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Jeon G, Kim S, Kim YJ, Kim S, Han K, Oh K, Lee HJ, Choi J. Identification of fluoroquinolone-resistant Mycobacterium tuberculosis through high-level data fusion of Raman and laser-induced breakdown spectroscopy. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2024. [PMID: 39221494 DOI: 10.1039/d4ay01331j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Accurate and rapid diagnosis of drug susceptibility of Mycobacterium tuberculosis is crucial for the successful treatment of tuberculosis, a persistent global public health threat. To shorten diagnosis times and enhance accuracy, this study introduces a fusion model combining laser-induced breakdown spectroscopy (LIBS) and Raman spectroscopy. This model offers a rapid and accurate method for diagnosing drug-resistance. LIBS and Raman spectroscopy provide complementary information, enabling accurate identification of drug resistance in tuberculosis. Although individual use of LIBS or Raman spectroscopy achieved approximately 90% accuracy in identifying drug resistance, the fusion model significantly improved identification accuracy to 98.3%. Given the fast measurement capabilities of both techniques, this fusion approach is expected to markedly decrease the time required for diagnosis.
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Affiliation(s)
- Gookseon Jeon
- Industrial Transformation Technology Department, Research Institute of Sustainable Development Technology, Korea Institute of Industrial Technology, 89, Yangdaegiro-gil, Ipjang-myeon, Seobuk-gu, Cheonan-Si, Chungcheongnam-do 31056, Republic of Korea.
- Photonic Device Physics Laboratory, Institute of Physics and Applied Physics, Yonsei University, 50, Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Soogeun Kim
- Advanced Photonics Research Institute (APRI), Gwangju Institute of Science and Technology (GIST), Gwangju 61005, Republic of Korea
| | - Young Jin Kim
- Department of Laboratory Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea
| | - Seungmo Kim
- Laboratory Medicine Center, Korean National Tuberculosis Association, The Korean Institute of Tuberculosis, Cheongju, Republic of Korea
| | - Kyungmin Han
- Clinical Laboratory Medicine Center, Korean National Tuberculosis Association, Seoul, Republic of Korea.
| | - Kyunghwan Oh
- Photonic Device Physics Laboratory, Institute of Physics and Applied Physics, Yonsei University, 50, Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Hee Joo Lee
- Clinical Laboratory Medicine Center, Korean National Tuberculosis Association, Seoul, Republic of Korea.
| | - Janghee Choi
- Industrial Transformation Technology Department, Research Institute of Sustainable Development Technology, Korea Institute of Industrial Technology, 89, Yangdaegiro-gil, Ipjang-myeon, Seobuk-gu, Cheonan-Si, Chungcheongnam-do 31056, Republic of Korea.
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Aguilar-Jiménez JR, Pelissari DM, Diaz-Quijano FA. How has the municipal availability of the GeneXpert®MTB/RIF system affected the detection of drug-resistant tuberculosis in Brazil? Trop Med Int Health 2024; 29:57-62. [PMID: 37919228 DOI: 10.1111/tmi.13945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
OBJECTIVE To evaluate the association between the availability of GeneXpert®MTB/RIF in municipalities and the proportion of people who have access to this diagnostic technology for tuberculosis (TB), as well as the resistance detected by the surveillance system in Brazil. METHODS We analysed 4998 Brazilian municipalities that reported 432,937 new TB cases between 2015 and 2020. We compared municipalities with and without the availability of GeneXpert®MTB/RIF regarding the effective access to GeneXpert®MTB/RIF diagnosis and the prevalence of detected resistance. RESULTS Municipalities with at least one GeneXpert®MTB/RIF system had three times (95% CI 2.9-3.0) the access to diagnostic tests and 80.4% (95% CI 70.6%-90.2%) higher detection of resistance, compared with municipalities without this technology. We estimated that there have been 1890 cases of undetected resistance during this period in the country. CONCLUSIONS The availability of GeneXpert®MTB/RIF system in the municipality increased the sensitivity of the surveillance for detecting TB resistance. PUBLIC HEALTH IMPLICATIONS It is a priority to strengthen laboratory networks and narrow the gap in access to rapid diagnosis in remote areas to improve the detection and control of drug-resistant tuberculosis.
