Reliability of PCR Testing Versus Culture Testing in Tuberculosis Diagnosis: A Six-Year Retrospective Study

Background: Tuberculosis (TB) remains a global health challenge, particularly in regions with high migration rates like Şanlıurfa, Türkiye. Rapid and accurate diagnosis is essential to improve treat-ment outcomes and reduce transmission. This study evaluated the reliability of Polymerase Chain Reaction (PCR) testing compared to culture testing, the gold standard, in pulmonary TB diagnosis. Materials and Methods: This retrospective study analyzed the records of 1,231 patients diag-nosed with pulmonary TB at the Şanlıurfa Tuberculosis Dispensary between January 2018 and June 2022. Patient demographics, clinical findings, and diagnostic test results were collected. Sensitivity and specificity of PCR and acid-fast bacilli (ARB) smear tests were calculated using culture results as the reference standard. Statistical significance was set at p<0.05. Results: The majority of patients were male (60.3%) and over 18 years old (94.5%). PCR showed a sensitivity of 97% and a specificity of 88%, while ARB had a sensitivity of 77% and a specificity of 99%. PCR and culture concordance was statistically significant across ethnic groups (p=0.001). Common clinical findings included pleural effusion (18.14%) and atelectasis (15.02%). Conclusions: PCR demonstrates high sensitivity and acceptable specificity, supporting its use as a rapid diagnostic tool for pulmonary TB, particularly in resource-limited settings. However, culture testing remains indispensable for definitive diagnosis.