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102 Serdar Arisan et al. compares to cultures (37%), bladder biopsies (47%) and intravenous pyelogram (IVP) examinations. Along an accurate clinical assessment, PCR is the best available tool to avoid delay in starting treatment because it takes only 6 hours (Davies et al., 1999). False-negative findings may result from the presence of inhibitors; non-homogeneous distribution of bacteria in the specimen so that the fraction tested does not contain mycobacterium; or low numbers of mycobacterium in the specimen, which decreases the probability of the presence of organisms in the fraction analyzed by PCR (Missirliu et al., 1996; Kolk et al., 1992). False-positive results with PCR may be caused by contamination due to the presence of amplicons or Mycobacterium tuberculosis complex bacilli or DNA (van Vollenhoven et al., 1996). Most PCR assays employed for the diagnosis of tuberculosis do not distinguish between infections caused by Mycobacterium bovis and Mycobacterium tuberculosis. The species-specific PCR assays developed for the differentiation of Mycobacterium tuberculosis and Mycobacterium bovis have been invalidated due to false negative results owing to absence of specific target sequences such as mtp40 in some Mycobacterium tuberculosis strains (Gillespie and McHugh, 1997 and Cousins, 1992). In conclusion, in this study PCR results were same with routine culture results. Therefore, PCR is a rapid tool to detect Mycobacterium tuberculosis in urine samples for UTB patients. Acknowledgement We thank to E. Damla Büyüktunçer for editorial comments and advisory critics. References Bennedsen J, Thomsen VO and Pfyffer GE. Utility of PCR in diagnosis pulmonary tuberculosis. J Clin Microbiol. 34: 1407-1411, 1996. Brisson-Noel A, Gicquel B and Lecossier D. Rapid diagnosis of tuberculosis by amplification of mycobacterial DNA in clinical samples. Lancet. 2: 1069-1071, 1989. Brisson-Noel A. Aznar C and Churean C. Diagnosis of tuberculosis by DNA amplification in clinical practice evaluation. Lancet. 338: 364-366, 1991. Colabawalla BN. Reflections on urogential tuberculosis. Indian J Urol. 6: 51-59, 1990. Cousins DV, Wilton SD and Francis BR. Use of polymerase chain reaction for rapid diagnosis of tuberculosis. J Clin Microbiol. 30 : 255-258, 1992. Crenshaw JL. Renal tuberculosis with calcification. J Urol. 23: 515-533, 1930. Davies AP, Newport LE, Billington OJ, and Gillespie SH. Length of time to laboratory diagnosis of Mycobacterium tuberculosis infection: comparison of inhouse methods with reference laboratory results. Journal of Infection. 39: 205-208, 1999. Desjardin LE, Chen Y and Perkins MD. Comparison of the ABI 7700 (TaqMan) system and competitive PCR for quantification of IS1660 DNA in sputum during treatment of tuberculosis. J Clin Microbiol. 36: 1964-1968, 1998. Eisenach KD, Sifford MD and Cave MD. Detection of Mycobacterium tuberculosis in sputum samples using a polymerase chain reaction. Am Rev Respir. 144: 1160-1163, 1991. Elkin M. Urogenital tuberculosis. In: Clinical Urography Pollack HM (Ed). WB Saunders, Philadelphia. 1020- 1052, 1990. Gillespie SH and McHugh TD. Monitoring the therapy of pulmonary tuberculosis by nested polymerase chain reaction. Journal of Infection. 35: 324-325, 1997. Gow JG. Renal calcification in genito-urinary tuberculosis. Br J Surg. 52: 283-288, 1965. Gow JG and Barbosa S. Genito-urinary tuberculosis-a study of 1117 cases over a period of 34 years. Br J Urol. 56: 449-455, 1984. Gow JG. Genito urinary tuberculosis. In: Campbell's Urology. 6th ed. Walsh PC, Retik AB and Stamey TA (Ed). WB Saunders, Philadelphia. 951-981, 1992. Kolk AH, Schuitema ARJ and Kuijper S. Detection of Mycobacterium tuberculosis in clinical samples by using polymerase chain reaction and a non-radioactive detection system. J Clin Microbiol. 30: 2567-2575, 1992. Manjunath N, Shankar P and Rajan L. Evaluation of a polymerase chain reaction for the diagnosis of tuberculosis. Tubercle. 72: 21-27, 1991. Missirliu A, Gasman D and Vogt B. Genito-urinary tuberculosis: Rapid diagnosis using the polymerase chain reaction. Eur Urol. 30: 523-524, 1996. Narayan AS. Overview of renal tuberculosis. Urology. 19: 231-236, 1982. Ney C and Friedenberg RM. Tuberculosis of the kidney. In: Radiographic Atlas of the Genito-urinary System. Ney C and Friedenberg RM (Ed). JB Lippincott, Philadelphia. 373-409, 1981. Peterson JC. Tuberculosis of the kidney. In: Renal Pathology, 2nd ed. Tisher CC and Brenner BM (Ed). JB Lippincott, Philadelphia. 895-905, 1994. Royalance J, Penry B and Davies R. Radiology in management of urinary tract tuberculosis. Br J Urol. 42: 679-687, 1970. Sambrook J, Fritsch EF, and Maniatis T. Molecular Cloning: A Laboratory Manual, 2nd ed. Cold Spring
Harbor Laboratory, New York. 1989. Seth P, Ahuja GK and Bhanu NV. Evaluation of polymerase chain reaction for rapid diagnosis of clinically suspected tuberculous meningitis. Tubercle Lung Dis. 77: 353-357, 1996. Styblo K. Recent advances in epidemiological research in tuberculosis. Adv Tubercular Res. 20: 1-63, 1980. Taylor HK. Renal tuberculosis: pathogenesis and roentgen findings. AJR Am J Roentgenol. 42: 700-708, 1939. Van VollenHoven P, Heyns CF and de Beer PM. Polymerase chain reaction in the diagnosis of urinary tract tuberculosis. Urol Res. 24: 107-111, 1996. Yamaguchi R, Matsuo K and Yamazaki A. Cloning characterization of the gene for immunogenic protein MPB 64 of Mycobacterium bovis BCG. Infect Immun. 57: 283-288, 1989. Mycobacterium diagnosis by PCR 103
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