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Affiliation(s)
- Jhancy Rocío Aguilar-Jiménez
- School of Public Health, Laboratory of Causal Inference in Epidemiology (LINCE-USP), Postgraduate Program in Epidemiology, University of São Paulo, São Paulo, Brazil
- Universidad de Santander, Bucaramanga, Colombia
| | - Daniele Maria Pelissari
- Postdoc Program in Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Fredi Alexander Diaz-Quijano
- Laboratory of Causal Inference in Epidemiology (LINCE-USP), Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
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Diagnostic challenges and Gene-Xpert utility in detecting Mycobacterium tuberculosis among suspected cases of Pulmonary tuberculosis. PLoS One 2021; 16:e0251858. [PMID: 34015016 PMCID: PMC8136641 DOI: 10.1371/journal.pone.0251858] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 05/04/2021] [Indexed: 11/19/2022] Open
Abstract
The incidence of pulmonary tuberculosis (PTB) can be reduced by preventing transmission with rapid and precise case detection and early treatment. The Gene-Xpert MTB/RIF assay is a useful tool for detecting Mycobacterium tuberculosis (MTB) with rifampicin resistance within approximately two hours by using a nucleic acid amplification technique. This study was designed to reduce the underdiagnosis of smear-negative pulmonary TB and to assess the clinical and radiological characteristics of PTB patients. This cross-sectional study included 235 participants who went to the Luyang primary health care clinic from September 2016 to June 2017. The demographic data were analyzed to investigate the association of patient gender, age group, and ethnicity by chi-square test. To assess the efficacy of the diagnostic test, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated. The area under the curve for sputum for both AFB and gene-Xpert was analyzed to compare their accuracy in diagnosing TB. In this study, TB was more common in males than in females. The majority (50.71%) of the cases belonged to the 25-44-year-old age group and the Bajau ethnicity (57.74%). Out of 50 pulmonary TB cases (smear-positive with AFB staining), 49 samples were positive according to the Gene-Xpert MTB/RIF assay and was confirmed by MTB culture. However, out of 185 smear-negative presumptive cases, 21 cases were positive by Gene-Xpert MTB/RIF assay in that a sample showed drug resistance, and these results were confirmed by MTB culture, showing resistance to isoniazid. In comparison to sputum for AFB, Gene-Xpert showed more sensitivity and specificity with almost complete accuracy. The additional 21 PTB cases detection from the presumptive cases by GeneXpert had significant impact compared to initial observation by the routine tests which overcame the diagnostic challenges and ambiguities.
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Wang C, Liu M, Wang Z, Li S, Deng Y, He N. Point-of-care diagnostics for infectious diseases: From methods to devices. NANO TODAY 2021; 37:101092. [PMID: 33584847 PMCID: PMC7864790 DOI: 10.1016/j.nantod.2021.101092] [Citation(s) in RCA: 216] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 01/22/2021] [Accepted: 01/23/2021] [Indexed: 05/04/2023]
Abstract
The current widespread of COVID-19 all over the world, which is caused by SARS-CoV-2 virus, has again emphasized the importance of development of point-of-care (POC) diagnostics for timely prevention and control of the pandemic. Compared with labor- and time-consuming traditional diagnostic methods, POC diagnostics exhibit several advantages such as faster diagnostic speed, better sensitivity and specificity, lower cost, higher efficiency and ability of on-site detection. To achieve POC diagnostics, developing POC detection methods and correlated POC devices is the key and should be given top priority. The fast development of microfluidics, micro electro-mechanical systems (MEMS) technology, nanotechnology and materials science, have benefited the production of a series of portable, miniaturized, low cost and highly integrated POC devices for POC diagnostics of various infectious diseases. In this review, various POC detection methods for the diagnosis of infectious diseases, including electrochemical biosensors, fluorescence biosensors, surface-enhanced Raman scattering (SERS)-based biosensors, colorimetric biosensors, chemiluminiscence biosensors, surface plasmon resonance (SPR)-based biosensors, and magnetic biosensors, were first summarized. Then, recent progresses in the development of POC devices including lab-on-a-chip (LOC) devices, lab-on-a-disc (LOAD) devices, microfluidic paper-based analytical devices (μPADs), lateral flow devices, miniaturized PCR devices, and isothermal nucleic acid amplification (INAA) devices, were systematically discussed. Finally, the challenges and future perspectives for the design and development of POC detection methods and correlated devices were presented. The ultimate goal of this review is to provide new insights and directions for the future development of POC diagnostics for the management of infectious diseases and contribute to the prevention and control of infectious pandemics like COVID-19.
