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Journal of Clinical Microbiology, April 2009, p. 924-926, Vol. 47, No. 4
0095-1137/09/$08.00+0 doi:10.1128/JCM.01842-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Kwame Nkrumah University of Science and Technology, Kumasi, Ghana,1 Komfo Anokye Teaching Hospital, Kumasi, Ghana,2 Tepa Government Hospital, Tepa, Ghana,3 National Buruli Ulcer Control Programme, Accra, Ghana,4 World Health Organization, Geneva, Switzerland,5 St. George's, University of London, London, United Kingdom6
Received 23 September 2008/ Returned for modification 11 November 2008/ Accepted 30 January 2009
In a previous study, we reported that the sensitivity of PCR targeting the IS2404 insertion sequence of Mycobacterium ulcerans was 98% when it was applied to 4-mm punch biopsy samples of Buruli lesions. Fine-needle aspiration (FNA) is a less traumatic sampling technique for nonulcerated lesions, and we have studied the sensitivity of PCR using FNA samples. Fine-needle aspirates were taken with a 21-gauge needle from 43 patients diagnosed clinically with M. ulcerans disease. Four-millimeter punch biopsies were obtained for microscopy, culture, and PCR targeting the IS2404 insertion sequence. The sensitivity of PCR using samples obtained by FNA was 86% (95% confidence interval [95% CI], 72 to 94%) compared with that for PCR using punch biopsy samples. In this study, the sensitivities of culture and microscopy for punch biopsy samples were 44% (95% CI, 29 to 60%) and 26% (95% CI, 14 to 41%), respectively. This demonstrates that PCR on an FNA sample is a viable minimally invasive technique to diagnose M. ulcerans lesions.
Published ahead of print on 9 February 2009.
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