseille, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mireille","family":"Henry","sequence":"additional","affiliation":[{"name":"URMITE CNRS-IRD, UMR 6236, Facult\u00e9 de M\u00e9decine, IFR48, Universit\u00e9 de la M\u00e9diterran\u00e9e et P\u00f4le de Maladies Infectieuses, Assistance Publique-H\u00f4pitaux de Marseille, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier","family":"Raoult","sequence":"additional","affiliation":[{"name":"URMITE CNRS-IRD, UMR 6236, Facult\u00e9 de M\u00e9decine, IFR48, Universit\u00e9 de la M\u00e9diterran\u00e9e et P\u00f4le de Maladies Infectieuses, Assistance Publique-H\u00f4pitaux de Marseille, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Drancourt","sequence":"additional","affiliation":[{"name":"URMITE CNRS-IRD, UMR 6236, Facult\u00e9 de M\u00e9decine, IFR48, Universit\u00e9 de la M\u00e9diterran\u00e9e et P\u00f4le de Maladies Infectieuses, Assistance Publique-H\u00f4pitaux de Marseille, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"345","reference":[{"key":"R1","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.prrv.2007.07.002","article-title":"Microbiological diagnostic procedures in respiratory infections: mycobacterial infections","volume":"8","author":"Andresen","year":"2007","journal-title":"Paediatr Respir Rev"},{"key":"R2","doi-asserted-by":"crossref","first-page":"2234","DOI":"10.1128\/JCM.28.10.2234-2239.1990","article-title":"Efficacies of selected disinfectants against Mycobacterium tuberculosis","volume":"28","author":"Best","year":"1990","journal-title":"J Clin Microbiol"},{"key":"R3","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1002\/jmv.20673","article-title":"Determination of HPV type 16 and 18 viral load in cervical smears of women referred to colposcopy","volume":"78","author":"Carcopino","year":"2006","journal-title":"J Med Virol"},{"key":"R4","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.3201\/eid1309.061020","article-title":"Tuberculosis in children and adolescents, Taiwan, 1996\u20132003","volume":"13","author":"Chan","year":"2007","journal-title":"Emerg Infect Dis"},{"key":"R5","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1046\/j.1440-1843.2003.00503.x","article-title":"Diagnostic value of gastric aspirate smear and polymerase chain reaction in smear-negative pulmonary tuberculosis","volume":"8","author":"Chierakul","year":"2003","journal-title":"Respirology"},{"key":"R6","first-page":"303","article-title":"Isolation of mycobacteria from stools and intestinal biopsies from HIV seropositive and HIV seronegative patients with and without diarrhea in Kinshasa, Zaire","volume":"70","author":"Colebunders","year":"1990","journal-title":"Preliminary results. Ann Soc Belg Med Trop"},{"key":"R7","doi-asserted-by":"crossref","first-page":"346","DOI":"10.3201\/eid1401.070901","article-title":"Early diagnosis of disseminated Mycobacterium genavense infection","volume":"14","author":"de Lastours","year":"2008","journal-title":"Emerg Infect Dis"},{"key":"R8","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1093\/tropej\/fmn056","article-title":"The role of flexible bronchoscopy in pediatric pulmonary tuberculosis","volume":"54","author":"Ding","year":"2008","journal-title":"J Trop Pediatr"},{"key":"R9","doi-asserted-by":"crossref","first-page":"e253","DOI":"10.1371\/journal.pntd.0000253","article-title":"A single-step sequencing method for the identification of Mycobacterium tuberculosis complex species","volume":"2","author":"Djelouadji","year":"2008","journal-title":"PLoS Negl Trop Dis"},{"key":"R10","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1093\/tropej\/42.5.311","article-title":"Stool microscopy and culture to assist the diagnosis of pulmonary tuberculosis in childhood","volume":"42","author":"Donald","year":"1996","journal-title":"J Trop Pediatr"},{"key":"R11","doi-asserted-by":"crossref","first-page":"2514","DOI":"10.1128\/JCM.33.9.2514-2515.1995","article-title":"Species-specific Mycobacterium genavense DNA in intestinal tissues of individuals not infected with human immunodeficiency virus","volume":"33","author":"Dumonceau","year":"1995","journal-title":"J Clin Microbiol"},{"key":"R12","first-page":"473","article-title":"Extra-pulmonary tuberculosis in patients with fever of unknown origin: clinical features and diagnosis","volume":"74","author":"Farid","year":"1999","journal-title":"J Egypt Public Health Assoc"},{"key":"R13","doi-asserted-by":"crossref","first-page":"2237","DOI":"10.1128\/JCM.00285-06","article-title":"Value of the chlorhexidine decontamination method for recovery of nontuberculous mycobacteria from sputum samples of patients with cystic fibrosis","volume":"44","author":"Ferroni","year":"2006","journal-title":"J Clin Microbiol"},{"key":"R14","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1007\/s10096-002-0737-x","article-title":"Evaluation of a new commercial assay for diagnosis of pulmonary and nonpulmonary tuberculosis","volume":"21","author":"Johansen","year":"2002","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"R15","volume-title":"A Guide for the Level III Laboratory","author":"Kent","year":"1985"},{"key":"R16","first-page":"745","article-title":"Culture of intestinal biopsy specimens and stool culture for detection of bacterial enteropathogens in patients infected with human immunodeficiency virus","volume":"33","author":"Liesenfeld","year":"1995","journal-title":"The Berlin Diarrhea\/Wasting Syndrome Study Group. J Clin Microbiol"},{"key":"R17","first-page":"31","article-title":"Use of culture methods for recovery of atypical mycobacteria from stools of AIDS patients","volume":"49","author":"Mavennyengwa","year":"2003","journal-title":"Cent Afr J