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Affiliation(s)
- Chao Wang
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210096, PR China
- Department of Biomedical Engineering, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 211166, Jiangsu, PR China
| | - Mei Liu
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210096, PR China
- School of Chemistry and Chemical Engineering, Southeast University, Nanjing 211189, PR China
| | - Zhifei Wang
- School of Chemistry and Chemical Engineering, Southeast University, Nanjing 211189, PR China
| | - Song Li
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou 412007, PR China
| | - Yan Deng
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou 412007, PR China
| | - Nongyue He
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210096, PR China
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou 412007, PR China
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Hao X, Bai J, Ding Y, Wang J, Liu Y, Yao L, Pan W. Characterization of antibody response against 16kD and 38kD of M. tuberculosis in the assisted diagnosis of active pulmonary tuberculosis. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:945. [PMID: 32953745 PMCID: PMC7475385 DOI: 10.21037/atm-20-5476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background In view of the inability of traditional etiological methods to diagnose pulmonary tuberculosis rapidly and effectively, the antibody responses against 38kD and 16kD-antigens of Mycobacterium tuberculosis (M. tuberculosis) were both detected in order to obtain a better serological detection method for M. tuberculosis. Methods M. tuberculosis-secreted protein 38kD and membrane protein 16kD were prokaryotically expressed and purified, and then used as detection antigens. A novel evolved immunoglobulin-binding molecule (NEIBM)-ELISA method was used to detect antibody levels against 38kD and 16kD in active tuberculosis patients (confirmed tuberculosis cases and clinically diagnosed cases), to explore the significance of these two antigens in serological detection of M. tuberculosis, and to study the diagnostic value of the combined detection of the two antigens in active pulmonary tuberculosis. Results The results showed that the positive detection rates of the 16kD antigen and 38kD antigen of M. tuberculosis were higher (about 44%) in the confirmed cases of tuberculosis, and there was no significant difference in the positive detection rates of the two antigens (P=0.786). The combined detection of these two antigens showed that the positive detection rate could be increased to 61.5%, which was significantly better than the detection effect of the two antigens alone. The positive detection rates of 16kD and 38kD antigens were 26–30% in clinically diagnosed tuberculosis cases, which were lower than those in confirmed tuberculosis cases, and there was no significant difference in the positive detection rates of the two antigens (P=0.242). The detection effect of the two combined antigens was better than that of the 16kD and 38kD antigens alone, but the detection rate was still lower than that of the confirmed tuberculosis cases. Conclusions This study found that the detection effect of 16kD and 38kD antigens was similar in confirmed cases and clinically diagnosed cases of pulmonary tuberculosis, and that the detection effect needs to be further improved. The combined detection of the two antigens showed a significantly better detection effect than the two antigens alone, suggesting that the combined detection of multiple antigens can be used for serological diagnosis of M. tuberculosis infection in clinic.
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Affiliation(s)
- Xiaohui Hao
- Department of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.,Shanghai Clinical Research Center for Tuberculosis, Shanghai, China
| | - Jie Bai
- Department of Medical Microbiology and Parasitology, Navy Medical University, Shanghai, China
| | - Yingying Ding
- Department of Medical Microbiology and Parasitology, Navy Medical University, Shanghai, China
| | - Jinhong Wang
- Department of Medical Microbiology and Parasitology, Navy Medical University, Shanghai, China
| | - Yidian Liu
- Department of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.,Shanghai Clinical Research Center for Tuberculosis, Shanghai, China
| | - Lan Yao
- Department of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.,Shanghai Clinical Research Center for Tuberculosis, Shanghai, China
| | - Wei Pan
- Department of Medical Microbiology and Parasitology, Navy Medical University, Shanghai, China
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Peláez EC, Estevez MC, Mongui A, Menéndez MC, Toro C, Herrera-Sandoval OL, Robledo J, García MJ, Portillo PD, Lechuga LM. Detection and Quantification of HspX Antigen in Sputum Samples Using Plasmonic Biosensing: Toward a Real Point-of-Care (POC) for Tuberculosis Diagnosis. ACS Infect Dis 2020; 6:1110-1120. [PMID: 32233503 DOI: 10.1021/acsinfecdis.9b00502] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Advancements that occurred during the last years in the diagnosis of Mycobacterium tuberculosis (Mtb), the causative agent of tuberculosis infection, have prompted increased survival rates of patients. However, limitations related to the inefficiency of an early detection still remain; some techniques and laboratory methods do not have enough specificity and most instruments are expensive and require handling by trained staff. In order to contribute to a prompt and effective diagnosis of tuberculosis, we report the development of a portable, user-friendly, and low-cost biosensor device for its early detection. By using a label-free surface plasmon resonance (SPR) biosensor, we have established a direct immunoassay for the direct detection and quantification of the heat shock protein X (HspX) of Mtb, a well-established biomarker of this pathogen, directly in pretreated sputum samples. The method relies on highly specific monoclonal antibodies that are previously immobilized on the plasmonic sensor surface. This technology allows for the direct detection of the biomarker without amplification steps, showing a limit of detection (LOD) of 0.63 ng mL-1 and a limit of quantification (LOQ) of 2.12 ng mL-1. The direct analysis in pretreated sputum shows significant differences in the HspX concentration in patients with tuberculosis (with concentration levels in the order of 116-175 ng mL-1) compared with non-tuberculosis infected patients (values below the LOQ of the assay).
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Affiliation(s)
- Enelia Cristina Peláez
- Nanobiosensors and Bioanalytical Applications Group (NanoB2A), Catalan Institute of Nanoscience and Nanotechnology (ICN2), CSIC, CIBER-BBN and BIST, Campus UAB, 08193 Barcelona, Spain
- Centro de Investigación y Desarrollo Tecnológico de la Industria Electro Electrónica y TIC (CIDEI), Calle 45a BIS # 19-09 Floor 2, Bogotá, DC, Colombia
- Corporación CorpoGen, Departamento Biotecnología Molecular, Carrera 4 # 20-41, Bogotá, DC, Colombia
- Research Cluster on Converging Sciences and Technology (NBIC), Universidad Central, Calle 21 #4-40, Bogotá, DC, Colombia
| | - Maria Carmen Estevez
- Nanobiosensors and Bioanalytical Applications Group (NanoB2A), Catalan Institute of Nanoscience and Nanotechnology (ICN2), CSIC, CIBER-BBN and BIST, Campus UAB, 08193 Barcelona, Spain
| | - Alvaro Mongui
- Corporación CorpoGen, Departamento Biotecnología Molecular, Carrera 4 # 20-41, Bogotá, DC, Colombia
| | - M-Carmen Menéndez
- Departamento de Medicina Preventiva, Salud Pública y Microbiología, Facultad de Medicina, Universidad Autónoma de Madrid, St Arzobispo Morcillo s/n, 28029 Madrid, Spain
| | - Carlos Toro
- Department of Microbiology, La Paz University Hospital, IdiPaz, St/Paseo de la Castellana 261, 28046 Madrid, Spain
| | - Oscar L. Herrera-Sandoval
- Centro de Investigación y Desarrollo Tecnológico de la Industria Electro Electrónica y TIC (CIDEI), Calle 45a BIS # 19-09 Floor 2, Bogotá, DC, Colombia
- Research Cluster on Converging Sciences and Technology (NBIC), Universidad Central, Calle 21 #4-40, Bogotá, DC, Colombia
| | - Jaime Robledo
- Corporación para Investigaciones Biológicas (CIB), Laboratorio de Micobacterias, Carrera 72A 78B-141, 050034 Medellín, Colombia
| | - Maria J. García
- Departamento de Medicina Preventiva, Salud Pública y Microbiología, Facultad de Medicina, Universidad Autónoma de Madrid, St Arzobispo Morcillo s/n, 28029 Madrid, Spain
| | - Patricia Del Portillo
- Corporación CorpoGen, Departamento Biotecnología Molecular, Carrera 4 # 20-41, Bogotá, DC, Colombia
| | - Laura M. Lechuga
- Nanobiosensors and Bioanalytical Applications Group (NanoB2A), Catalan Institute of Nanoscience and Nanotechnology (ICN2), CSIC, CIBER-BBN and BIST, Campus UAB, 08193 Barcelona, Spain
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Rapún Mas L, Angulo López I, Cecilio Irazola Á, Betrán Escartín AI. Discrepancy in the genotypic versus phenotypic testing for resistance to rifampicin in Mycobacterium tuberculosis. A case report. Enferm Infecc Microbiol Clin 2019; 37:212-213. [PMID: 29773408 DOI: 10.1016/j.eimc.2018.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 03/28/2018] [Accepted: 03/30/2018] [Indexed: 11/19/2022]
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Ramirez-Priego P, Martens D, Elamin AA, Soetaert P, Van Roy W, Vos R, Anton B, Bockstaele R, Becker H, Singh M, Bienstman P, Lechuga LM. Label-Free and Real-Time Detection of Tuberculosis in Human Urine Samples Using a Nanophotonic Point-of-Care Platform. ACS Sens 2018; 3:2079-2086. [PMID: 30269480 DOI: 10.1021/acssensors.8b00393] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Tuberculosis (TB) is the leading global cause of death from a single infectious agent. Registered incidence rates are low, especially in low-resource countries with weak health systems, due to the disadvantages of current diagnostic techniques. A major effort is directed to develop a point-of-care (POC) platform to reduce TB deaths with a prompt and reliable low-cost technique. In the frame of the European POCKET Project, a novel POC platform for the direct and noninvasive detection of TB in human urine was developed. The photonic sensor chip is integrated in a disposable cartridge and is based on a highly sensitive Mach-Zehnder Interferometer (MZI) transducer combined with an on-chip spectral filter. The required elements for the readout are integrated in an instrument prototype, which allows real-time monitoring and data processing. In this work, the novel POC platform has been employed for the direct detection of lipoarabinomannan (LAM), a lipopolysaccharide found in the mycobacterium cell wall. After the optimization of several parameters, a limit of detection of 475 pg/mL (27.14 pM) was achieved using a direct immunoassay in undiluted human urine in less than 15 min. A final validation of the technique was performed using 20 clinical samples from TB patients and healthy donors, allowing the detection of TB in people regardless of HIV coinfection. The results show excellent correlation to those obtained with standard techniques. These promising results demonstrate the high sensitivity, specificity and applicability of our novel POC platform, which could be used during routine check-ups in developing countries.