Med"},{"key":"R18","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1086\/516509","article-title":"Genetic similarity among Mycobacterium avium isolates from blood, stool, and sputum of persons with AIDS","volume":"176","author":"Mazurek","year":"1997","journal-title":"J Infect Dis"},{"key":"R19","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1086\/588661","article-title":"Molecular quantification of Gardnerella vaginalis and Atopobium vaginae loads to predict bacterial vaginosis","volume":"47","author":"Menard","year":"2008","journal-title":"Clin Infect Dis"},{"key":"R20","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1128\/JCM.31.5.1385-1387.1993","article-title":"Mycobacteria in stool specimens: the nonvalue of smears for predicting culture results","volume":"31","author":"Morris","year":"1993","journal-title":"J Clin Microbiol"},{"key":"R21","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1111\/j.1742-1241.2004.00361.x","article-title":"Two cases of colonic tuberculosis presenting with massive melena","volume":"58","author":"Namisaki","year":"2004","journal-title":"Int J Clin Pract"},{"key":"R22","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1053\/j.spid.2004.05.007","article-title":"Tuberculosis in children: considerations for children from developing countries","volume":"15","author":"Nelson","year":"2004","journal-title":"Semin Pediatr Infect Dis"},{"key":"R23","doi-asserted-by":"crossref","first-page":"e100","DOI":"10.1542\/peds.2005-2623","article-title":"Improved recovery of Mycobacterium tuberculosis from children using the microscopic observation drug susceptibility method","volume":"118","author":"Oberhelman","year":"2006","journal-title":"Pediatrics"},{"key":"R24","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1136\/adc.2006.108308","article-title":"Nasopharyngeal aspiration for diagnosis of pulmonary tuberculosis","volume":"92","author":"Owens","year":"2007","journal-title":"Arch Dis Child"},{"key":"R25","first-page":"543","volume-title":"Mycobacterium: General Characteristics, Laboratory Detection and Staining Procedures","author":"Pfyffer","year":"2007"},{"key":"R26","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1128\/JCM.25.5.929-930.1987","article-title":"Acid-fast smear and culture of respiratory secretions, bone marrow, and stools as predictors of disseminated Mycobacterium avium complex infection","volume":"25","author":"Poropatich","year":"1987","journal-title":"J Clin Microbiol"},{"key":"R27","doi-asserted-by":"crossref","first-page":"2853","DOI":"10.1128\/JCM.36.10.2853-2860.1998","article-title":"Clinical evaluation of the automated COBAS AMPLICOR MTB assay for testing respiratory and nonrespiratory specimens","volume":"36","author":"Reischl","year":"1998","journal-title":"J Clin Microbiol"},{"key":"R28","first-page":"517","article-title":"Evaluation of a diagnostic algorithm for smear-negative pulmonary tuberculosis in HIV-infected adults","volume":"97","author":"Saranchuk","year":"2007","journal-title":"S Afr Med J"},{"key":"R29","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1016\/j.mimet.2006.01.010","article-title":"Direct and simultaneous identification of Mycobacterium tuberculosis complex (MTBC) and Mycobacterium tuberculosis (MTB) by rapid multiplex nested PCR-ICT assay","volume":"66","author":"Soo","year":"2006","journal-title":"J Microbiol Methods"},{"key":"R30","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1097\/00006454-199506000-00001","article-title":"Management of mycobacterial infection and disease in children","volume":"14","author":"Starke","year":"1995","journal-title":"Pediatr Infect Dis J"},{"key":"R31","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1099\/ijs.0.63485-0","article-title":"Mycobacterium florentinum sp. nov., isolated from humans","volume":"55","author":"Tortoli","year":"2005","journal-title":"Int J Syst Evol Microbiol"},{"key":"R32","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1038\/nm.1795","article-title":"A membrane protein preserves intrabacterial pH in intraphagosomal Mycobacterium tuberculosis","volume":"14","author":"Vandal","year":"2008","journal-title":"Nat Med"},{"key":"R33","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/S0140-6736(05)17705-8","article-title":"Diagnosis of sputum-scarce HIV-associated pulmonary tuberculosis in Lima, Peru","volume":"365","author":"Vargas","year":"2005","journal-title":"Lancet"},{"key":"R34","doi-asserted-by":"crossref","first-page":"893","DOI":"10.4269\/ajtmh.2008.79.893","article-title":"Diagnosis of pediatric pulmonary tuberculosis by stool PCR","volume":"79","author":"Wolf","year":"2008","journal-title":"Am J Trop Med Hyg"},{"key":"R35","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1128\/JCM.31.2.302-306.1993","article-title":"Comparison of four decontamination methods for recovery of Mycobacterium avium complex from stools","volume":"31","author":"Yajko","year":"1993","journal-title":"J Clin Microbiol"}],"container-title":["Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.microbiologyresearch.org\/content\/journal\/micro\/10.1099\/mic.0.026484-0?crawler=true","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,17]],"date-time":"2020-11-17T04:31:06Z","timestamp":1605587466000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.microbiologyresearch.org\/content\/journal\/micro\/10.1099\/mic.0.026484-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,7,1]]},"references-count":35,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2009,7,1]]}},"URL":"https:\/\/doi.org\/10.1099\/mic.0.026484-0","relation":{},"ISSN":["1350-0872","1465-2080"],"issn-type":[{"value":"1350-0872","type":"print"},{"value":"1465-2080","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,7,1]]}}}