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Affiliation(s)
- Patricia Ramirez-Priego
- Nanobiosensors
and Bioanalytical Applications Group, Catalan Institute of Nanoscience
and Nanotechnology (ICN2), CSIC, BIST and CIBER-BBN, Campus UAB, Bellaterra, 08193 Barcelona, Spain
| | - Daan Martens
- Photonics Research Group, Ghent University/imec, Technologiepark-Zwijnaarde 15, 9052 Ghent, Belgium
- Center for Nano- and Biophotonics, Ghent University, Technologiepark-Zwijnaarde 15, 9052 Ghent, Belgium
| | - Ayssar A. Elamin
- LIONEX Diagnostics and Therapeutics GmbH, Salzdahlumer Str. 196, Building 1A, 38126 Braunschweig, Germany
| | | | | | - Rita Vos
- imec, Kapeldreef 75, 3001 Leuven, Belgium
| | - Birgit Anton
- microfluidic ChipShop GmbH, Stockholmer Str. 20, 07747 Jena, Germany
| | | | - Holger Becker
- microfluidic ChipShop GmbH, Stockholmer Str. 20, 07747 Jena, Germany
| | - Mahavir Singh
- LIONEX Diagnostics and Therapeutics GmbH, Salzdahlumer Str. 196, Building 1A, 38126 Braunschweig, Germany
| | - Peter Bienstman
- Photonics Research Group, Ghent University/imec, Technologiepark-Zwijnaarde 15, 9052 Ghent, Belgium
- Center for Nano- and Biophotonics, Ghent University, Technologiepark-Zwijnaarde 15, 9052 Ghent, Belgium
| | - Laura M. Lechuga
- Nanobiosensors
and Bioanalytical Applications Group, Catalan Institute of Nanoscience
and Nanotechnology (ICN2), CSIC, BIST and CIBER-BBN, Campus UAB, Bellaterra, 08193 Barcelona, Spain
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Samper S, González-Martin J. Microbiological diagnosis of infections caused by the genus Mycobacterium. Enferm Infecc Microbiol Clin 2017; 36:104-111. [PMID: 29287920 DOI: 10.1016/j.eimc.2017.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 11/01/2017] [Indexed: 10/18/2022]
Abstract
Mycobacterial culture has a high sensitivity and is the test of choice for the microbiological diagnosis of tuberculosis and nontuberculous mycobacterial infections. However, the results of this culture require at least 2-3 weeks to obtain positivity. Staining is rapid and can be used as a complementary study, although its sensitivity is low. Gene amplification tests have an intermediate sensitivity and obtain results in 1-2 days. These last tests are indicated in cases with moderate or high clinical suspicion. In HIV patients with severe immunodeficiency (<200 CD4), lipoarabinomannan antigen detection in urine may be useful. The identification of isolates from positive cultures is essential to evaluate the clinical significance of the culture results and consider the therapeutic options available. At present, there is a wide range of identification techniques available, which provide results within just 1-4 days. The future of diagnostic techniques in tuberculosis and nontuberculous mycobacterial infections lies in greater development of gene amplification techniques and promoting the search for biomarkers which enable a new approach to the diagnosis of these infections.
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Affiliation(s)
- Sofía Samper
- Instituto Aragonés de Ciencias de la Salud, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria (IIS) Aragón, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Zaragoza, España
| | - Julià González-Martin
- Servei de Microbiologia, Centro de Diagnóstico Biomédico (CDB), Hospital Clínic, Instituto de Salud Global de Barcelona (ISGlobal), Universitat de Barcelona, Red Española de Investigación en Patología Infecciosa (REIPI), Barcelona, España.
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